a I studied yesterday in JAMA Internal Medicine Researchers found that 22% of adults aged 50 and older hospitalized with respiratory syncytial virus (RSV) infection experienced acute heart disease, most commonly acute heart failure (16%). is showing. Furthermore, 1 in 12 (8.5%) of the infected patients had no known underlying cardiovascular disease.

RSV is associated with a total of up to 160,000 hospitalizations, 10,000 deaths, and $4 billion in direct medical costs annually in adults aged 65 and older in the United States.

“DDespite evidence that RSV-related morbidity, mortality, and health care costs are substantial, the potential severity of RSV infection in adults has historically been underestimated by public health professionals and clinicians. I did.” the authors write. They added that RSV is rarely tested in clinical settings and symptoms usually reflect other respiratory illnesses.

DDespite evidence of substantial RSV-related morbidity, mortality, and health care costs, the potential severity of RSV infection in adults has been historically underestimated.

The study looked at outcomes for 6,248 adults aged 50 and older who were hospitalized for respiratory syncytial virus in 12 U.S. states from 2014 to 2018 and then in 2022 and 2023. Almost 60% of adults were female and 65.9% were Caucasian.

Upon admission to the hospital, 93.1% of study participants had a fever and 80.6% had symptoms of cough.

Most common events in heart failure

A total of 56.4% of patients had underlying cardiovascular disease, including 31.9% heart failure, 30.2% coronary artery disease, and 25.2% atrial fibrillation. After cardiovascular disease, diabetes (35%) and chronic obstructive pulmonary disease (34.8%) were the most common underlying conditions.

According to the authors, the weighted estimated prevalence of acute cardiac events in adults aged 50 years and older hospitalized with laboratory-confirmed respiratory syncytial virus infection was 22.4% (95% confidence interval). [CI]Among these events, acute heart failure was the most common, with a prevalence of 15.8% (95% CI, 14.6% to 17.0%) among all RSV-infected patients.

Patients with underlying cardiovascular disease had a higher weighted risk of experiencing any category of acute cardiac event compared to patients without underlying cardiovascular disease (33.0% vs. 8.5%). A history of heart failure, age >85 years, and atrial fibrillation were also associated with a higher risk of acute cardiac events.

Experiencing acute cardiac events during hospitalization was also associated with more severe RSV outcomes, including intensive care unit admission, invasive mechanical ventilation, and in-hospital death.

”Acute cardiac events occurred frequently in adults with a history of underlying cardiovascular disease, particularly chronic heart failure.” The authors concluded. ”However, acute heart disease occurs in as many as 1 in 12 adults without a history of cardiovascular disease, and severe RSV infection can worsen or reveal previously undiagnosed cardiovascular disease. It was suggested that this is possible.”

RSV vaccine uptake rate is low

However, there is growing awareness of the high cost of RSV in the United States, and the first vaccine for adults 65 and older was approved for use in older Americans in 2023.

in the editor Note has been published About this study, Tracy Wang, MD, MHS; JAMA Internal Medicine The associate editor warns that uptake of respiratory syncytial virus vaccination among older adults in the United States is very low, much lower than influenza vaccination.

“Previous RSV-related efforts have focused on infants and young children, and many clinicians and patients are still unaware of the disease burden and prognosis of RSV in older adults,” Wang wrote. . Additionally, the RSV vaccine is not consistently covered by insurance companies.

“This difference in coverage means that many clinics will need to refer patients to a pharmacy for vaccination, which may require a co-pay,” she said. added. “Vaccine fatigue and access barriers among currently eligible populations need to be addressed to encourage uptake among those who stand to benefit.”