Study also shows long-term effects not limited to COVID-19
EXPERT Q&A
Full study: Long-Term Illness in Adults Hospitalized for Respiratory Syncytial Virus Disease, United States, February 2022-September 2023. (DOI: 10.3201/eid3114.241982)
Recovering from respiratory syncytial virus often doesn't end when it's time to leave the hospital, even for younger adults.
For months after discharge, a new study led by a University of Michigan researcher found that adults young and old often live with profound effects such as lingering breathlessness, difficulty performing daily activities and more.
The study showed it's not just the very young and elderly hit hard by RSV and left unwell for as long as a year after infection. While adults over age 65 make up the largest proportion of RSV deaths followed by young children, all ages are at risk of serious RSV.
The toll that RSV, an infection that can be prevented or made less severe with vaccination, is detailed in a study published in Emerging Infectious Diseases, the peer-reviewed, weekly journal of the Centers for Disease Control and Prevention.
Aleda Leis, a research assistant professor in epidemiology at the U-M School of Public Health, led the study that was funded by CDC. Leis explains more:
What were the most surprising or significant findings about the physical and mental health of RSV survivors after hospitalization?
Overall, we found that many patients hospitalized with RSV had poor physical functioning, functional impairment and persistent symptoms including shortness of breath six to 12 months after their hospitalization-regardless of age.
One of our most surprising findings was that many patients hospitalized with RSV were younger than 60 years old. RSV is generally thought to cause severe illness primarily in very young children and older adults, but our study shows that younger adults can also experience serious RSV infections requiring hospitalization.
Interestingly, we found very few significant differences in our long-term outcomes between those respondents younger than 60 and those 60 years and older. One of our biggest findings was that older adults had higher odds of losing at least one independent activity of daily living compared to before their illness than those under 60.
On the other hand, we found that younger adults had higher odds of more significant sleep disturbances compared to older adults. We're hoping to dig more into the causes of some of these effects in future research.
Why study the long-term outcomes in adults hospitalized with RSV?
The COVID-19 pandemic really brought the possibility of long-term outcomes following viral illness into the spotlight. While long COVID has received significant attention, lasting effects can happen after illness with other acute respiratory viruses, including RSV.
Since there are limited treatment options for RSV, it's important to understand the potential long-term outcomes of severe RSV infection so that clinicians and public health workers can identify who might benefit from additional follow-up after illness. This information can also help inform efforts to prevent disease or reduce severity, such as through vaccination, which is now available to certain groups of adults.
How is this research different from previous work on RSV?
Our research differs from previous work on RSV in a few key areas. First, while most studies have focused on adults over 60 years of age, our study includes those 18 years and older hospitalized with RSV. Additionally, our follow-up period is longer than that of most other studies, including outcomes six to 12 months after their acute illness. We also offered surveys in both English and Spanish, and our participants came from a large nationwide cohort of adults with severe acute respiratory infection. Combined, these strengths allowed us to gain a more generalizable understanding of longer-term outcomes after severe RSV in adults.
How did the long-term effects of RSV compare to those seen in adults hospitalized for COVID-19? Are there important similarities or differences?
We found that those hospitalized with RSV reported similar outcomes to those hospitalized with COVID-19. In both situations, there was moderately low physical functioning and quality of life. The notable exception is dyspnea, or shortness of breath. Those with RSV had almost two times higher odds of more severe dyspnea six to 12 months after their hospitalization than those with COVID-19.
What do you want people to learn from this study?
We hope the takeaway from our study is that long-term effects can happen after respiratory illnesses other than COVID-19, too. For those with RSV, these long-term effects appeared similar to those after COVID-19, and younger adults with RSV had similar long-term outcomes to older adults. We hope that this study can help provide more information about the risks of RSV in adults beyond the acute infection phase and the potential benefits of RSV prevention such as vaccination.
