TOPLINE:

Hospitalization for a respiratory syncytial virus (RSV) infection was associated with an increased risk for myocardial infarction, stroke, exacerbations of chronic obstructive pulmonary disease (COPD), exacerbations of congestive heart failure (CHF), and arrhythmias. The risk was highest in the first 2 weeks after hospitalization and persisted for up to 42 days for most conditions.

METHODOLOGY:

• Researchers conducted a retrospective analysis to assess whether adults had an increased risk for cardiorespiratory events in the 180 days following RSV-related hospitalization than during control periods.
• They included 11,887 adults (mean age, 69.4 years; 61.4% women) who had RSV-related hospitalization and at least one cardiorespiratory event.
• RSV-related hospitalization was identified by an RSV-positive test during admission or an RSV diagnosis or RSV-positive test result in a noninpatient setting followed by hospitalization within 14 days.
• The analysis compared the incidence of cardiorespiratory events during risk periods (≤ 180 days after RSV-related hospitalization) and control periods (> 21 days before or > 180 days after the date of RSV-related hospitalization).
• The cardiorespiratory events assessed were myocardial infarction, stroke, exacerbations of COPD, exacerbations of CHF, and arrhythmias.

TAKEAWAY:

• The incidence rate ratios (IRRs) for all outcomes were highest during days 1-7 after RSV-related hospitalization and remained elevated during days 8-14; the estimates during days 1-7 were highest for exacerbations of COPD (IRR, 23.1; 95% CI, 20.2-26.5) and arrhythmias (IRR, 16.5; 95% CI, 14.5-18.7).
• The IRRs were elevated for all outcomes (except exacerbations of COPD) for up to 42 days and attenuated over time. Risks for myocardial infarction and stroke remained significantly elevated for up to 63 days and that for exacerbations of CHF for up to 84 days.
• The most frequent cardiorespiratory events were arrhythmias (n = 5844), followed by exacerbations of COPD (n = 5018), exacerbations of CHF (n = 4204), myocardial infarction (n = 2421), and stroke (n = 1622).
• Among adults aged 75 years or older, early risk was more pronounced, with IRRs during days 1-7 after RSV-related hospitalization of 10.1 for myocardial infarction and 14.6 for exacerbation of CHF.

IN PRACTICE:

“Results of our study support a potential role of RSV infection in triggering cardiorespiratory complications in adults, especially older adults, and present a clinical and economic burden beyond the acute phase of the illness,” the authors wrote.

SOURCE:

The study was led by Caihua Liang, MD, PhD, Vaccines Real-World Evidence Epidemiology, Pfizer, Inc., New York City. It was published online on February 3, 2026, in JAMA Network Open.

LIMITATIONS:

The findings might not have been generalizable to people outside the US, uninsured individuals, or members of plans not represented in the dataset. The sensitivity of RSV coding in older adults was low because testing was limited, which may have led to missed cases and reduced statistical power. Unmeasured factors that changed over time could have influenced the findings. 

DISCLOSURES:

The study was sponsored by Pfizer, Inc. Seven authors reported being employees of Pfizer, and six reported owning stocks with Pfizer. One author reported receiving nonfinancial support from Genesis Research (funded by Pfizer), and another reported receiving personal fees from Genesis Research.

This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.