Study Finds RSV Positivity Not Linked to Higher Mortality in Adults With Acute Respiratory Illness
A study leveraging data from the Respiratory Virus Laboratory Emergency Department Network Surveillance (RESP-LENS) has found that adults who tested positive for respiratory syncytial virus (RSV) were not at a higher risk of death or hospitalization compared to those who tested negative. The findings, published from a large national surveillance effort, offer insights into the impact of RSV on adult patients presenting with acute respiratory illness (ARI) in emergency departments (EDs).
The study, conducted between August 2021 and March 2024, analyzed data from 91 hospitals in the US and was supported by the Centers for Disease Control and Prevention (CDC). Researchers aimed to determine the relationship between RSV positivity and 30-day mortality while adjusting for multiple factors.
Of the more than 1 million patients with ARI included in the study, 345 185 adults underwent RSV testing as part of routine care. Among those tested, 2.4% were found to be RSV-positive. The overall mortality rate for patients who were RSV-positive was 1.9%, compared with 2.9% for patients who were RSV-negative. Among adults aged 65 years and older who tested positive for RSV, the mortality rate increased to 3.8%.
However, when researchers adjusted for multiple variables in a generalized estimating equation model, RSV positivity was not associated with an increased risk of hospitalization (adjusted odds ratio, 0.79; 95% CI, 0.75-0.84) or 30-day mortality (odds ratio, 0.62; 95% CI, 0.53-0.74). Instead, factors such as advanced age (≥ 65 years), male sex, worsening vital signs, and heart failure were independently linked to higher mortality risk.
The findings challenge the perception that RSV infection in adults is necessarily linked to worse clinical outcomes. While RSV has long been recognized as a leading cause of respiratory infections in older adults, the study suggests that RSV positivity alone does not significantly contribute to mortality risk in adults presenting to the ED with ARI.
Reference
Kline JA, Welch RD, Kabrhel C, Courtney DM, Camargo, Jr. CA, RESP-LENS site investigators. Laboratory confirmation of respiratory syncytial virus infection is not associated with an increased risk of death in adults with acute respiratory illness. Open Forum Infect Dis. 2025;15;12(2):ofaf004. doi:10.1093/ofid/ofaf004
