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P203: Respiratory Syncytial Virus Infection in Long-term Care Facilities: Clinical Characteristics and Outcomes

Poster Presenter

Heather Hiscock

Account Development Representative
PointClickCare
Canada

Objectives

To describe the epidemiology of RSV in a representative sample of US Long Term Care residents, including those with compromising conditions and across factors including pharmacotherapies, race/ethnicity, different types of community dwelling facilities, and other associated pathogens.

Method

We used a representative sample of US LTC residents infected with COVID, influenza, and RSV between the years of 2017 and early 2023, defined by ICD 10 J codes and U code (U07) reviewed by persons in long term care facilities throughout the US and provided to us by a large commercial dataset.

Results

Using a commercially available dataset, we used a representative sample of US LTC residents with the ICD 10 codes of interest. We subset the diagnosed residents with the following ICD 10 codes, I50 (heart failure) and J44 (COPD), to further identify high risk residents. For both high risk and healthy RSV sample populations, we used ICD 10 codes in resident chart review to indicate comorbidities of interest (including asthma, diabetes, and immunocompromising conditions). We used EHR data to indicate the type of intervention and duration of infection for all sample groups. We further evaluated several variables in chart review from all sample populations including, vitals of interest (temperature, oxygen saturation), acute respiratory symptoms as defined by ICD 10 codes, functionality scores, and hospitalizations. We identified RSV infection in 3597 high risk residents and 6786 low risk residents. Of these sample populations, we summarize population characteristics and variations in, pharmacotherapy, ARI symptoms, and functionality through descriptive statistics. The high risk population demonstrated increased symptom severity and hospitalizations. Development of chronic conditions were significant post RSV infection within healthy residents, increasing their susceptibility for other pathogens. Variations in RSV infection year over year are indicated, as well as variations in RSV infections associated with co- occurring respiratory viruses. We recognize total burden of viral respiratory disease in this setting and describe why the discrepancy of these diagnoses impact interventions and overall patient care. We compare interventions, symptom severity, functionality, and hospitalizations between RSV, influenza, and COVID 19 for both high and low risk residents, and we used Poisson distribution to compare the rates of illness and viral infection. RSV was associated with significant long term health impacts.

Conclusion

To our knowledge there are few studies have followed the clinical characteristics, outcomes, and diagnostic impacts pre and post (COVID) pandemic within community dwelling facilities. Our study provides important framework to consider prior to vaccine trials. We considered the functional burden, and infection rate of respiratory viruses within the elderly population, as well as providing evidence for patients who are, and are not, likely to benefit from vaccine development.