Incidence, Complications, and Quality of Life in Adults ≥ 60 Years Old With Laboratory‐Confirmed RSV Infections Attended in Primary Care and in Hospitals: A Study Over Three Seasons in Valladolid, Spain

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BACKGROUND: Respiratory syncytial virus (RSV) infection in adults ≥ 60 years significantly affects health, particularly in those with comorbidities. Despite evidence on disease burden, data on quality of life (QoL) and complications after infection remain scarce. This study describes the incidence and prevalence of laboratory-confirmed RSV infections over three consecutive seasons, as well as related complications and QoL in primary care and hospitalized patients. METHODS: We conducted a prospective observational study during the 2022-2023, 2023-2024, and 2024-2025 seasons in three primary care centers and two hospitals in Valladolid, Spain. Patients ≥ 60 years with acute respiratory infection (ARI) and laboratory-confirmed RSV were included. Follow-up was performed at 90 days to assess complications and at 30 days to evaluate QoL. RESULTS: Of 973 primary care patients, 477 were tested and 113 (23.9%) were RSV-positive. In hospitals, 956 cases were screened and 172 included. RSV incidence in primary care was 8.4, 34.9, and 29.2/1000 inhabitants for the three respective seasons. The most frequent complications were new ARI (23.0%) in primary care and viral/bacterial co-infection (31.4%) in hospitalized patients. Hospitalization occurred in 7.1% of primary care cases, 15.1% of inpatients were readmitted, 4.7% admitted to ICU, and 3.5% died. Worsening of prior conditions occurred in 81.6% with COPD, 67.7% with asthma, and 31.1% with cardiac disease. QoL was impaired in > 50% during the acute phase, improving by 30 days but persisting in > 30%. CONCLUSIONS: RSV infection in adults ≥ 60 years carries a considerable burden, with frequent co-infections, disease decompensation, and sustained QoL impairment despite partial recovery.

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