Abstract
BACKGROUND: Respiratory syncytial virus (RSV) infection has been associated with an increased risk of cardiac events. This systematic review aims to synthesise the evidence on the absolute and relative risks of cardiac events in adults with RSV disease. METHODS: We searched Embase, PubMed and grey literature sources for studies published between 1 January 2000 and 6 March 2024, reporting on cardiac events in adults with RSV disease. Study quality was assessed using a validated checklist. Absolute and relative risks of cardiac events following RSV disease were summarised and pooled estimates using random effects meta-analysis were calculated. RESULTS: Of 3887 publications, 28 met the inclusion criteria. Among hospitalised patients with RSV disease (25 studies), the pooled estimates showed that 19.2% (95% CI 15.1-24.2) experienced any cardiac event (including specific and unspecific events and combinations of cardiac events), 15.7% (95% CI 14.8-16.5%) heart failure (HF) and 5.4% (95% CI 3.1-9.5%) acute coronary syndrome (ACS). Cardiac event-related mortality ranged from 1.1 to 9.8%. Compared to influenza patients, those with RSV disease had a risk ratio of 1.2 (95% CI 1.1-1.4) for any cardiac event, 1.3 (95% CI 1.1-1.6) for HF and 1.2 (95% CI 0.9-1.5) for ACS. CONCLUSION: RSV disease poses significant risks beyond respiratory illness, including cardiac events, among older adult patients. RSV was associated with a higher risk of HF compared to influenza. Further research is needed to more precisely define the risk period of cardiac events following RSV disease.