Adults hospitalized with respiratory syncytial virus (RSV) face a significantly greater risk of acute cardiovascular events compared to those admitted for COVID-19 or influenza, according to new findings from a population-based study.
In this cross-sectional analysis of 32,960 hospitalizations in Singapore, 10.9% of unvaccinated adults hospitalized for RSV experienced an acute cardiovascular event, including dysrhythmias, heart failure, cerebrovascular, or thrombotic events. The study compared outcomes across RSV, influenza, and Omicron XBB/JN.1 COVID-19 hospitalizations from 2017 to mid-2024, prior to the rollout of RSV vaccines in the region.
Adjusted analyses revealed that patients hospitalized for RSV had significantly higher odds of cardiac complications than those with COVID-19 who had received three or more vaccine doses. Specifically, the adjusted odds ratio (AOR) for any cardiovascular event in RSV vs boosted COVID-19 patients was 1.31 (95% CI, 1.12–1.54), with greater risks seen for dysrhythmia (AOR, 1.52) and heart failure (AOR, 1.75). Similar elevated risks were observed when RSV was compared to unboosted COVID-19 hospitalizations.
While overall odds of cardiovascular events did not differ significantly between RSV and influenza cases, RSV hospitalizations during the post-pandemic period (2023–2024) were associated with over twice the odds of heart failure compared to contemporaneous vaccine-breakthrough influenza cases (AOR, 2.09; 95% CI, 1.21–3.59).
Importantly, cardiovascular events during RSV hospitalization were strongly associated with severe clinical courses requiring intensive care (AOR, 2.36; 95% CI, 1.21–4.62), underscoring the clinical significance of cardiac complications in RSV cases.
These findings highlight the need to evaluate the role of RSV vaccination, now available for older adults, in mitigating cardiovascular risks. Clinicians managing patients with preexisting heart conditions or advanced age should remain vigilant during RSV seasons and consider preventive strategies to reduce severe outcomes.
Reference:
Wee LE et al. Cardiac Events in Adults Hospitalized for Respiratory Syncytial Virus vs COVID-19 or Influenza. JAMA Netw Open. 2025;8(5):e2511764.
