RSV infection increases the risk of adverse cardiovascular events

Respiratory syncytial virus (RSV) infection can lead to severe outcomes, including pneumonia, hospitalization and death, especially in older adults (≥ 45 years) with chronic underlying health conditions. In these vulnerable populations, it has an overall disease burden comparable to that of seasonal influenza. Current evidence also supports that acute respiratory infections are strong, but transient, risk factors for cardiovascular disease. For example, influenza infection has been consistently associated with an increased short-term risk of myocardial infarction and stroke. Similarly, evidence is growing to suggest that RSV infection may also be an important trigger for acute cardiovascular disease in adults. However, data are lacking on the burden of cardiovascular disease from RSV infection beyond the immediate acute phase.To examine whether RSV infection is associated with an increased risk of cardiovascular events beyond the immediate acute phase, Danish researchers estimated the 365-day absolute excess risk (risk difference) of composites of cardiovascular disease and their individual components following lab-confirmed RSV infection in adults.The nationwide, matched cohort study was conducted using Danish national health registries. It included adults (aged ≥ 45 years) with a lab-confirmed RSV infection during 2019–2024, who were matched 1:1 on age, sex and preexisting comorbid conditions to individuals without RSV infection. Similar matched cohorts were established for influenza infection, hip fracture and urinary tract infection without sepsis as control groups.The primary outcomes were major adverse cardiovascular events (ischemic heart disease, stroke, heart failure), and any cardiovascular event (major adverse cardiovascular events together with arrhythmias, venous thromboembolism and inflammatory heart disease). Matched individuals were followed up for up to 365 days after the index date. Absolute risk differences and 95% confidence intervals (CIs) were calculated at 30 and 365 days.Key results:The study included 17,494 matched individuals (mean age, 71.8 years; 57.6% female), i.e., 8,747 individuals with a first-time recording of lab-confirmed RSV infection were matched 1:1 to 8,747 individuals without infection.At 365 days, 665 “any cardiovascular events” had occurred among 8,747 individuals with RSV infection and 257 among 8,747 individuals without infection, corresponding to a risk difference of 4.69 percentage points (95%CI, 4.02–5.36 percentage points).The largest 365-day risk differences for any cardiovascular event were seen in:hospitalized patients (6.61 percentage points [95%CI, 5.70–7.52 percentage points])older individuals (e.g., 7.93 percentage points [95%CI, 5.34–10.53 percentage points] for those aged 85–94 years)preexisting cardiovascular disease (11.95 percentage points [95% CI, 8.80–15.10 percentage points])diabetes (7.50 percentage points [95%CI, 4.53–10.47 percentage points]).A total of 8,823 individuals with laboratory-confirmed RSV infection were matched 1:1 to 8,823 individuals with laboratory-confirmed influenza infection. No significant differences in the cumulative incidences of any cardiovascular event and major adverse cardiovascular event were seen throughout the follow-up, meaning that the one-year cardiovascular event risk following RSV was comparable to that following influenza infection.The authors conclude that in this cohort study of adults 45 years of age or older, the cumulative incidences of any cardiovascular event and major adverse cardiovascular events were increased among individuals with RSV infection compared with those without infection throughout one year of follow-up. This significant excess risk of cardiovascular events was statistically significant, clinically meaningful and comparable in magnitude to that seen following influenza infection. The burden on day 365 of follow-up corresponded to 4.69 additional cardiovascular events per 100 individuals with RSV infection compared to those without infection. These study findings highlight the substantial and prolonged cardiovascular burden imposed by RSV infection. They underscore the importance of RSV infection as a potential risk factor for cardiovascular morbidity and the need for increased clinical vigilance for cardiovascular complications following RSV infection. The results also reinforce the need for vaccination in older adults to lessen this burden.ReferenceHviid A, Fischer TK, Biering-Sørensen T, et al. Cardiovascular events 1 year after respiratory syncytial virus infection in adults. JAMA Network Open 2025;8(12):e2547618. (accessed December 11, 2025).

RSV infection increases the risk of adverse cardiovascular events

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