Outcomes and Mortality Risk Factors in Adults Hospitalised with RSV: A Descriptive Cohort Study in an Ageing Population

Abstract

Background Respiratory syncytial virus (RSV) is increasingly recognised as a significant cause of morbidity in older adults. However, real-world outcome data in this population remains limited. This retrospective observational study explores mortality, hospital course, and clinical predictors of outcome in a cohort of RSV-positive inpatients. Methods Data was collected for 89 adult inpatients (mean age 71.5 years; range 19–100) with laboratory-confirmed RSV infection admitted over a single winter season. Key outcomes included 30-, 60-, and 90-day mortality, length of stay (LOS), ICU admission, respiratory support, and antibiotic use. Kaplan-Meier survival analysis was performed, though limited by low event numbers. Results Overall 90-day mortality was 6.1%, with most deaths occurring within 10–20 days of admission. Non-survivors were significantly older (mean age 83.8 vs. 70.9 years), had longer LOS (median 8 vs. 3.5 days), and were more likely to require respiratory support and ICU care. ICU admission occurred in only 2.2% of patients. Antibiotic use was common (57.3%), with Co-Amoxiclav being most prescribed. Patients receiving antibiotics or advanced respiratory support (Airvo, BiPAP) had longer LOS (median 13–18 days). Thirty-day readmission occurred in 11.2% of discharged patients. Conclusion This cohort of RSV-positive inpatients demonstrated low short-term mortality despite advanced age and comorbidity. Mortality risk appeared highest in older patients requiring ICU-level care or respiratory support. Given the increasing burden of RSV in older adults, this study supports the need for preventative strategies, improved risk stratification, and resource planning—particularly as RSV vaccines and monoclonal therapies become more widely available.