Hospitalized Older Adults With RSV Commonly Experience Severe Acute Cardiac Events, Study Finds

Hospitalized older adults with respiratory syncytial virus (RSV) often have acute cardiac events that are associated with severe clinical outcomes, according to a study published in JAMA Network Open.

“Comprehensive data about potential cardiac complications of RSV infection, similar to what are available for hospitalizations for influenza or SARS-CoV-2 infections, could help guide clinical and public health practices, characterize the burden of RSV-associated cardiovascular disease prior to the introduction of novel vaccines, and prompt studies evaluating the prevention of acute cardiac events through RSV vaccination,” explained Rebecca Woodruff, PhD, MPH, Division for Heart Disease and Stroke Prevention, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention in Atlanta, Georgia, and coauthors.

To estimate the period prevalence of acute cardiac events among hospitalized adults aged 50 years or older with RSV infection, researchers performed a cross-sectional study within 12 states over 5 RSV seasons annually from 2014 to 2015, through 2017 to 2018, and 2022 to 2023.

The period prevalence of acute cardiac events among the 6248 hospitalized patients was 22.4% (95% CI, 21.0%-23.7%). Acute heart failure was the most common event, affecting 15.8% of patients, followed by acute ischemic heart disease at 7.5%, and less frequent events like hypertensive crisis (1.3%) and ventricular tachycardia (1.1%). Patients with a history of cardiovascular disease had significantly higher rates of acute cardiac events (33.0%) compared with those without (8.5%).

Older patients aged 85 years or older and those with existing cardiovascular conditions such as heart failure, atrial fibrillation, and diabetes were at higher risk for acute cardiac events. Specifically, the risk of acute heart failure and ischemic heart disease was higher in older patients and those with heart failure or coronary artery disease.

Among the patients, 18.6% required intensive care unit (ICU) admission, 6.8% required invasive mechanical ventilation, and 4.9% died during hospitalization. Those who experienced an acute cardiac event were at higher risk for severe outcomes such as ICU admission (ARR, 1.54), mechanical ventilation (ARR, 2.00), and in-hospital death (ARR, 1.77) compared to those who did not experience such events.

“The results of this cross-sectional study over 5 RSV seasons suggest that acute cardiac events are prevalent among hospitalized adults aged 50 years or older who have laboratory-confirmed RSV infection, occurring in nearly one-quarter of hospitalizations,” concluded the study authors.

Reference

Woodruff RC, Melgar M, Pham H, et al. Acute cardiac events in hospitalized older adults with respiratory syncytial virus infection. JAMA Intern Med. doi:10.1001/jamainternmed.2024.0212