Impact of Timing of Diagnosis of Respiratory Syncytial Virus (RSV) Disease on Hospital Length of Stay (LOS) in Adults: Final Analysis from a Retrospective Chart Review Study

BACKGROUND: Despite growing clinical awareness of RSV disease in at-risk adult subpopulations, significant gaps remain in knowledge, especially around diagnosis. This analysis aimed to understand the impact of timing of diagnosis on hospital LOS. METHODS: A retrospective review of patient charts was conducted. Data for adults ≥18 years with confirmed RSV (Oct 2014–Oct 2016; USA) were collected. Each physician (n = 132) submitted up to 3 randomly selected patient cases via an online survey. RESULTS: This study comprised 379 patients, collected in 4 groups (Table). >80% of patients received an RT-PCR test; rapid antigen tests were uncommon (≤10%) with an RT-PCR test also performed in 45% of these. Early RSV diagnosis and less severe disease were associated with a shorter mean LOS (Figure 1and2). Patients diagnosed >24h post-admission had a longer mean [SD] LOS (9.8 [8.6] days; n = 29) than patients diagnosed <12h post-admission (6.2 [3.9] days; n = 67; P = 0.006), and patients diagnosed 12–24h post-admission (7.4 [4.2] days; n = 56; P = 0.038). LOS was higher (P = 0.005) in patients diagnosed in the intensive care unit (9.4 days) than the emergency room or hospital ward (both 6.8 days). CONCLUSION: RSV disease in adults was typically diagnosed by PCR. Delayed diagnosis and greater RSV disease severity are associated with longer LOS, but results need to be confirmed by prospective trials. Introduction of diagnostic testing protocols may lead to earlier identification of patients in need of supportive care and reduce mean LOS. DISCLOSURES: E. Walsh, Janssen Pharmaceuticals: Scientific Advisor, Consulting fee; I. Sander, Janssen Pharmaceuticals: Independent Contractor, Licensing agreement or royalty; R. Stolper, Janssen Pharmaceuticals: Independent Contractor, Licensing agreement or royalty; J. Zakar, Janssen: Independent Contractor, Licensing agreement or royalty; G. De La Rosa, Janssen Pharmaceuticals: Employee, Salary; V. Wyffels, Janssen Pharmaceuticals: Employee, Salary; D. Myers, Janssen Pharmaceuticals: Employee, Salary; R. Fleischhackl, Janssen Pharmaceuticals: Employee, Salary