Adult RSV-ARI Linked to Higher Death Risk and Health Care Costs

New study findings presented at the European Society of Clinical Microbiology and Infectious Diseases (ESCMID) Global 2025 conference revealed a higher risk of death among adults infected with respiratory syncytial virus–associated acute respiratory infection (RSV-ARI) compared with the general population.¹

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RSV-ARI is an illness that is caused by RSV, which mainly impacts the respiratory tract, resulting in severe outcomes among adults, including pneumonia and chronic respiratory diseases.¹ According to the CDC, the ARI metric is used to track respiratory illness activity by monitoring emergency department visits for a wide range of respiratory diagnoses, from the common cold to severe infections such as influenza, COVID-19, and RSV. Unlike the previous influenza-like illness metric, ARI includes illnesses that may not present with fever, providing a more comprehensive understanding of respiratory illness trends.²

A Danish nationwide cohort study assessed data from adults 18 years and older who were diagnosed with RSV-ARI between 2011 and 2022 to assess the under-recognized, long-term health, and economic burden of RSV-ARI. The study authors noted that a total of 5289 adults were included and compared with 15,867 matched cohorts from the general population.¹

The results demonstrated that adults with RSV-ARI not only faced an increased risk of death but also experienced significantly worse health outcomes, including 3.1 times more frequent chronic obstructive pulmonary disease (COPD) exacerbations and 4.6 times more frequent asthma exacerbations over a 365-day period.¹

“One of the most striking findings from this study was the prolonged and significant impact of RSV-ARI,” lead study author Maria João Fonseca, PhD, said in a news release. “Even after the acute phase, patients continued to experience worse outcomes compared to the general population. This underscores just how serious and enduring the effects of RSV-ARI can be.”¹

Further results found that hospitalization rates for RSV-ARI patients were more than double the control group (57% vs 28%, respectively), and intensive care unit admissions were nearly 4 times higher (5.3% vs 1.4%, respectively). The economic impact was substantial, with total direct health care costs for RSV-ARI patients doubling the amount spent on the control group.¹

“Exacerbations of COPD and asthma were the most common adverse clinical outcomes. These preexisting conditions are already challenging in themselves, and RSV-ARI exacerbates their severity. Because of this, it’s crucial that we pay closer attention to patients with these underlying conditions to prevent further, potentially life-threatening complications,” Fonseca said in the news release.¹

The findings suggest that adults with RSV-ARI have a 2.7-fold increased risk of death within 1 year compared with the general population. The study authors noted that these findings highlight the substantial and frequently underestimated long-term health and economic burden of RSV-ARI in adults, especially those with underlying conditions such as COPD and asthma.¹

“Vaccination has proven highly effective in preventing severe outcomes from RSV. Given the significant burden of RSV-ARI highlighted by our study, prioritizing vaccination for vulnerable populations is essential to reduce both health complications and associated costs,” Fonseca said.¹

Currently, the CDC recommends a single dose of any of the FDA-approved RSV vaccines—RSVPreF3 (Arexvy; GSK), RSVpreF (Abrysvo; Pfizer), and mRNA-1345 (mRESVIA; Moderna)—for all adults 75 years and older, along with individuals aged 60 to 74 years who are at increased risk of severe illness.³

“Looking forward, we hope our findings will inspire further research into the broader clinical and societal burden of RSV, particularly in high-risk groups,” Fonseca concluded. “This will help shape more targeted preventive strategies and ensure timely interventions for those who need it most.”¹

REFERENCES

1. Common respiratory condition nearly triples the risk of death in adults, new study finds. EurekAlert!. News release. April 11, 2025. Accessed April 30, 2025. https://www.eurekalert.org/news-releases/1079313

2. Respiratory virus activity levels. CDC. News release.Updated April 25, 2025. Accessed April 30, 2025. https://www.cdc.gov/respiratory-viruses/data/activity-levels.html

3. RSV vaccines. CDC. August 30, 2024. Accessed April 17, 2025. https://www.cdc.gov/rsv/vaccines/index.html