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Deviations in RSV epidemiological patterns and population structures in the United States following the COVID-19

Estefany Rios-Guzman1,2, Lacy M Simons1,2, Taylor J Dean1,2

  • 1Division of Infectious Diseases, Northwestern University Feinberg School of Medicine, Chicago, IL, 60611, USA.

Nature Communications
|April 20, 2024
PubMed

Insights

Respiratory Syncytial Virus (RSV) prevalence changed post-COVID-19, with RSV-A hospitalizations increasing intensive care risk. RSV-B showed genetic shifts, suggesting potential impacts on future vaccines and therapies.

Area of Science:

  • Virology
  • Epidemiology
  • Public Health

Background:

  • Respiratory Syncytial Virus (RSV) significantly impacts vulnerable populations like infants, the immunocompromised, and older adults.
  • RSV patterns shifted post-COVID-19 non-pharmaceutical interventions, with altered seasonality and unclear underlying factors.
  • Understanding these changes is crucial for public health strategies and medical interventions.

Purpose of the Study:

  • To investigate the epidemiology, clinical severity, and genetic diversity of RSV in Chicago from 2009 to 2023.
  • To identify factors contributing to altered RSV seasonality and prevalence post-2020.
  • To assess differences in clinical outcomes between RSV-A and RSV-B infections and analyze genetic evolution.

Main Methods:

  • Retrospective cohort study analyzing RSV data from 2009-2023 in Chicago, Illinois.
  • Examination of RSV diagnostic platform changes and their impact on detection rates.
  • Analysis of clinical severity, focusing on intensive care unit admission risk for RSV-A versus RSV-B.
  • Genomic analysis of RSV strains to identify population structures and genetic shifts, particularly in antigenic regions.

Main Results:

  • Increased RSV detections post-2020 were linked to changes in diagnostic platforms, particularly in outpatient settings.
  • Hospitalized adults with RSV-A faced higher intensive care admission risk compared to those with RSV-B.
  • RSV-A population structure remained stable, whereas RSV-B evolved into distinct geographic clusters.
  • Mutations were identified in the fusion protein's antigenic regions of RSV-B, indicating potential convergent evolution.

Conclusions:

  • Diagnostic platform changes significantly influenced observed RSV trends post-2020.
  • RSV-A and RSV-B exhibit differential clinical severity and evolutionary trajectories.
  • Genetic shifts in RSV, especially concerning the fusion protein, may have implications for vaccine and therapeutic efficacy.
  • Further research is needed to understand the long-term impact of these evolutionary changes on RSV control.

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