• Overall, the rate of hospitalizations associated with respiratory viruses continues to increase (92.8% increase from November 2023 to the end of December 2023). The largest increases in hospitalizations over the past month were associated with influenza (251.7% increase), HMPV (115.0% increase), and COVID-19 (88.6% increase).
  • For infants and children (aged 0-4 years old), RSV accounted for the most respiratory virus-associated hospitalizations, despite decreases throughout December 2023. In this population, COVID-associated hospitalizations had the biggest increase in the last month.
  • For the older adult population (aged 65 and older), respiratory virus-associated hospitalizations increased to 10.3% per all hospitalizations. COVID remained the largest contributor with 5.3% of all hospitalizations associated with COVID in the older adult population.

Few sources regularly monitor hospitalizations associated with respiratory viruses. Truveta Research has created a monthly respiratory virus monitoring report to supplement the surveillance data provided by the CDC by describing weekly trends in the rate of hospitalizations overall and for each of the six most common respiratory viruses: COVID-19, influenza, human metapneumovirus (HMPV), parainfluenza virus, respiratory syncytial virus (RSV), and rhinovirus. This information can inform decisions about public health, clinical care, and public policy.

Because Truveta Data provides the most complete, timely, and clean de-identified EHR data, including full patient medical records, notes, and images, linked with claims, SDOH, and mortality data for more than 100 million patients across the US, we can show the latest trends in these respiratory virus-associated hospitalizations, including valuable insight into two at-risk populations: infants and children (age 0-4 years old) and older adults (age 65 and over).

This blog provides a snapshot of the key findings in the report specific to the overall population across all respiratory viruses, as well as for two high-risk populations: infants and children (age 0-4 years old) and older adults (age 65 and older). For the full analysis – inclusive of demographics, comorbidities, and overall trends in virus-associated hospitalizations across all age groups for each virus – see the complete monitoring report on MedRxiv.

Key findings: Trends in respiratory virus-associated hospitalizations

Using a subset of real-world electronic health record (EHR) data from Truveta, a growing collective of health systems that provide more than 18% of all daily clinical care in the US, we identified 502,484 hospitalizations of 471,401 unique patients who tested positive for a respiratory virus between October 01, 2019 and December 31, 2023.

Overall population trends

Overall, the rate of hospitalizations associated with respiratory viruses continues to increase (92.8% increase from November 2023 to the end of December 2023). The largest increases in hospitalizations over the past month were due to influenza (251.7% increase), HMPV (115.0% increase), and COVID (88.6% increase). COVID- and influenza-associated hospitalizations comprise 3.3% and 3.0% of all hospitalizations, respectively. Other viruses are each below 1% of hospitalizations. Nevertheless, at the end of December 2023, respiratory virus-associated hospitalizations accounted for 7.7% of all hospitalizations.

Truveta Research uses de-identified EHR data to explore the latest rates of respiratory virus-associated hospitalizations, including COVID-19, RSV, influenza, and others.
Truveta Research uses de-identified EHR data to explore the latest rates of respiratory virus-associated hospitalizations, including COVID-19, RSV, influenza, and others.
Infants and children (age 0-4)

For the population between 0-4 years old, in December 2023, RSV accounted for the most respiratory virus-associated hospitalizations, despite decreasing rates since November 2023 (24.7% decrease).

COVID- (183.5% increase), influenza- (52.5% increase), and rhinovirus-associated (39.5% increase) hospitalizations are increasing in this population.

In this age group, 5.1% of all hospitalizations were associated with respiratory viruses in December 2023, a 10.5% increase from November 2023.

Truveta Research uses de-identified EHR data to explore the latest rates of respiratory virus-associated hospitalizations, including COVID-19, RSV, influenza, and others. This image shows the rate of pediatric hospitalizations.
Truveta Research uses de-identified EHR data to explore the latest rates of respiratory virus-associated hospitalizations, including COVID-19, RSV, influenza, and others. This shows the month-over-month change from the end of November to the end of December 2023 for pediatric hospitalizations associated with respiratory viruses.
Older adults (age 65 and over)

In the older adult population (individuals over 65 years of age), there was a 93.7% increase in hospitalizations associated with respiratory viruses; 10.3% of all hospitalizations are associated with a respiratory virus.

Influenza-associated hospitalizations had the largest percent increase between November and December 2023 (267.8% increase).

COVID-associated hospitalizations continue to make up the largest percentage of hospitalizations in this age group (5.3% in December).

Truveta Research uses de-identified EHR data to explore the latest rates of respiratory virus-associated hospitalizations, including COVID-19, RSV, influenza, and others. This graphic shows the rate of respiratory virus-associated hospitalizations for adults over age 65.
Truveta Research uses de-identified EHR data to explore the latest rates of respiratory virus-associated hospitalizations, including COVID-19, RSV, influenza, and others. This graphic shows the month-over-month change in rate from end of November to end of December 2023 for adults over the age of 65.

Discussion

It is important for public health experts and clinical providers to understand the trends in these infections to inform decisions about public health, clinical care, and public policy. Connecting population-level trends with granular clinical information available in Truveta Studio can be very useful to understand which populations are most impacted and may require additional support.

We will continue to monitor respiratory virus-associated hospitalizations overall and for at-risk populations.

You can read the latest full respiratory virus-associated hospitalizations report on MedRxiv.