Two studies shed new light on the long-term effects of respiratory syncytial virus (RSV) in adults, with one linking infection to an additional five cardiovascular events per 100 patients in the year after diagnosis, and the other suggesting that the virus is tied to a 1.8-times-higher risk of worsened shortness of breath (dyspnea) than COVID-19 infection.
Hospitalized, older adults at higher risk
For the first study, published yesterday in JAMA Network Open, Danish researchers used national registry data to assess rates of cardiovascular events among 17,494 matched patients aged 45 and older as of January 2019 with and without RSV infection. The average patient age was 71.8 years, and 57.6% were women. Infections were diagnosed from January 2019 through December 2024.
The team also compared cardiovascular events in similar matched cohorts for influenza, hip fracture, and non-sepsis urinary tract infection during the same period.
The primary outcomes were major adverse cardiovascular events (ischemic heart disease, stroke, and heart failure) and any cardiovascular event (major adverse cardiovascular events plus abnormal heart rhythms, venous thromboembolism, or inflammatory heart disease).
By one year post-infection, 665 cardiovascular events of any kind had occurred among 8,747 RSV patients and 257 of 8,747 uninfected patients, corresponding to a risk difference of 4.69 percentage points. In total, 69.1% of patients infected with RSV were hospitalized.
This study should prompt heightened clinical vigilance for cardiovascular complications following RSV infection and reinforces the public health rationale for preventive measures, most notably vaccination, in older adult populations to mitigate this burden.
The greatest risk differences for any cardiovascular event were seen in hospitalized patients (6.61 percentage points), those who were older (eg, 7.93 percentage points for those aged 85 to 94), and those with preexisting cardiovascular disease (11.95 percentage points) or diabetes (7.50 percentage points). The one-year risk after RSV was similar to that after flu.
“This study should prompt heightened clinical vigilance for cardiovascular complications following RSV infection and reinforces the public health rationale for preventive measures, most notably vaccination, in older adult populations to mitigate this burden,” the study authors concluded.
Almost 25% reported severe breathing difficulty
The second study, by a University of Michigan–led research team, involved a survey of adult RSV and COVID-19 survivors six months to one year after hospitalization about physical function and quality of life.
The investigators compared post-hospitalization outcomes among 146 RSV patients by age (younger or 60 years or 61 and older) and among 118 patients hospitalized for COVID-19. Participants were admitted to one of 26 hospitals in 20 US states from February 2022 to September 2023. The survey began in April 2023.
The findings were published last week in Emerging Infectious Diseases.
Together, those results suggest the potential for substantial and lingering harm from severe RSV illness across the entire adult age spectrum.
The median RSV patient age was 60.5 years, and 60.3% were women. During hospitalization, 25% were admitted to an intensive care unit (ICU), and 36% had poor in-hospital outcomes. The median hospital length of stay was 5 days. Of these patients, 27.4% reported severe dyspnea and 21.9% reported poor quality of life at follow-up. Few differences were observed in post-hospitalization illness by age.
At the time of the survey, 44% of RSV patients reported receiving home care for medical care or activities of daily living. Of the 27 patients still working or enrolled in an educational program, 59% said they missed at least one day of work or school because of illness after hospitalization.
After adjustment, RSV patients were at 1.81 times higher risk of worsened dyspnea than their peers with COVID-19. Participants reported impaired physical function and quality of life after RSV hospitalization, regardless of age, as well as a symptom cluster similar to that of hospitalized COVID-19 patients.
“Together, those results suggest the potential for substantial and lingering harm from severe RSV illness across the entire adult age spectrum,” the authors wrote.
They said that RSV vaccination may help prevent adverse long-term outcomes. “This information can be used by clinicians and public health practitioners who monitor at-risk patients after hospitalization, and to inform efforts to prevent and reduce the severity of these hospitalizations through targeted vaccination campaigns and other measures,” they wrote.
