Although the prevalence of RSV infection in adults has recently been identified, there is a dearth of information about the burden of cardiovascular disease (CVD) after the acute phase. To determine the 365-day absolute excess risk (risk difference) of CVD composites and their individual components after laboratory-confirmed RSV infection in adults, this study was carried out.
Danish national health registries were used in this countrywide, registry-based, matched cohort investigation. Adults 45 years of age or older on January 1, 2019, who had a laboratory-confirmed RSV infection between January 1, 2019, and December 31, 2024, were matched 1:1 with those who did not have an RSV infection based on age, sex, and preexisting comorbid diseases. As control groups, comparable matched cohorts were created for hip fractures, influenza infections, and urinary tract infections without sepsis.
Major adverse cardiovascular events, which include stroke, ischemic heart disease, and heart failure, as well as any cardiovascular event, which includes venous thromboembolism, arrhythmias, and inflammatory heart disease, were the main outcomes. Following the index date, matched people were monitored for a maximum of 365 days. Using cumulative occurrences obtained from the Aalen-Johansen estimator, absolute risk differences and 95% CIs were computed at 30 and 365 days.
A total of 17,494 matched participants (mean [SD] age, 71.8 [12.0] years; 57.6% female) were included in the research. There was a risk difference of 4.69 percentage points (95% CI, 4.02-5.36 percentage points) at 365 days, with 665 cardiovascular events occurring among 8747 persons with RSV infection and 257 among 8747 individuals without virus.
Hospitalized patients (6.61 percentage points [95% CI, 5.70-7.52 percentage points]), older people (e.g., 7.93 percentage points [95% CI, 5.34-10.53 percentage points] for those aged 85-94 years), preexisting CVD (11.95 percentage points [95% CI, 8.80-15.10 percentage points]) or diabetes (7.50 percentage points [95% CI, 4.53-10.47 percentage points]). After RSV, the 1-year risk of cardiovascular events was similar to that after influenza.
Overall, a substantial elevated risk of cardiovascular events over a one-year period was reported in this cohort analysis of persons 45 years of age or older with RSV infection; this risk was similar to that of influenza infection. The results of this study highlight the significance of identifying RSV as a respiratory infection as well as a significant risk factor for adult cardiovascular morbidity.
Source:
Hviid, A., Fischer, T. K., Biering-Sørensen, T., & Bech Svalgaard, I. (2025). Cardiovascular events 1 year after respiratory syncytial virus infection in adults. JAMA Network Open, 8(12), e2547618. https://doi.org/10.1001/jamanetworkopen.2025.47618
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