In‐Hospital Death and Risk Factors in Adults With Respiratory Syncytial Virus in Spain (2016–2023). A Cross‐Sectional Study With Focus on Older Patients

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ABSTRACT Background and Aims Respiratory syncytial virus (RSV) mortality varies across different populations. This study aims to assess RSV mortality in hospitalized adults (≥ 15 years) and identify key risk factors according to age. Methods This was a retrospective, single‐center study conducted in Alicante (Spain), including patients hospitalized for PCR‐confirmed RSV infection between 2016 and 2023. Risk factors for death were assessed using multivariable logistic regression. Results Of 367 patients admitted for RSV, 24 died (6.5%). Mortality was higher in very old adults (≥ 80 years, 8.9%) than in those aged under 80 years (4.8%). Significant risk factors were glomerular filtration rate (GFR) less than 38 mL/min/m 2 (adjusted odds ratio [aOR] 3.15, 95% confidence interval [CI] 1.16–8.56), use of high‐flow nasal cannula (aOR 3.67, 95% CI 1.15–11.74), and metastatic cancer (aOR 10.01, 95% CI 1.28–78.55). In the group ≤ 79 years ( n = 210), risk factors were non‐invasive mechanical ventilation (aOR 26.07 95% CI 2.01–338) and C‐reactive protein levels over 11 mg/dL (aOR 12.48, 95% CI 1.14–136). In the patients ≥ 80 years ( n = 157; 42.8%), low GFR was associated with higher mortality (aOR 4.53, 95% CI 1.36–15.04). Conclusion RSV deaths increase with age. In‐hospital mortality was associated with non‐invasive mechanical ventilation and C‐reactive protein levels and in patients under 80, and low GFR in older patients.

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