{"title":"呼吸道合胞病毒感染对住院成人死亡率、再住院以及长期肺、心血管和功能结局的影响：一项系统回顾和荟萃分析","authors":"Josef Yayan","doi":"10.1186/s12985-025-02785-9","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>Respiratory syncytial virus (RSV) is increasingly recognized as a significant pathogen in adults, particularly those with underlying comorbidities. However, the burden of RSV on post-hospital outcomes remains underexplored. This study aimed to assess the impact of RSV infection on mortality, rehospitalization, and long-term pulmonary, cardiovascular, and functional outcomes in hospitalized adults.</p><p><strong>Methods: </strong>A systematic review and meta-analysis were conducted according to PRISMA 2020 guidelines. A comprehensive search of major databases until February 2025 identified cohort and observational studies reporting on clinical outcomes in adults with laboratory-confirmed RSV infection. A total of seven eligible studies encompassing 180,125 patients were included. Pooled odds ratios (OR) with 95% confidence intervals (CI) were calculated using a random-effects model. The risk of bias was assessed using the Newcastle-Ottawa Scale and the ROBINS-I tool. Funnel plots and Egger's test were used to assess publication bias.</p><p><strong>Results: </strong>RSV infection was associated with significantly increased 30-day mortality (OR 0.22, 95% CI: 0.12-0.41; P < 0.01, I² = 96%) and 90-day mortality (OR 0.30, 95% CI: 0.19-0.46; P < 0.01, I² = 97%). Although the odds ratios are below 1, this indicates higher mortality in RSV-positive patients, as the reference groups had lower risk. Statistically significant associations were also found for cardiovascular complications (OR 0.46, 95% CI: 0.33-0.64) and functional impairments (OR 0.57, 95% CI: 0.42-0.78). No significant association was identified for 90-day rehospitalization (OR 0.67, 95% CI: 0.39-1.14) or pulmonary impairments (OR 1.09, 95% CI: 0.79-1.50). Heterogeneity was high across most outcomes. Publication bias was only evident for the 30-day mortality outcome.</p><p><strong>Conclusions: </strong>RSV infection in hospitalized adults is associated with elevated short- and medium-term mortality, as well as increased risk of cardiovascular and functional complications post-discharge. These findings highlight the need for RSV-specific prevention strategies, including vaccination and post-acute care planning, particularly for vulnerable adult populations.</p><p><strong>Clinical trial number: </strong>Not applicable.</p>","PeriodicalId":23616,"journal":{"name":"Virology Journal","volume":"22 1","pages":"160"},"PeriodicalIF":4.0000,"publicationDate":"2025-05-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12103016/pdf/","citationCount":"0","resultStr":"{\"title\":\"Impact of RSV infection on mortality, rehospitalization, and long-term pulmonary, cardiovascular, and functional outcomes in hospitalized adults: a systematic review and meta-analysis.\",\"authors\":\"Josef Yayan\",\"doi\":\"10.1186/s12985-025-02785-9\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background: </strong>Respiratory syncytial virus (RSV) is increasingly recognized as a significant pathogen in adults, particularly those with underlying comorbidities. However, the burden of RSV on post-hospital outcomes remains underexplored. This study aimed to assess the impact of RSV infection on mortality, rehospitalization, and long-term pulmonary, cardiovascular, and functional outcomes in hospitalized adults.</p><p><strong>Methods: </strong>A systematic review and meta-analysis were conducted according to PRISMA 2020 guidelines. A comprehensive search of major databases until February 2025 identified cohort and observational studies reporting on clinical outcomes in adults with laboratory-confirmed RSV infection. A total of seven eligible studies encompassing 180,125 patients were included. Pooled odds ratios (OR) with 95% confidence intervals (CI) were calculated using a random-effects model. The risk of bias was assessed using the Newcastle-Ottawa Scale and the ROBINS-I tool. Funnel plots and Egger's test were used to assess publication bias.</p><p><strong>Results: </strong>RSV infection was associated with significantly increased 30-day mortality (OR 0.22, 95% CI: 0.12-0.41; P < 0.01, I² = 96%) and 90-day mortality (OR 0.30, 95% CI: 0.19-0.46; P < 0.01, I² = 97%). Although the odds ratios are below 1, this indicates higher mortality in RSV-positive patients, as the reference groups had lower risk. Statistically significant associations were also found for cardiovascular complications (OR 0.46, 95% CI: 0.33-0.64) and functional impairments (OR 0.57, 95% CI: 0.42-0.78). No significant association was identified for 90-day rehospitalization (OR 0.67, 95% CI: 0.39-1.14) or pulmonary impairments (OR 1.09, 95% CI: 0.79-1.50). Heterogeneity was high across most outcomes. Publication bias was only evident for the 30-day mortality outcome.</p><p><strong>Conclusions: </strong>RSV infection in hospitalized adults is associated with elevated short- and medium-term mortality, as well as increased risk of cardiovascular and functional complications post-discharge. These findings highlight the need for RSV-specific prevention strategies, including vaccination and post-acute care planning, particularly for vulnerable adult populations.</p><p><strong>Clinical trial number: </strong>Not applicable.</p>\",\"PeriodicalId\":23616,\"journal\":{\"name\":\"Virology Journal\",\"volume\":\"22 1\",\"pages\":\"160\"},\"PeriodicalIF\":4.0000,\"publicationDate\":\"2025-05-24\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12103016/pdf/\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Virology Journal\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1186/s12985-025-02785-9\",\"RegionNum\":3,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q2\",\"JCRName\":\"VIROLOGY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Virology Journal","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1186/s12985-025-02785-9","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"VIROLOGY","Score":null,"Total":0}
Impact of RSV infection on mortality, rehospitalization, and long-term pulmonary, cardiovascular, and functional outcomes in hospitalized adults: a systematic review and meta-analysis.
Background: Respiratory syncytial virus (RSV) is increasingly recognized as a significant pathogen in adults, particularly those with underlying comorbidities. However, the burden of RSV on post-hospital outcomes remains underexplored. This study aimed to assess the impact of RSV infection on mortality, rehospitalization, and long-term pulmonary, cardiovascular, and functional outcomes in hospitalized adults.
Methods: A systematic review and meta-analysis were conducted according to PRISMA 2020 guidelines. A comprehensive search of major databases until February 2025 identified cohort and observational studies reporting on clinical outcomes in adults with laboratory-confirmed RSV infection. A total of seven eligible studies encompassing 180,125 patients were included. Pooled odds ratios (OR) with 95% confidence intervals (CI) were calculated using a random-effects model. The risk of bias was assessed using the Newcastle-Ottawa Scale and the ROBINS-I tool. Funnel plots and Egger's test were used to assess publication bias.
Results: RSV infection was associated with significantly increased 30-day mortality (OR 0.22, 95% CI: 0.12-0.41; P < 0.01, I² = 96%) and 90-day mortality (OR 0.30, 95% CI: 0.19-0.46; P < 0.01, I² = 97%). Although the odds ratios are below 1, this indicates higher mortality in RSV-positive patients, as the reference groups had lower risk. Statistically significant associations were also found for cardiovascular complications (OR 0.46, 95% CI: 0.33-0.64) and functional impairments (OR 0.57, 95% CI: 0.42-0.78). No significant association was identified for 90-day rehospitalization (OR 0.67, 95% CI: 0.39-1.14) or pulmonary impairments (OR 1.09, 95% CI: 0.79-1.50). Heterogeneity was high across most outcomes. Publication bias was only evident for the 30-day mortality outcome.
Conclusions: RSV infection in hospitalized adults is associated with elevated short- and medium-term mortality, as well as increased risk of cardiovascular and functional complications post-discharge. These findings highlight the need for RSV-specific prevention strategies, including vaccination and post-acute care planning, particularly for vulnerable adult populations.
期刊介绍：
Virology Journal is an open access, peer reviewed journal that considers articles on all aspects of virology, including research on the viruses of animals, plants and microbes. The journal welcomes basic research as well as pre-clinical and clinical studies of novel diagnostic tools, vaccines and anti-viral therapies.
The Editorial policy of Virology Journal is to publish all research which is assessed by peer reviewers to be a coherent and sound addition to the scientific literature, and puts less emphasis on interest levels or perceived impact.
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