News: RSV hospitalizations linked to rise in month-long heart, lung complications
A self-controlled case series study published in the Journal of the American Medical Association (JAMA) suggests that respiratory syncytial virus (RSV) poses a far greater long-term health risk to adults in the months following hospitalization than previously understood, JustCoding reported. Examining 11,887 United States adults hospitalized with RSV between January 2017 and March 2024, researchers focused on five major outcomes:
- Myocardial infarction (MI)
- Stroke
- Chronic obstructive pulmonary disease (COPD) exacerbation
- Congestive heart failure (CHF) exacerbation
- Arrhythmia
Patients were included if they were aged 18 years or older, had an RSV-related hospitalization, and a cardiorespiratory event was identified during the observation period in the inpatient setting using ICD-10-CM codes. Categories and codes used in this study include:
- B97.4, J20.5, J12.1, and J21.0 for RSV
- I21.- and I22.- for MI
- I60.-, I61.-, I62.-, and I63.- for stroke
- J44.0 and J44.1 for COPD exacerbation
- I50.21, I50.23, I50.31, I50.33, I50.41. I50.43, I50.811, and I50.813 for CHF exacerbation
- I47.9, I48.20, I48.21, I49.1, I49.2, I49.3, I49.40, I49.49, I49.8, and I49.9 for arrhythmias
- I47.0, I47.2-, and I49.0- for ventricular arrhythmias
- I47.1- for paroxysmal supraventricular tachycardias
- I48.0, I48.1-, I48.3, I48.4, and I48.9- for atrial tachycardias
- I49.5 for brady-arrhythmias
The results found that the risk of complications surged immediately after RSV-related hospitalization, peaking in the first two weeks. Compared with control periods:
- MI risk was nearly nine times higher in the first week, gradually declining but still elevated in the following weeks
- The risk of stroke was more than seven times higher during the first week
- CHF exacerbation showed a similar pattern to stroke, with risk more than twelve times higher in the first week
- COPD exacerbation risk soared 23 times in the first seven days but decreased substantially after two weeks
- Arrhythmias were more than 16 times more likely during that first week and persisted up to 42 days
Although the magnitude of risk decreased over time, several conditions remained significantly elevated for at least 63 days, including MI, stroke, and CHF exacerbation. For some outcomes such as paroxysmal supraventricular tachycardia following a positive COVID-19 test result, increased risk persisted even longer for up to 180 days after hospitalization. This demonstrates that RSV, similar to influenza and COVID-19, is associated with an increased risk of cardiorespiratory events two weeks following RSV-related hospitalization, reinforcing the need to increase RSV immunization in adults.
Editor’s note: This article originally appeared in JustCoding.