Journal article
Multimorbidity Profiles and Severe In-Hospital Outcomes in Adults with Respiratory Syncytial Virus
Clinical infectious diseases, Vol.82(3), pp.e561-e570
03/15/2026
DOI: 10.1093/cid/ciaf405
PMCID: PMC13193655
PMID: 40708527
Abstract
Adults hospitalized with acute respiratory infections, including respiratory syncytial virus (RSV), often have multiple underlying conditions. Few data are available on the combined effect of conditions on risk of severe outcomes from RSV disease.
We enrolled adults hospitalized with RSV at 26 hospitals in 20 US states admitted January 2022-July 2024. Seventeen underlying conditions were selected after excluding those with rare prevalence (≤1%) or high pairwise correlation (≥0.7). We applied Bayesian profile regression to identify profiles of conditions associated with increased risk of RSV severe outcomes, stratifying among adults aged 18-59 and ≥60 years.
We analyzed data from 1111 adults hospitalized with RSV (median age [IQR] = 66 [53-75]). Among 397 adults aged 18-59 years, two profiles were identified: (1) minimal prevalence with fewer underlying conditions and a posterior median ICU admission risk of 21% (95% credible interval = [16‒25]); (2) cardiorenal/diabetes with frequent heart failure, chronic kidney disease, diabetes, and increased ICU admission risk (37% [27‒48]). Among 714 adults aged ≥60 years, four profiles were identified: (1) minimal prevalence (ICU admission risk = 22% [18‒26]), (2) cardiorenal/diabetes (27% [21‒34]), (3) hematologic malignancy and transplant receipt (12% [6‒21]), and (4) chronic pulmonary disease with home oxygen dependence (44% [25‒66]).
Distinct underlying condition profiles with varying risks of critical illness were observed among inpatients with RSV. These findings could support recognition of high-risk patients to inform RSV prevention strategies and suggest the role of multimorbidity in severe RSV disease risk warrants further attention.
Details
- Title: Subtitle
- Multimorbidity Profiles and Severe In-Hospital Outcomes in Adults with Respiratory Syncytial Virus
- Creators
- Kevin C Ma - National Center for Immunization and Respiratory DiseasesDiya Surie - Centers for Disease Control and PreventionYuwei Zhu - Vanderbilt University Medical CenterCarlos G Grijalva - Vanderbilt University Medical CenterPaul W Blair - Vanderbilt University Medical CenterBasmah Safdar - Yale UniversityAdit A Ginde - University of Colorado DenverIthan D Peltan - Intermountain Medical CenterSamuel M Brown - Intermountain Medical CenterManjusha Gaglani - Baylor Scott & White Medical Center - TempleShekhar Ghamande - Baylor Scott & White HealthCristie Columbus - Baylor Scott & White HealthNicholas M Mohr - University of IowaKevin W Gibbs - Wake Forest UniversityDavid N Hager - Johns Hopkins UniversityMatthew E Prekker - Hennepin County Medical CenterMichelle N Gong - Albert Einstein College of MedicineAmira Mohamed - Albert Einstein College of MedicineNicholas J Johnson - University of WashingtonJay S Steingrub - Baystate Medical CenterAkram Khan - Oregon Health & Science UniversityCatherine L Hough - Oregon Health & Science UniversityAbhijit Duggal - Cleveland ClinicAlexandra June Gordon - Stanford UniversityNida Qadir - University of California, Los AngelesSteven Y Chang - University of California, Los AngelesChristopher Mallow - University of MiamiLaurence W Busse - Emory UniversityJennie H Kwon - Washington University in St. LouisMatthew C Exline - The Ohio State UniversityIvana A Vaughn - Henry Ford Health SystemMayur Ramesh - Henry Ford Health SystemAdam S Lauring - University of MichiganEmily T Martin - University of MichiganAleda M Leis - University of MichiganJarrod M Mosier - University of ArizonaEstelle S Harris - University of UtahAdrienne Baughman - Vanderbilt University Medical CenterCassandra Johnson - Vanderbilt University Medical CenterJonathan D Casey - Vanderbilt University Medical CenterNatasha Halasa - Vanderbilt University Medical CenterJames D Chappell - Vanderbilt University Medical CenterNathaniel Lewis - Centers for Disease Control and PreventionSascha Ellington - Centers for Disease Control and PreventionWesley H Self - Vanderbilt University Medical CenterFatimah S Dawood - Centers for Disease Control and Prevention
- Resource Type
- Journal article
- Publication Details
- Clinical infectious diseases, Vol.82(3), pp.e561-e570
- DOI
- 10.1093/cid/ciaf405
- PMID
- 40708527
- PMCID
- PMC13193655
- NLM abbreviation
- Clin Infect Dis
- ISSN
- 1537-6591
- eISSN
- 1537-6591
- Publisher
- OXFORD UNIV PRESS INC
- Grant note
- US Centers for Disease Control and Prevention: 75D30122C14944
This work was supported by the US Centers for Disease Control and Prevention (contract number 75D30122C14944).
- Language
- English
- Electronic publication date
- 07/24/2025
- Date published
- 03/15/2026
- Academic Unit
- Epidemiology; Emergency Medicine; Anesthesia; Injury Prevention Research Center
- Record Identifier
- 9984865442202771
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