What is the risk of Respiratory Syncytial Virus (RSV) infection in a healthy male 75 years old?

Risk of RSV Infection in a Healthy 75-Year-Old Male

A healthy 75-year-old male has a significantly elevated risk of RSV-associated hospitalization and death compared to younger adults, with hospitalization rates of approximately 210 per 100,000 adults in the 75-84 age group. 1

Age-Related Risk Factors

• Advanced age (75 years) is a significant independent predictor of RSV hospitalization:

  • 75-84 years: OR = 1.73 (p = 0.008) 1
  • ≥85 years: OR = 2.53 (p < 0.001) 1

• Hospitalization rates by age group (per 100,000):

  • 18-49 years: 7.7-11.9
  • 50-64 years: 33.5-57.5
  • ≥65 years: 136.9-255.6 1
  • 75-84 years: 210 1

• Even for a healthy 75-year-old, immunosenescence (age-related immune decline) is a recognized risk factor for RSV infection and severe disease 1

Mortality Risk

• In-hospital mortality rates:

  • 60-74 years: 4.6%
  • ≥75 years: 6.1% 1

• Age 75-84 years is independently associated with increased mid- to long-term mortality (aHR = 5.37; 95% CI: 1.32-22.90) 1

• Cumulative mortality after RSV hospitalization:

  • 1 month: 8.6%
  • 3 months: 12.3%
  • 6 months: 17.2%
  • 12 months: 25.8% 2

Clinical Presentation and Complications

For a 75-year-old male with RSV infection, the following complications are common:

• Pneumonia: occurs in up to 42.3% of hospitalized adults with RSV 3, 4
• Acute bronchitis: occurs in 21.9% of hospitalized cases 4
• Respiratory failure requiring ventilatory support: 11.1% 4
• Need for supplemental oxygen: 67.9% 4
• Bacterial superinfections: 12.5% 4

Functional Decline Risk

Even if a 75-year-old is currently healthy, RSV infection can lead to:

• Acute functional decline in adults ≥60 years hospitalized with RSV 1
• Prolonged loss of function in some patients 1
• Potential long-term impact on Activities of Daily Living 1

Comparison to Other Respiratory Viruses

• RSV causes a disease burden similar to influenza in adults ≥60 years 1, 5
• Hospitalization and mortality rates are comparable between RSV and influenza in older adults 1
• RSV may cause more severe disease than influenza in vaccinated patients 1

Risk Mitigation

For a 75-year-old male, RSV vaccination should be considered given the high risk profile:

• Two RSV vaccines are available that can prevent lower respiratory tract disease caused by RSV in adults aged ≥60 years 1
• Vaccination is particularly important for adults ≥75 years due to their significantly higher risk of complications and mortality 1

Key Considerations

• Being 75 years old is itself a major risk factor for severe RSV disease, even without comorbidities
• The risk of hospitalization is approximately 210 per 100,000 for the 75-84 age group 1
• If hospitalized, the risk of death during hospitalization is approximately 6.1% 1
• Long-term mortality risk following RSV hospitalization is substantial, with 25.8% mortality within 12 months 2

The evidence clearly demonstrates that a healthy 75-year-old male faces substantial risk from RSV infection, primarily due to age-related immunosenescence, with outcomes comparable to seasonal influenza in terms of hospitalization and mortality risk.