Publication date: Jul 21, 2025

Respiratory syncytial virus (RSV), influenza virus, and SARS-CoV-2 cause significant morbidity and mortality. Understanding prevalences 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

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