{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,4]],"date-time":"2026-09-04T15:21:20Z","timestamp":1788535280710,"version":"build-2803163510"},"reference-count":19,"publisher":"Oxford University Press (OUP)","issue":"7","license":[{"start":{"date-parts":[[2025,7,2]],"date-time":"2025-07-02T00:00:00Z","timestamp":1751414400000},"content-version":"vor","delay-in-days":2,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2025,6,30]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Background<\/jats:title>\n                  <jats:p>Respiratory syncytial virus (RSV) causes hospitalization in older adults and those with preexisting medical conditions. Three RSV vaccines are now licensed for all adults but not recommended for persons age &amp;lt;60 years with risk factors for RSV hospitalization. We therefore assessed the relationship of preexisting medical conditions to age-specific RSV hospitalization incidence and severe outcomes.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>Adults age \u226518 years hospitalized over 3 winters (2017\u20132020) with polymerase chain reaction\u2013confirmed RSV were enrolled in Rochester and New York City, NY. Population-based incidence was estimated by race and ethnicity for 4 age groups: 18\u201344, 45\u201364, 65\u201374, and \u226575 years. A general linear model assessed variables associated with 2 outcomes: (1) composite of intensive care unit admission and\/or in-hospital mortality and (2) all-cause 6-month mortality.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>Adults of all ages with congestive heart failure (CHF), coronary artery disease, chronic obstructive pulmonary disease (COPD), and diabetes were more likely to be hospitalized with RSV (incidence rate ratio, 13.66, 8.24, 5.85, and 5.35, respectively), and asthma, obesity, and immunosuppression were more prevalent among younger adults age \u226465 years. Mean annual RSV hospitalization incidence was 2.5-fold higher for Black adults age 18\u201344 years and 8-fold higher for those age 45\u201364 years compared with other races. Hispanic adults had a 2-3-fold higher incidence of hospitalization in each age stratum compared with non-Hispanics. COPD conferred a 1.9-fold higher risk of intensive care unit admission or in-hospital mortality (97.5% CI, 1.27\u20132.68), and both COPD and CHF increased risk of 6-month all-cause mortality. Age \u226565 years was not associated with either outcome.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>Future RSV vaccine recommendations should consider the impact of preexisting conditions and racial and ethnic differences in age-related RSV hospitalization.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/ofid\/ofaf394","type":"journal-article","created":{"date-parts":[[2025,7,2]],"date-time":"2025-07-02T13:08:46Z","timestamp":1751461726000},"source":"Crossref","is-referenced-by-count":4,"title":["Respiratory Syncytial Virus Risk Assessment in Adults: Implications for Vaccine Recommendations Beyond Age"],"prefix":"10.1093","volume":"12","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7742-5352","authenticated-orcid":false,"given":"Angela R","family":"Branche","sequence":"first","affiliation":[{"name":"Division of Infectious Diseases, Department of Medicine, University of Rochester , Rochester, New York ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7141-9701","authenticated-orcid":false,"given":"Ann R","family":"Falsey","sequence":"additional","affiliation":[{"name":"Division of Infectious Diseases, Department of Medicine, University of Rochester , Rochester, New York ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lisa","family":"Saiman","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Columbia University Irving Medical Center , New York, New York ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Luis","family":"Alba","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Columbia University Irving Medical Center , New York, New York ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8603-660X","authenticated-orcid":false,"given":"Derick","family":"Peterson","sequence":"additional","affiliation":[{"name":"Department of Biostatistics and Computational Biology, University of Rochester , Rochester, New York ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1428-971X","authenticated-orcid":false,"given":"Lu","family":"Wang","sequence":"additional","affiliation":[{"name":"Department of Biostatistics and Computational Biology, University of Rochester , Rochester, New York ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lyn","family":"Finelli","sequence":"additional","affiliation":[{"name":"Beacon Epidemiology Associates, LLC , Rose Valley, Pennsylvania ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Edward E","family":"Walsh","sequence":"additional","affiliation":[{"name":"Division of Infectious Diseases, Department of Medicine, University of Rochester , Rochester, New York ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2025,7,2]]},"reference":[{"key":"2025072211063502600_ofaf394-B1","doi-asserted-by":"crossref","first-page":"1749","DOI":"10.1056\/NEJMoa043951","article-title":"Respiratory syncytial virus infection in elderly and high-risk adults","volume":"352","author":"Falsey","year":"2005","journal-title":"N Engl J Med"},{"key":"2025072211063502600_ofaf394-B2","doi-asserted-by":"crossref","first-page":"1004","DOI":"10.1093\/cid\/ciab595","article-title":"Incidence of respiratory syncytial virus infection among hospitalized adults, 2017-2020","volume":"74","author":"Branche","year":"2022","journal-title":"Clin Infect Dis"},{"key":"2025072211063502600_ofaf394-B3","first-page":"XXX\u2013XX","article-title":"Rates of medically attended RSV among US adults: a systematic review and meta-analysis","volume":"9","author":"McLaughlin","year":"2022","journal-title":"Open Forum Infect Dis"},{"key":"2025072211063502600_ofaf394-B4","first-page":"XXX\u2013XX","article-title":"Risk factors and medical resource utilization of respiratory syncytial virus, human metapneumovirus, and influenza-related hospitalizations in adults\u2014a global study during the 2017-2019 epidemic seasons (Hospitalized Acute Respiratory Tract Infection [HARTI] study)","volume":"8","author":"Falsey","year":"2021","journal-title":"Open Forum Infect Dis"},{"key":"2025072211063502600_ofaf394-B5","doi-asserted-by":"crossref","first-page":"1075","DOI":"10.15585\/mmwr.mm7240a1","article-title":"Characteristics and outcomes among adults aged &gt;\/=60 years hospitalized with laboratory-confirmed respiratory syncytial virus\u2014RSV-NET, 12 states, July 2022-June 2023","volume":"72","author":"Havers","year":"2023","journal-title":"MMWR Morb Mortal Wkly Rep"},{"key":"2025072211063502600_ofaf394-B6","doi-asserted-by":"crossref","first-page":"906","DOI":"10.1111\/irv.12994","article-title":"Risk factors and medical resource utilization in US adults hospitalized with influenza or respiratory syncytial virus in the hospitalized acute respiratory tract infection study","volume":"16","author":"Hartnett","year":"2022","journal-title":"Influenza Other Respir Viruses"},{"key":"2025072211063502600_ofaf394-B7","doi-asserted-by":"crossref","first-page":"e158","DOI":"10.1093\/cid\/ciaa730","article-title":"Respiratory syncytial virus-associated hospitalizations among adults with chronic medical conditions","volume":"73","author":"Prasad","year":"2021","journal-title":"Clin Infect Dis"},{"key":"2025072211063502600_ofaf394-B8","doi-asserted-by":"crossref","first-page":"793","DOI":"10.15585\/mmwr.mm7229a4","article-title":"Use of respiratory syncytial virus vaccines in older adults: recommendations of the Advisory Committee on Immunization Practices\u2014United States, 2023","volume":"72","author":"Melgar","year":"2023","journal-title":"MMWR Morb Mortal Wkly Rep"},{"key":"2025072211063502600_ofaf394-B9","doi-asserted-by":"crossref","first-page":"595","DOI":"10.1056\/NEJMoa2209604","article-title":"Respiratory syncytial virus prefusion F protein vaccine in older adults","volume":"388","author":"Papi","year":"2023","journal-title":"N Engl J Med"},{"key":"2025072211063502600_ofaf394-B10","doi-asserted-by":"crossref","first-page":"1465","DOI":"10.1056\/NEJMoa2213836","article-title":"Efficacy and safety of a bivalent RSV prefusion F vaccine in older adults","volume":"388","author":"Walsh","year":"2023","journal-title":"N Engl J 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