Increased burden of respiratory syncytial virus (RSV) disease in adults with asthma: a systematic literature review (SLR)

<bold>Background:</bold> RSV is an important cause of respiratory illness and can have severe outcomes in adults with underlying comorbidities, including those with asthma. However, the burden of RSV disease in this population is not fully understood. <bold>Methods:</bold> An SLR was conducted to explore the RSV burden in adults with asthma aged ≥18 years. PubMed, Embase and grey literature were searched on 28/11/2023 for studies conducted in high-income countries, published since 01/01/2000 in English. Outcomes included asthma prevalence in adults with confirmed RSV disease, RSV-associated hospitalizations and complications in adults with asthma. <bold>Results:</bold> Inclusion criteria were met for 25 studies. The median asthma prevalence in RSV-positive adults was 13.1% (quartile 1–3: 8.9%–25.7%). Data was limited to conclude on differences among in- and outpatients (<bold>Figure</bold>). RSV-related hospitalization incidence rate ratio in adults with asthma vs those without varied from 2.0 (95% confidence interval [CI]: 1.0–4.1) to 8.2 (95% CI: 5.5–12.2), across different age groups. Asthma exacerbations were observed in 49.5%–64.9% of RSV-hospitalized adults. <bold>Conclusion:</bold> Asthma prevalence is high in adults with RSV disease. Across all age groups, adults with asthma have higher RSV-hospitalization rates compared to those without asthma. More research is needed to establish RSV long-term outcomes in adults with asthma. <bold>Funding:</bold> GSK <fig><object-id>erj;64/suppl_68/PA4190/F1</object-id><object-id>F1</object-id><object-id>F1</object-id><graphic></graphic></fig>