RSV: Understanding Its Impact and Laboratorial Implications

PREPARE collaboration analysis at Singapore General Hospital finds respiratory syncytial virus (RSV) causes substantial acute severity and short‑term mortality in hospitalized adults—matching COVID‑19 and exceeding influenza—shifting diagnostic and surveillance priorities toward adult RSV testing in hospital laboratories.

In hospitalized adults, the analysis quantifies a one‑in‑20 28‑day mortality (≈5%) after RSV admission and a higher incidence of acute cardiovascular events versus influenza and COVID‑19; primary endpoints were 28‑day mortality and acute cardiac, cerebrovascular, or thrombotic events.

Across large cohorts (≈13,000 admissions in the severity comparison, ≈33,000 in the cardiac‑event analysis, plus broader long‑term follow‑up cohorts), RSV exceeded influenza and matched COVID‑19 for short‑term mortality within admitted patients rather than community‑managed cases.

The PREPARE collaboration findings indicate hospitalized adults with RSV have elevated short‑term mortality and an increased risk of acute cardiovascular events compared with influenza and a comparable risk to COVID‑19.

These data support greater diagnostic attention to RSV in adult inpatient settings and adjustments to laboratory workflows and surveillance to enable early cardiac follow‑up and targeted post‑discharge monitoring.

Key Takeaways:

• For adults admitted with severe respiratory illness, prioritize lower‑respiratory or multiplex sampling that includes RSV, given higher 28‑day mortality and ICU admission rates versus influenza.
• Flag RSV‑positive inpatient results in laboratory workflows and link them to clinical pathways for targeted cardiac monitoring and early outpatient follow‑up.
• Broaden adult‑targeted multiplex testing and surveillance to capture seasonal and interseasonal RSV burden and permit systematic post‑discharge follow‑up for potential long‑term cardiovascular or neurological sequelae.