P6 The clinical outcomes in patients hospitalised with respiratory syncytial virus (RSV) Infection

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Introduction A recent meta-analysis has identified RSV as a major cause of life-threatening respiratory illness in developed counties and estimated it is responsible annually for 470,000 hospitalisations and 33,000 in-hospital deaths (Savid M, 2023). In contrast, the Joint Committee on Vaccination and Immunisation (JCVI) has advised based on its modelling a programme to vaccinate only adults aged 75 to potentially commence in winter 2024. The objective of this study was to determine the incidence and outcomes across different age groups for hospitalisation with RSV infection in Manchester University NHS Foundation Trust, the largest hospital trust in the UK. Method A retrospective multicenter observational cohort study was conducted between 1 November 2023 and 31 December 2023 for adults patients aged greater than years admitted with PCR positive RSV infection. Clinical data was collected, including length of stay, ICU admission and mortality. Results A total of 182 patients were included. The mean age was 64.5 (range 19 -99). There were 62 patients aged 75 and above, 42 patients aged 65 – 74 and 78 patients under 65. 31 patients suffered poor outcome defined as either ICU admission or death. The mean age of patients in the poor outcome group was 70.9 vs 63.2 (p-value = 0.04). The median length of stay in the <65 age group was 5 days, 6 days in 65–74 and 11 in >75 (p-value = 0.001). The odds ratio of poor outcome was 1.57 in the 65–74 years group (p-value = 0.37) and 2.42 (p-value = 0.05). Kaplan-meier analysis of poor outcome showed poorer outcomes by age although these were not statistically significant (p-value = 0.19). Conclusion Our data shows poor outcomes with RSV infection in hospitalised patients. There are poorer outcomes and length of stay in those aged >75, supporting JCVI recommendations. However, the mean age of patients with a poor outcome was 70, compared to 63 for those without a poor outcome. Our Kaplan-meier curve shows a trend to age predicting poor outcome, but this was not significant likely due to a small sample size. Our data suggest the JCVI should lower the age of vaccination

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