Influenza, Respiratory Syncytial Virus Linked to Rehospitalizations in Postacute Setting

The uptick of influenza and respiratory syncytial virus (RSV) activity was linked to a greater number of cardiorespiratory rehospitalizations for residents of skilled nursing facilities (SNFs), new findings showed.

“Although hospital readmissions during the postacute period are already common among older adults in SNFs, there may be added risk of cardiorespiratory rehospitalizations when community levels of circulating influenza and RSV are highest because staff, visitors, and new SNF admissions are more likely to introduce viruses into the SNF setting, which may subsequently precipitate cardiorespiratory events,” researchers wrote.

The retrospective cohort study was conducted using Medicare Provider Analysis and Review claims, Minimum Data Set version 3.0 assessments, PRISM Climate Group data, and viral testing data from the Centers of Disease Control and Prevention. Authors analyzed the viral activity of RSV and 3 influenza strains: H1N1pdm09, H3N2, and B. Strains were determined to be “in season” according to a 10% positive testing threshold.

For every 5% increase in circulating RSV and influenza strains H3N2 and B, there were approximately 1% more cardiorespiratory rehospitalizations. A 5% increase in circulating influenza H1N1pdm09, however, resulted in a 1% decrease in the rate of rehospitalizations.

Rehospitalization rates increased by 6%, 3%, and 5% when influenza H3N2, influenza B, and RSV were in season, respectively. By contrast, when influenza H1N1pdm09 was in season, rehospitalization rates fell by 6%.

The pandemic has called attention to the importance of controlling the spread of respiratory diseases in SNFs, authors wrote, and many of the infection control measures used to curb COVID-19 “are likely applicable to other respiratory viruses that may lead to outbreaks, morbidity, and mortality.”

Authors recommended the following: “influenza vaccination for residents and staff, use of personal protective equipment, improved environmental cleaning measures, screening and testing of residents and staff, surveillance of viral activity, and quarantining infected individuals may be potential strategies to limit viral infections and associated cardiorespiratory rehospitalizations.”

Reference:
Riester MR, Bosco E, Manthana R, et al. Relationships between community virus activity and cardiorespiratory rehospitalizations from post-acute care. J Am Med Dir Assoc. Published online January 24, 2022. doi:10.1016/j.jamda.2021.12.036