Relative to uninfected control patients, those hospitalized with acute respiratory infections (ARIs) due to respiratory syncytial virus (RSV) or influenza were at substantially higher adjusted risk for all-cause death, heart attack, exacerbation of asthma and chronic obstructive pulmonary disease (COPD), and hospitalization for heart failure, researchers from vaccine maker GSK and the Analysis Group report.
The retrospective study, published last week in Clinical Infectious Diseases, used claims data from October 2015 to June 2023 to compare clinical outcomes among US adults aged 50 and older hospitalized for RSV or flu with those of controls without ARI. The average ages in the RSV and flu cohorts were higher than those of controls (76.5 and 75.4 vs 69.5 years, respectively).
“Current evidence on longer-term RSV-ARI outcomes among adults aged ≥50 years is limited, with insufficient research comparing the impact of RSV-ARI hospitalization to an appropriate comparator population representing the long-term health outcomes these patients would have experienced without severe RSV disease,” the study authors wrote.
Increased risk at 1 year
The study included 14,759 RSV, 77,468 flu, and 73,795 control patients. RSV patients had a substantially higher adjusted risk of all-cause death than controls, with the highest risk 0 to 30 days after hospitalization (adjusted hazard ratio [aHR], 10.8).
At 30 days and 1 year after hospitalization, the risk of all-cause death rose from 6.5% to 26.3% in the RSV group, compared with 6.6% to 23.3% among flu patients and from 0.3% to 3.1% among controls.
These results underscore the need for increased awareness of the clinical burden of RSV among adults aged ≥50 years and the role of RSV prevention in reducing the risk of adverse clinical outcomes.
At 30 days and 1 year after hospital admission, the risk of heart attack in the RSV, flu, and control cohorts rose from 10.0% to 14.5%, 10.3% to 14.0%, and 0.2% to 1.6%, respectively.
Among asthma patients, the RSV group was at higher risk for asthma exacerbation than both the flu (aHR, 1.5) and control (aHR, 6.5) cohorts across all ages. Among COPD patients, the RSV group also consistently showed higher risk of COPD exacerbation compared with flu patients (aHR, 1.1) and controls (aHR, 2.8).
Likewise, RSV patients diagnosed as having heart failure had a consistently higher risk of hospitalization than those with flu (aHR, 1.1) and controls (aHR, 3.1). The risk of hospital readmission was 16.1% in RSV patients at 30 days and 26.1% at 3 months; the risk was 14.4% and 23.3% for flu patients at 30 days and 3 months, respectively.
The authors noted that RSVhad considerably greater long-term effects on clinical outcomes than no acute respiratory infection and similar outcomes as flu.
“Severe RSV had a significant impact on clinical outcomes similar to that of influenza, highlighting the potential benefits of RSV prevention beyond avoiding acute disease impacts,” the researchers concluded. “These results underscore the need for increased awareness of the clinical burden of RSV among adults aged ≥50 years and the role of RSV prevention in reducing the risk of adverse clinical outcomes.”
