Study Finds Elevated RSV Hospitalization Rates in Patients With Asthma, COPD

Asthma and chronic obstructive pulmonary disease (COPD) could increase the risk of severe respiratory syncytial virus (RSV) infection, according to data published in Springer Nature Link. The analysis revealed that out of 100 adults hospitalized for RSV infection, an average of 19 had asthma, and an average of 31 had COPD.¹

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RSV can cause severe outcomes for certain individuals, including those who are aged 75 years and older and those with underlying medical conditions, such as chronic heart or lung disease or possessing a weakened immune system. Severe RSV could lead to hospitalization, causing fatal outcomes for some adults. According to the CDC, RSV can also exacerbate serious conditions such as asthma and COPD.²

Previous studies have confirmed RSV as a significant viral cause of acute asthma and COPD exacerbations. Further, RSV can lead to long-term issues in at-risk individuals, such as worsened lung function, reduced physical ability, and increased morality. The impact of RSV in hospitalized adults, especially those with asthma or COPD, is comparable with or greater than that of other respiratory viruses such as influenza and COVID-19.¹

In the current study, the researchers performed a systematic literature review including a total of 40 studies from PubMed and Embase databases to provide an up-to-date overview of RSV disease burden among adults aged 18 years and older with asthma and COPD. The study aimed to determine the prevalence of these respiratory conditions in individuals with confirmed RSV infection, measuring RSV-related hospitalization rates and associated risks. Additionally, the study investigated the complications and mortality rates linked to RSV in adults with asthma or COPD.¹

The study presented significant data for asthma and COPD groups, analyzing each outcome separately. Pooled prevalence estimates of asthma or COPD in adults with RSV were calculated from individual study percentages. The study authors noted that a generalized linear mixed effects meta-analysis, using a logit link function and maximum likelihood method, was employed to derive these pooled estimates. Age-stratified percentages were used in the meta-analysis to maintain data granularity without altering the final pooled estimates.¹

The results demonstrated that RSV-infected adults showed a high prevalence of asthma and COPD, with pooled estimates of 19.3% (15.0–24.6) for asthma and 30.8% (26.1–36.0) for COPD, particularly in hospitalized patients. Adults with asthma or COPD were significantly more likely to be hospitalized after RSV infection, with hospitalization incidence rate ratios of 2.0 to 3.6 (crude) and 6.7 to 8.2 (adjusted) for asthma and 3.2 to 13.4 (crude) and 9.6 to 9.7 (adjusted) for COPD.¹

Further results demonstrated that the most common RSV-related complications were exacerbations of asthma, reaching up to 64.9%, and COPD, reaching up to or exceeding 83.0%. In-hospital fatality rates ranged from 2.6% to 4.3% for asthma and 2.8% to 17.8% for COPD.¹

The study authors noted that the review had several limitations. This includes potential publication bias, demographic impacts that were not analyzed due to data gaps, methodological quality that varied as studies had differing objectives, and high heterogeneity across studies, which limits drawn conclusions.¹

The findings confirm that adults with asthma or COPD face a heightened risk of RSV-related illness, which can result in hospitalization, various complications like asthma or COPD exacerbations, ICU admission, and mechanical ventilation, as well as increased mortality.¹

However, the study authors noted that further research is needed to better understand the long-term impact of RSV on these vulnerable populations. Despite this, the current review contributes significantly to RSV epidemiology by providing updated evidence and a focused analysis on asthma and COPD in adults aged 18 and older.¹

REFERENCES

1. Burden of Respiratory Syncytial Virus Disease in Adults with Asthma and Chronic Obstructive Pulmonary Disease: A Systematic Literature Review. Springer Nature Link. News release. Published February 25, 2025. Accessed March 12, 2025. https://link.springer.com/article/10.1007/s11882-025-01194-w

2. RSV in Older Adults. CDC. New release. April 30, 2024. Accessed March 12, 2025. https://www.cdc.gov/rsv/older-adults/index.html#:~:text=other%20respiratory%20viruses.-,Severe%20RSV,and%20oxygen%20through%20the%20body