Acute cardiac events occurred in 22.4% of adults hospitalized for RSV

A new investigation in JAMA Internal Medicine highlights additional risks of respiratory syncytial virus (RSV) in older adults. It notes that 22.4% of patients, or roughly one in five older adults, hospitalized for RSV experience acute cardiac events.

The cross-sectional study evaluated data from the RSV Hospitalization Surveillance Network, reviewing information on adults aged 50 and older who had RSV across five seasons. The RSV seasons studied included the 2014–2015, 2015–2016, 2016–2017, 2017–2018, and 2022–2023 seasons, excluding the years at the height of the pandemic where RSV rates declined.

Evaluating RSV patients across the 12 states included in the study, the researchers noted severe disease outcomes, including intensive care unit (ICU) admission, invasive mechanical ventilation, and in-hospital death.

The researchers included insights from 6,248 hospitalized adults, noting a median age of 72.7. Over half of the study participants, 56.4%, had an underlying cardiovascular disease, which was weighed as the researchers assessed the incidence of acute cardiac events.

While the total prevalence of acute cardiac events was 22.4%, the highest prevalence was 15.8% for acute heart failure. Acute ischemic heart disease, hypertensive crisis, ventricular tachycardia, and cardiogenic shock followed at 7.5%, 1.3%, 1.1%, and 0.6%, respectively.

Stratifying patients by their history of underlying cardiovascular disease, the researchers found that older adults with a history of cardiovascular disease were more likely to experience acute cardiac events when hospitalized with RSV, with a prevalence of 33.0% compared to 8.5% among those who did not have a history of cardiovascular disease.

Additionally, the investigators considered ICU admissions and in-hospital deaths, noting an overall ICU admission rate of 18.6% and in-hospital mortality rate of 4.9%. Deeper analysis revealed that adults who experienced an acute cardiac event were over twice as likely to experience in-hospital death, at an 8.1% prevalence compared to 4.0%. Additionally, they also had an elevated risk of ICU admission at 25.8% compared to 16.5%.

The statistics extracted from this study emphasize the risk associated with contracting RSV in older adults. Additionally, it underscores the importance of RSV vaccine uptake, RSV prevention efforts, and public health practices to mitigate disease spread.