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RSV hospitalization in older adults links to increased cardiovascular events, highlighting the need for vigilant monitoring and vaccination strategies.
Respiratory syncytial virus (RSV) is known to cause severe illness and mortality in adults, yet research on its connection with cardiovascular outcomes after other acute respiratory infections is limited. In a retrospective cohort study published in the Journal of the American Geriatrics Society, researchers compared cardiovascular events up to 1 year postdischarge among individuals aged 65 years and older with RSV, influenza, urinary tract infection (UTI), or fracture.1,2
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RSV is one of the major global causes of respiratory illness that impacts all age groups. According to the CDC, individuals that are older, have chronic heart or lung disease, have a weakened immune system, and have other underlying medical conditions are at risk of developing severe RSV. Additionally, asthma, chronic obstructive pulmonary disease (COPD), and heart failure also place individuals at an increased risk. Previous Global Burden of Disease data from 2015 revealed that industrialized countries accounted for about 1.5 million RSV-related cases in adults aged 65 years and older, with nearly 14.5% requiring hospitalization.1,3
Regarding cardiovascular outcomes, previous research indicates that multiple respiratory infections are linked to later cardiovascular issues, and cardiac complications are common following severe RSV hospitalizations. To address the gap, researchers aimed to estimate the rate of cardiovascular events and other serious outcomes in older adults hospitalized with RSV in Ontario, Canada, and then compared the rates with individuals hospitalized for influenza, UTIs, and fractures between 2011 and 2020.1
A total of 104,095 patient admissions were identified prior to matching, including 2558 for RSV, 16,688 for influenza, 73,587 for UTIs, and 11,262 for fracture. After matching, the researchers retained 2234 RSV-influenza, 2308 RSV-UTI, and 1612 RSV-fracture matched pairs. The average age of patients in the matched cohorts was 80 years, with nearly 60% being women and half receiving an influenza vaccine. Additionally, there was a high prevalence of comorbidities, with 45% of individuals with COPD and dyslipidemia, 40% with diabetes, 30% with atrial fibrillation and asthma, and 28% with heart failure.1
The results revealed that cardiovascular events were found in approximately 18.5% of individuals that were hospitalized for an RSV-related issue, compared to 17.7%, 12.1%, and 8.4% of individuals that were hospitalized with influenza, UTI, or fracture, respectively. Further results from the matched cohort revealed that RSV hospitalizations were linked with a greater rate of heart failure events compared with the other patient groups involved, including those with or without prior cardiovascular conditions. Differing depending on the preexisting cardiovascular condition, individuals with RSV also experienced a higher rate of atrial fibrillation up to 1 year post-discharge.1
Additionally, individuals hospitalized for RSV had a longer duration of stay or needed to be transferred to intensive care with 30-day mortality compared to individuals with influenza, UTI, or fracture. The findings emphasize the need for increased monitoring and follow-up for cardiovascular symptoms in older individuals hospitalized for RSV.1
“Unlike other respiratory viruses, immunity against RSV tends to decline relatively quickly. This means that a previous infection will not afford the same long-term protection as it might for influenza or COVID-19,” Chris Verschoor, PhD, HSN, foundation research chair in healthy aging at Health Sciences North Research Institute and corresponding study author, said in a news release. “Our findings reinforce the importance of RSV vaccination in older adults and suggest that monitoring for signs of heart disease following an RSV illness may be pragmatic.”2
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