Impact of RSV infection on mortality, rehospitalization, and long-term pulmonary, cardiovascular, and functional outcomes in hospitalized adults: a systematic review and meta-analysis
Bibliographic record
Abstract
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. CLINICAL TRIAL NUMBER: Not applicable.
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.002 | 0.001 |
| Meta-epidemiology (narrow) | 0.001 | 0.000 |
| Meta-epidemiology (broad) | 0.009 | 0.004 |
| Bibliometrics | 0.002 | 0.001 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.001 |
| Insufficient payload (model declined to judge) | 0.000 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".