Comprehensive Analysis of Cardiovascular Events and Risk Factors in Patients Hospitalized With Respiratory Syncytial Virus.

Abstract

Cardiovascular complications contribute to adverse outcomes in patients with influenza and severe acute respiratory syndrome coronavirus 2 infections. While the association of respiratory syncytial virus (RSV) infection with cardiovascular events (CVEs) has been described, data are limited. We performed a retrospective study of hospitalized patients with RSV in Rochester, New York, during the 2017-2020 winter seasons. A range of CVEs requiring medical intervention such as new congestive heart failure (CHF), atrial fibrillation or flutter (AF), myocardial infarction (MI), supraventricular and ventricular arrhythmias, venous thromboembolism and stroke, and exacerbations of preexisting CHF and AF were included. The cumulative numbers of CVE during a prehospitalization 6-month period, high-risk period of 28 days from admission, and late-risk period from day 29 to 6 months after admission were compared. Of 471 patients evaluated, 37% experienced CVEs in the high-risk period, with CHF (25%), AF (13%), and MI (9%) being the most common. Of these, 44% occurred in patients with no personal history of these conditions. However, age ≥65 years, preexisting hypertension, CHF, AF, and coronary artery disease, as well as the presence of ≥3 classic cardiac risk factors, were significantly associated with CVE during the high-risk period. Cardiac complications were associated with increased mortality in the high-risk period. The incidence rate ratio of CVEs was 18.5 and 1.6 during the high-risk and late-risk periods, respectively, compared to the prehospitalization period. Hospitalization with RSV was associated with increased risk of new CVEs as well as exacerbations of preexisting cardiovascular conditions, particularly in patients with comorbidities. This information is relevant for informed decision-making on RSV vaccination.