CDC Reports Higher Than Expected Mortality Among RSV Hospitalizations

WASHINGTON — Analysis by the CDC of eight RSV seasons from 2014 to 2024 reveals that nearly 10% of adults hospitalized with respiratory syncytial virus (RSV) infection died either during hospitalization or within 30 days of discharge, a mortality rate previously underappreciated.

Of the 18,301 adults hospitalized with RSV during this period, 8.6% (1,565 patients) died, with over half (812) passing away during their hospital stay, while 753 died within 30 days post-discharge. Among those who died after leaving the hospital, 467 were discharged to locations other than hospice—representing a 2.6% mortality rate among all RSV hospitalized adults, according to CDC researcher Michael Melgar, MD, who presented these findings at the IDWeek conference.

“This latter group is particularly concerning because these patients were likely discharged home or to a higher level of care, yet many died within a month of hospitalization, which was not their expected outcome,” Melgar explained. He emphasized that these results highlight an elevated risk of death in the immediate post-hospital period and underscore the importance of vaccination and follow-up care for at-risk individuals.

RSV infections range from mild respiratory symptoms to severe pneumonia requiring hospitalization, with post-discharge complications such as cardiovascular events further complicating recovery. Vaccination against RSV became available for adults in the 2023-2024 season, demonstrating 75% effectiveness in preventing hospitalization. The CDC recommends a single dose of any FDA-approved vaccine for individuals aged 65 and older, as well as those aged 50-74 with underlying health conditions.

The study, conducted via the CDC’s Respiratory Virus Hospitalization Surveillance Network (RESP-NET) across 14 states, used ICD-10 codes to identify RSV cases. Annual mortality rates among hospitalized adults remained consistent, fluctuating between 7.4% and 9.7% over the eight seasons, with post-discharge deaths outside hospice showing similar stability. The majority of deceased patients were elderly (81.3%), female (53.9%), non-Hispanic white (69.7%), and had comorbidities (89%). Nearly half required ICU care, and nearly 30% underwent mechanical ventilation.

Survivors who died after discharge were more likely to be older (85.8% vs. 77.1% in-hospital deaths) and had lower ICU admission rates (29.9% vs. 66.5%) and ventilation use (10.5% vs. 46.3%). Comorbidity prevalence was higher among in-hospital fatalities (94.8% vs. 82.6%). Researchers noted the 2023-2024 vaccination rollout may influence outcomes, though vaccination data were not analyzed in this study. Limitations include potential underreporting of hospitalizations and the possibility that deaths were not directly caused by RSV, with findings not fully generalizable nationwide.

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