Prevalence of health conditions associated with higher risk for severe respiratory syncytial virus, influenza, or COVID-19

Respiratory syncytial virus (RSV), influenza virus, and SARS-CoV-2 cause significant morbidity and mortality. Understanding the prevalence of underlying conditions associated with higher risk for severe RSV, influenza, or COVID-19, and demographic trends in multi-morbidity prevalence, may help inform effective interventional strategies against these respiratory infections in high-risk populations. This study analyzed data from the National Health and Nutrition Examination Survey (NHANES) database (2017–2018) from a representative sample of US adults (≥20 years). Of 239 million surveyed adults, 44.5% had ≥1 underlying condition associated with higher risk of severe RSV, influenza, or COVID-19; this proportion increased to 72.2% of adults if 2 additional underlying conditions were also considered (hypertension and smoking; both associated risk factors for severe COVID-19). Among older adults (≥60 years), the majority had ≥1 underlying condition associated with higher risk for severe RSV, influenza, or COVID-19. Across different racial/ethnic groups, overall prevalence of ≥2 conditions was highest among individuals of Other Race (including multiracial) at 19.5%, followed by non-Hispanic Black (18.9%), non-Hispanic White (18.5%), Mexican-American/Other Hispanic (10.3%), and non-Hispanic Asian individuals (7.7%). Notably, non-Hispanic Black individuals had a higher prevalence of ≥1 underlying condition compared with other race/ethnicity groups across all age groups <75 years. These findings indicate increased prevalence of underlying health conditions associated with higher risk of severe RSV, influenza, or COVID-19 among older adults (≥60 years) and disproportionate prevalence among younger non-Hispanic Black individuals. Understanding racial and ethnic disparities in multi-morbidity prevalence of underlying conditions can inform public health interventions that target these respiratory viruses.