P-683. Estimation of RSV-attributable cardiovascular and respiratory hospitalizations in adults in Germany between 2015–2019

Abstract Background RSV can cause severe outcomes among adults, especially those with underlying comorbidities. However, RSV incidence in adults is frequently underestimated due to non-specific symptomatology, limited standard-of-care testing and lower test sensitivity compared to infants. To address these gaps, we conducted a retrospective study to estimate RSV-attributable incidence of hospitalizations among adults in Germany between 2015–2019. Methods Information on hospitalizations was gathered from a Statutory Health Insurance (SHI) database. A quasi-Poisson regression model was fitted to estimate RSV-attributable incidence rate (IR) of four specific cardiovascular hospitalizations (arrythmia, ischemic heart diseases, chronic heart failure exacerbations, cerebrovascular diseases) and four specific respiratory hospitalizations (influenza/pneumonia, bronchitis/bronchiolitis, chronic lower respiratory diseases, upper respiratory diseases) accounting for within-season fluctuations and virus activity stratified by age groups (18–44, 45–59, ≥60, 60–74, ≥75 years). Results RSV-attributable IRs of hospitalizations were generally increasing with age. Among cardiovascular hospitalizations in adults aged ≥60 years, arrythmia and ischemic heart diseases accounted for the highest incidence, followed by chronic heart failure exacerbation, with annual IR ranges of 157–260, 133–214, and 105–169 per 100,000 person-years, respectively. Among respiratory hospitalizations, highest RSV-attributable incidence in adults aged ≥60 years were for chronic lower respiratory diseases and bronchitis/bronchiolitis, with annual IR ranges of 103–168 and 77­­–122 per 100,000 person-years, respectively. Conclusion RSV infection is a well-established trigger for chronic heart failure exacerbations, but in this study RSV-related arrythmia and ischemic events were detected to have a higher incidence. RSV causes a considerable burden of both respiratory and cardiovascular hospitalizations in adults in Germany, similar to other respiratory viruses (e.g., influenza and SARS-CoV-2). This highlights the need to implement effective prevention strategies, especially for the older adults. Disclosures Caroline Beese, n/a, Pfizer Pharma GmbH: Employee Caihua Liang, MD, PhD, Pfizer: Stocks/Bonds (Private Company) Lea Johanna Bayer, n/a, Pfizer Pharma: Employee Bennet Huebbe, n/a, Pfizer Pharma GmbH: Ex-employee Aleksandra Polkowska-Kramek, n/a, Pfizer: employee of P95 which received funding from Pfizer to conduct this study Maribel Casas, PhD, Pfizer: Advisor/Consultant Christof Von Eiff, n/a, Pfizer Pharma: I am working as Sen. Medical Direktor for Vaccines at Pfizer Pharma GmbH, Berlin, , Germany and in that position I also get stocks. Bradford D. Gessner, M.D., M.P.H., Pfizer: Employee|Pfizer: Stocks/Bonds (Public Company) Elizabeth Begier, MD, M.P.H., Pfizer Vaccines: Employee|Pfizer Vaccines: Stocks/Bonds (Private Company) Gernot Rohde, MD, Astra Zeneca: Advisor/Consultant|Astra Zeneca: Honoraria|Berlin Chemie: Honoraria|Boehringer Ingelheim: Honoraria|GSK: Advisor/Consultant|GSK: Honoraria|Insmed: Advisor/Consultant|Insmed: Honoraria|Pfizer: Honoraria|sanofi: Advisor/Consultant|sanofi: Honoraria