Table 2

Disclaimer: Early release articles are not considered as final versions. Any changes will be reflected in the online version in the month the article is officially released.

Volume 31, Supplement—October 2025

SUPPLEMENT ISSUE

Long-Term Illness in Adults Hospitalized for Respiratory Syncytial Virus Disease, United States, February 2022–September 2023

Aleda M. Leis

, Kelsey N. Womack, Courtney Maxcy, Ellen Caldwell, Caroline Cheng, Sydney A. Cornelison, Diya Surie, Fatimah S. Dawood, Sharon Saydah, Manjusha Gaglani, Cristie Columbus, Abhijit Duggal, Laurence W. Busse, Laurynn M. Giles, Ivana A. Vaughn, Ithan D. Peltan, David N. Hager, Amira Mohamed, Matthew C. Exline, Akram Khan, Jennifer G. Wilson, Jarrod S. Mosier, Steven Y. Chang, Adit A. Ginde, Nicholas M. Mohr, Christopher Mallow, Estelle S. Harris, Nicholas J. Johnson, Kevin W. Gibbs, Jennie H. Kwon, Basmah Safdar, Emily T. Martin, Wesley H. Self, Catherine L. Hough, Jin H. Han, and for the Investigating Respiratory Viruses in the Acutely Ill (IVY) Network¹

Author affiliation: University of Michigan School of Public Health, Ann Arbor, Michigan, USA (A.M. Leis, C. Cheng, E.T. Martin); Vanderbilt Institute for Clinical and Translational Research, Vanderbilt University Medical Center, Nashville, Tennessee, USA (K.N. Womack, W.H. Self); Oregon Health & Sciences University, Portland, Oregon, USA (C. Maxcy, E. Caldwell, A. Khan, C.L. Hough); Vanderbilt University Medical Center, Nashville (S.A. Cornelison, J.H. Han); Centers for Disease Control and Prevention, Atlanta, Georgia, USA (D. Surie, F.S. Dawood, S. Saydah); Baylor College of Medicine–Temple, Temple, Texas, USA (M. Gaglani); Baylor Scott & White Health, Dallas, Texas, USA (M. Gaglani, C. Columbus); Texas A&M University College of Medicine, Dallas (M. Gaglani, C. Columbus); Cleveland Clinic, Cleveland, Ohio, USA (A. Duggal); Emory University, Atlanta (L.W. Busse); Hennepin County Medical Center, Minneapolis, Minnesota, USA (L.M. Giles); Henry Ford Medical Center, Detroit, Michigan, USA (I.A. Vaughn); Intermountain Medical Center, Murray, Utah, USA (I.D. Peltan); University of Utah, Salt Lake City, Utah, USA (I.D. Peltan, E.S. Harris); Johns Hopkins University School of Medicine, Baltimore, Maryland, USA (D.N. Hager); Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, New York, USA (A. Mohamed); The Ohio State University, Columbus, Ohio, USA (M.C. Exline); Stanford University School of Medicine, Stanford, California, USA (J.G. Wilson); University of Arizona, Tucson, Arizona, USA (J.S. Mosier); University of California, Los Angeles, California, USA (S.Y. Chang); University of Colorado School of Medicine, Aurora, Colorado, USA (A.A. Ginde); University of Iowa, Iowa City, Iowa, USA (N.M. Mohr); University of Miami, Miami, Florida, USA (C. Mallow); University of Washington, Seattle, Washington, USA (N.J. Johnson); Wake Forest School of Medicine, Winston-Salem, North Carolina, USA (K.W. Gibbs); Washington University, St. Louis, Missouri, USA (J.H. Kwon); Yale University, New Haven, Connecticut, USA (B. Safdar); Geriatric Research, Education, and Clinical Center, Tennessee Valley Healthcare System, Nashville (J.H. Han)

Main Article

Six- to 12-mo outcomes in a study of long-term illness in adults hospitalized for respiratory syncytial virus disease or COVID-19, United States, February 2022–September 2023*

Category	RSV only			RSV versus COVID-19
Category	Age <60, n = 71	Age >60, n = 75	p value†	RSV positive, n = 146	SARS-CoV-2 positive, n = 118	p value†
Primary outcomes‡
SF36-PF, median (IQR)	47.5 (20.0–80.0)	20.0 (10.0–60.0)	0.008	40.0 (15.0–75.0)	42.5 (10.0–80.0)	0.799
Change from baseline, median (IQR)	0.0 (–5.0 to 0.0)	0.0 (–10.0 to 0.0)	0.087	0.0 (–5.0 to 0.0)	0.0 (–10.0 to 0.0)	0.462
Katz ADLs,§ median (IQR)	6.0 (6.0–6.0)	6.0 (5.0–6.0)	0.053	6.0 (5.0–8.0)	6.0 (5.0–6.0)	0.854
Decrease from baseline >1 point	7 (9.9)	9 (12.0)	0.682	16 (11.0)	12 (10.2)	0.858
Lawton instrumental ADLs,§ median (IQR)	8.0 (6.0–8.0)	7.0 (3.0–8.0)	0.077	8.0 (5.0–8.0)	8.0 (5.0–8.0)	0.802
Decrease from baseline >1 point	3 (4.2)	14 (18.7)	0.005	17 (11.6)	17 (14.4)	0.519
Dyspnea			0.558			0.104
Grade 0/1	21 (29.6)	22 (29.3)		43 (29.5)	49 (41.5)
Grade 2	9 (12.7)	6 (8.0)		15 (10.3)	7 (5.9)
Grade 3	19 (26.8)	18 (24.0)		37 (25.3)	26 (22.0)
Grade 4	16 (22.5)	24 (32.0)		40 (27.4)	23 (19.5)
Self-rated health, median (IQR)	62.5 (50.0–80.0)	60.0 (50.0–80.0)	0.222	60.0 (50.0–80.0)	70.0 (50.0–80.0)	0.678
EQ-5D-5L, median (IQR)	0.712 (0.394–0.926)	0.687 (0.363–0.883)	0.551	0.705 (0.338–0.902)	0.719 (0.458–0.904)	0.481
Good, >0.632	39 (54.9)	39 (52.0)		78 (53.4)	67 (56.8)
Fair, 0.338–0.632	13 (18.3)	15 (20.0)		28 (19.2)	24 (20.3)
Poor, <0.338	16 (22.5)	16 (21.3)		32 (21.9)	22 (18.6)
Secondary outcomes
PROMIS Sleep Disturbances
Median (IQR)	53.9 (41.2–63.8)	51.4 (41.2–57.2)	0.219	51.7 (41.2–61.1)	50.0 (42.1–57.7)	0.606
>1 SD >50	25 (35.2)	14 (18.7)	0.023	39 (26.7)	23 (19.5)	0.189
PROMIS Cognitive Function
Median (IQR)	50.8 (43.4–66.2)	52.7 (43.4–66.2)	0.931	51.4 (43.4–66.2)	51.7 (43.9–66.2)	0.880
>1 SD <50	8 (11.3)	12 (16.0)	0.333	20 (13.7)	16 (13.6)	0.963
PROMIS Social Activities
Median (IQR)	51.8 (37.2–64.2)	49.9 (40.2–58.1)	0.489	51.5 (37.9–64.2)	51.8 (40.3–64.2)	0.423
>1 SD <50	19 (26.8)	16 (21.3)	0.626	35 (24.0)	26 (22.0)	0.666
CAP-Sym Score
Total score	14.0 (3.0–24.0)	12.0 (6.0–20.0)	0.533	13.0 (5.0–23.0)	9.0 (3.0–20.0)	0.161
Total no. severe symptoms	1.0 (0.0–3.0)	1.0 (0.0–2.0)	0.269	1.0 (0.0–3.0)	1.0 (0.0–2.0)	0.430
Exploratory outcomes§
Receives regular help at home with medical care or ADL	27 (38.0)	38 (50.7)	0.125	65 (44.5)	53 (44.9)	0.900
New receipt of home health care from hospitalization	10 (14.1)	17 (22.7)	0.195	27 (18.5)	10 (8.5)	0.019
SNF/LTCF at survey timepoint	2 (2.8)	7 (9.3)	0.094	9 (6.2)	7 (5.9)	0.784
New SNF/LTCF compared with hospitalization	1 (1.4)	5 (6.7)	0.099	6 (4.1)	2 (1.7)	0.263
Patient missed work or school¶	12/18 (66.7)	4/9 (44.4)	0.411	16/27 (59.3)	11/19 (57.9)	0.926
Caregiver missed work or school	31 (43.7)	18 (24.0)	0.016	49 (34.5)	29 (24.6)	0.196
New/worsened home oxygen use#	19 (26.9)	17 (22.7)	0.566	36 (24.7)	19 (16.1)	0.110
New/worsened CPAP/other breathing machine use#	6 (8.5)	5 (6.7)	0.683	11 (7.5)	5 (4.2)	0.287

*Values are no. (%) except as indicated. Earliest completed survey from 6, 9, or 12 mo was used. Percentages for fields with missing values are computed based on the full column. Details on each testing scale are provided in the text. For those with RSV, variables missing data were SF36-PF (n = 9), baseline SF-36 PF comparison (n = 17), Katz (n = 5), baseline Katz comparison (n = 6), Lawton (n = 4), baseline Lawton comparison (n = 11), dyspnea (n = 11), self-rated health (n = 9), EQ-5D-5L (n = 8), PROMIS sleep disturbance (n = 4), PROMIS cognitive function (n = 8), PROMIS social activities (n = 14), new home care help (n = 3), new LTCF (n = 3), and caregiver time off (n = 4). For those with COVID-19, variables missing data were SF36-PF (n = 8), baseline SF-36 PF comparison (n = 12), Katz (n = 5), baseline Katz comparison (n = 6), Lawton (n = 5), baseline Lawton comparison (n = 8), dyspnea (n = 13), self-rated health (n = 4), EQ-5D-5L (n = 5), PROMIS sleep disturbance (n = 5), PROMIS cognitive function (n = 6), PROMIS social activities (n = 10), home care help (n = 1), new home care help (n = 2), new LTCF (n = 4), caregiver time off (n = 10), new home oxygen use (n = 3), and new home CPAP use (n = 3). Of those with RSV, 94 (64%) had nonmissing data for the survey components, and of those with COVID-19, 76 (64%) had nonmissing data for the survey components; missing data was imputed to 0/no for symptoms, so those missing individual symptoms are not included. ADL, activity of daily living; CPAP, continuous positive airway pressure; EQ-5D-5L, EuroQol 5-dimension, 5-level questionnaire; IQR, interquartile range; LTCF, long-term care facility; RSV, respiratory syncytial virus; SF-36 PF, Short Form-36 Physical Function Subscale score; SNF, skilled nursing facility. †p values compare persons <60 y of age to those >60 y of age and patients with RSV versus those with COVID-19 and were computed using χ² or Fisher exact tests for categorical variables or Wilcoxon signed-rank tests for continuous variables, as appropriate. ‡Change from baseline calculated for those surveys with nonmissing data. §Basic ADLs include bathing, feeding, and dressing; instrumental ADLs include shopping, managing finances, or making telephone calls ¶Column percentages computed for those who reported being employed or in school at time of hospitalization. ¶Compared with 1 mo before hospitalization.

Main Article

¹A full list of collaborators in the IVY Network is provided in Appendix 1.

Page created: August 25, 2025

Page updated: December 04, 2025

Page reviewed: December 04, 2025

The conclusions, findings, and opinions expressed by authors contributing to this journal do not necessarily reflect the official position of the U.S. Department of Health and Human Services, the Public Health Service, the Centers for Disease Control and Prevention, or the authors' affiliated institutions. Use of trade names is for identification only and does not imply endorsement by any of the groups named above.