ArticleRespiratory research2026
Respiratory syncytial virus is associated with a higher disease burden than influenza and SARS-CoV-2 in adults with chronic lung disease: a multi-center cohort study.
Article in Respiratory research, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
backgroundComparative data on the disease burden of respiratory syncytial virus (RSV) versus other respiratory viruses in adults with chronic lung disease (CLD; asthma, COPD, or bronchiectasis) remain limited. This study aimed to compare clinical outcomes associated with RSV, influenza, and SARS-CoV-2 in this population during a period that largely preceded widespread adult RSV vaccine uptake.
methodsAdult patients diagnosed with CLD and confirmed to have RSV, influenza, or Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) infection through combo tests including polymerase chain reaction or rapid antigen testing from June 2022 to April 2024 were included. A total of 82,871 participants diagnosed with CLD who tested positive for RSV, influenza, or SARS-CoV-2 using combo tests were included in the analysis. Patients with co-existing viral infections were excluded. Short-term adverse outcomes were defined as events occurring within 28 days after the index date, while long-term adverse outcomes were defined as events that occurred between 12 to 52 weeks.
resultsAfter propensity score matching, RSV-infected patients had higher rates of exacerbations compared to those with influenza (HR:1.37, 95% CI:1.28–1.47) and those with SARS-CoV-2 (HR:2.98, 95% CI:2.73–3.26). These patients also showed an increased requirement for mechanical ventilation compared to those with influenza (HR:1.50, 95% CI:1.29–1.75) and those with SARS-CoV-2 (HR:1.97, 95% CI:1.67–2.33). Additionally, RSV-infected individuals experienced higher incidences of acute decompensated heart failure compared to influenza (HR:1.32, 95% CI:1.20–1.46), and (HR:1.46, 95% CI:1.32–1.61) relative to SARS-CoV-2, respectively.
conclusionsRSV infection in patients with CLD revealed higher disease severity compared to influenza and SARS-CoV-2, warranting increased clinical attention for this population. In this national cohort spanning June 2022 to March 2024, adults with chronic lung disease contracting RSV, influenza or SARS-CoV-2 were analyzed. Relative to the other viruses, RSV infection led to higher emergency visits, hospitalizations and mechanical ventilation, highlighting an urgent prevention gap.
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