Burden and severity of respiratory syncytial virus infection in adults with cardiovascular diseases: A systematic literature review.

Abstract

Cardiovascular diseases (CVD) are risk factors for severe respiratory syncytial virus (RSV) infection, which in turn increases the risk of cardiovascular complications. The burden of RSV disease among adults with CVD is not yet fully understood and evidence remains to be consolidated through a systematic approach. Covering the publication period from January 1, 2000 to November 28, 2023, this systematic literature review documented RSV disease burden among adults ≥18 years with CVD including heart failure (HF), ischemic heart disease (IHD), and non-specified CVD. Relevant publications were retrieved from databases (PubMed, Embase) and gray literature (conference abstracts) to quantify the prevalence of CVD among RSV-infected adults, and RSV-related hospitalizations, complications, and mortality among adults with CVD. Sixty-two studies were selected for data extraction; most were conducted in the United States and among inpatients. The highest pooled estimates of CVD prevalence were observed among inpatients: 27.5 % (95 % confidence interval: 24.0-31.2) for HF, 22.9 % (17.7-29.0) for IHD, and 44.4 % (38.5-50.5) for non-specified CVD. Adults with CVD were at significantly higher risk of hospitalization following RSV infection compared to those without these comorbidities. Various general, respiratory, and cardiovascular complications attributable to RSV were documented among adults with CVD. RSV-related in-hospital case fatality rates of 7.8-14.8 % (HF), 13.7-20.0 % (IHD), and 2.9-12.5 % (non-specified CVD) were reported. This study shows that adults with CVD bear a significant burden of RSV infection, highlighting the need for effective RSV preventive measures and strategies (i.e., vaccination) targeting this high-risk population.