Cardiovascular Complications Following Respiratory Syncytial Virus Infection: A Systematic Review

Background
Respiratory Syncytial Virus (RSV) is widely recognized as a respiratory pathogen, but emerging evidence suggests it also leads to significant cardiovascular complications. The objective of this systematic review was to identify and summarize evidence on cardiovascular complications associated with RSV infection, specifically the types, prevalence and risks of cardiovascular events linked to RSV

Methods
A systematic search of PubMed, Embase, and Web of Science databases was conducted using the keywords “respiratory syncytial virus” and “cardiac complication.” Observational studies reporting laboratory-confirmed RSV infection and associated cardiovascular complications, and published in English were included. Articles were screened using Covidence software. Cardiovascular adverse events, prevalence and risks were narratively summarized.

Results
Of 287 records identified, nine studies comprising seven primary observational studies and two review articles comprising adult and/or pediatric populations, were included. Cardiovascular complications commonly reported included myocardial infarction, heart failure, and arrhythmias, particularly in hospitalized adults aged over 65 years. The prevalence of cardiovascular complications ranged 8% to 24.6% in hospitalized patients; 51% of high-risk hospitalized adults developed cardiac complications. Adults with pre-existing cardiovascular conditions were at greater risk (adjusted risk ratio 3.51 [95% confidence interval, CI 2.38 – 5.89]. Adults with pre-existing coronary arterial disease also had an increased odds of cardiovascular complications (adjusted OR 6.18, 95% CI 1.18–32.5). Cardiovascular complications were less frequently reported among children.

Conclusions
This review suggests a significant burden of cardiovascular complications following RSV infection, notably among older adults. High-risk groups could benefit from targeted preventive measures such as RSV vaccination programs.