RSV Hospitalization Linked to Increased Short- and Long-Term Cardiorespiratory Risk: JAMA
USA: Researchers have found in a new study that RSV infection, like influenza and SARS-CoV-2, was associated with a higher risk of cardiorespiratory events in the two weeks after RSV-related hospitalization, with some risks remaining significantly elevated for up to 180 days. The findings highlight the importance of expanding RSV immunization among adults.
The study, published in JAMA Network Open, was led by Caihua Liang from the Vaccines Real-World Evidence (RWE) Epidemiology group at Pfizer Inc, New York, and colleagues. The researchers examined whether respiratory syncytial virus (RSV), traditionally considered a pediatric pathogen, poses long-term cardiovascular and respiratory risks for adults following hospitalization.
Using a self-controlled case series design, the investigators analyzed real-world data from the Optum Market Clarity Dataset from January 2017 to March 2024. The analysis included 11,887 adults who had experienced at least one RSV-related hospitalization and at least one subsequent cardiorespiratory event. These events included myocardial infarction, stroke, exacerbations of chronic obstructive pulmonary disease (COPD) and congestive heart failure (CHF), as well as cardiac arrhythmias. The average age of participants was nearly 70 years, and more than 60% were women, reflecting a population already vulnerable to cardiopulmonary complications.
The researchers compared the incidence of cardiorespiratory events during the risk window—defined as up to 180 days after RSV-related hospitalization—with control periods before or well after the index hospitalization.
The following are the key findings:
- The risk of cardiorespiratory events increased markedly after discharge from RSV-related hospitalization, particularly within the first two weeks.
- The highest risk elevations occurred during the first seven days, indicating an acute period of post-infection vulnerability.
- The risk of myocardial infarction was nearly ninefold higher in the first week after hospitalization and remained significantly elevated in the following weeks.
- Stroke risk showed a similar pattern, with substantially increased incidence during the first three weeks after RSV-related admission.
- Exacerbations of congestive heart failure rose sharply soon after hospitalization and declined gradually, without immediately returning to baseline levels.
- COPD exacerbations exhibited the highest relative risk shortly after RSV hospitalization.
- Cardiac arrhythmias were also strongly associated with the early post-hospitalization period.
- Although risks declined over time, several cardiorespiratory outcomes remained elevated for up to 180 days after admission.
According to the authors, these findings suggest that RSV infection may act as a trigger for acute and longer-term cardiopulmonary instability, similar to patterns previously reported with influenza and COVID-19. The prolonged risk window underscores that the burden of RSV in adults extends well beyond the immediate respiratory illness.
Overall, the study reinforces the clinical and public health importance of preventing RSV in older adults and high-risk populations. The authors emphasize that expanding adult RSV immunization strategies could play a key role in reducing not only hospitalizations but also serious downstream cardiorespiratory complications.
Reference:
Liang C, Judy J, Aliabadi N, et al. Risk of Cardiorespiratory Events Following Respiratory Syncytial Virus–Related Hospitalization. JAMA Netw Open. 2026;9(2):e2556767. doi:10.1001/jamanetworkopen.2025.56767
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