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Observational Study Aims to Assess RSV Incidence and Impact in Older Adults
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Key Takeaways
- Lack of routine RSV testing in primary care leads to gaps in understanding its clinical impact and burden.
- RSV is linked to significant morbidity and mortality in older adults and those with weakened immune systems or cardiopulmonary conditions.
Point-of-care testing implementation could provide valuable data on community respiratory syncytial virus incidence and enhance sentinel surveillance efforts.
A lack of routine testing at point of care has created gaps in understanding the clinical characteristics and disease burden of respiratory syncytial virus (RSV) among community-dwelling individuals, according to research from the Nuffield Department of Primary Care Health Sciences at the University of Oxford.1
RSV is linked with hospitalizations and mortality for individuals that are older age, have a weakened immune system, or have underlying cardiopulmonary conditions at an increased risk for serious acute lower respiratory tract infection (LRTI). Despite this, current guidelines in England do not recommend rapid diagnostic testing for RSV in primary care.1
A recent study conducted in the UK found an estimated 175,070 primary care visits and 7915 deaths annually among older adults, translating to 1946 visits and 88 deaths per 100,000 individuals over 65. Further results revealed that RSV contributes to 4.66% of symptomatic respiratory infections in adults over 60 years of age in annual studies and 7.80% in seasonal studies.1,2
However, the study authors noted that point-of-care tests (POCT) for RSV could estimate the incidence of infection in communities and address gaps in knowledge on economic and disease burdens.1
Researchers conducted an observational study of acute respiratory infection (ObservatARI) between November 2023 and November 2024, recruiting around 3600 individuals from 21 practices in England, and is currently ongoing. The primary objective of the study is to determine the incidence of virologically confirmed RSV among adults 40 years and older within a primary care-based surveillance cohort, analyzed by age, sex, and specific subgroups. The secondary objectives include examining overall population-level RSV incidence, RSV-associated LRTI, secondary care utilization, clinical profiles, and comparing clinical and economic burdens between RSV cases and those without RSV, with analyses conducted within prespecified age and sex subgroups, according to study authors.1
The study authors noted that 2 swabs are advised to be collected in ObservatARI—a nasopharyngeal swab for Cepheid POCT analyzer testing, which is considered more accurate for RSV detection than nasal swabs, and a nasal swab for UKHSA National Virology Reference Laboratory testing. After obtaining consent from the participants, the primary care physician or research nurse collects the swabs. The nasopharyngeal swab is immediately tested using the POCT analyzer, with only the patient study number entered the machine.1
The researchers estimated the number of individuals with and without RSV that would present a positive and negative test with the POCT if 3600 tests were administered—expecting to observe approximately 211 POCT true-positive RSV cases, which is adequate to meet the primary objective of evaluating the incidence proportion of POCT confirmed RSV.1
The researchers noted that POCT for RSV in primary care settings have been initiated and RSV detection in the sentinel network increased between October and late November 2023, with a peak in week 48. However, data collection for this specific study is ongoing, and results from the participating practices are not yet available. Following, the study authors noted that the initial results suggest that widespread POCT implementation could provide valuable data on community RSV incidence, enhance sentinel surveillance efforts, and inform decision-making regarding the potential benefits of a nationwide RSV vaccination program for the adult population in the UK.1
REFERENCES
1. Clinical Characteristics of Virologically Confirmed Respiratory Syncytial Virus in English Primary Care: Protocol for an Observational Study of Acute Respiratory Infection. JMIR Publications. News release. January 22, 2025. Accessed January 23, 2025. https://www.researchprotocols.org/2025/1/e60669
2. Ferruggia K. Surge in Hospital-Onset Respiratory Viral Infections Linked With Easing of Masking and Testing Policies. Pharmacy Times. News release. December 5, 2024. Accessed January 23, 2025. https://www.pharmacytimes.com/view/surge-in-hospital-onset-respiratory-viral-infections-linked-with-easing-of-masking-and-testing-policies
