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A CDC analysis covering eight RSV seasons found that 1,565 of 18,301 hospitalized adults died in hospital or within 30 days after discharge. Of those deaths, 467 occurred after discharge to somewhere other than hospice; researchers said the findings support vaccination for eligible adults and stronger post-hospital follow-up.
A CDC analysis of 18,301 adults hospitalized with RSV found that 8.6% died in hospital or within 30 days after discharge across eight RSV seasons from 2014 to 2024. Researchers reported that 467 patients died within 30 days of discharge after leaving for somewhere other than hospice, a finding they said supports attention to vaccination and post-hospital care.
Of the 1,565 deaths recorded during hospitalization or in the month after discharge, 812 occurred in hospital and 753 occurred after discharge. Among the post-discharge deaths, 286 people had been discharged to hospice. The other 467 deaths represent 2.6% of all adults in the analysis; the report does not establish that RSV caused each death.
CDC’s Michael Melgar presented the findings at the IDWeek annual meeting. The proportion of patients who died in hospital or within 30 days of discharge was broadly steady across seasons, ranging from 7.4% in 2018-2019 to 9.7% in 2015-2016. Deaths after discharge to a non-hospice destination ranged from 1.8% in 2022-2023 to 3.2% in 2019-2020.
Most people who died during hospitalization or within 30 days were 65 or older (81.3%), and 89.0% had at least one underlying medical condition. Nearly half were admitted to intensive care, while 29.1% received invasive mechanical ventilation. Patients who died after discharge were older on average than those who died in hospital, but were less likely to have had an ICU admission or invasive ventilation during their stay.
Deaths After RSV Discharge
The results draw attention to the period after an RSV hospitalization, when patients may still face serious health risks. The 467 non-hospice deaths within 30 days identify a group whose deaths were not already anticipated by a hospice discharge, according to the researcher presenting the findings. The analysis does not show what caused those deaths, but it raises the importance of considering follow-up needs after patients leave hospital.
Melgar said the findings support recommended RSV vaccination for eligible adults and stronger discharge planning and early follow-up. The analysis itself did not test whether vaccination or follow-up would have prevented deaths, so those recommendations should be understood as public-health implications rather than outcomes measured by the study.
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Eight Seasons of Hospital Data
Investigators used the CDC’s Respiratory Virus Hospitalization Surveillance Network (RESP-NET), which tracks hospitalizations involving laboratory-confirmed influenza, COVID-19 or RSV in 14 states. The RSV analysis covered the 2014-2024 period and identified cases using specified ICD-10 diagnosis codes for RSV pneumonia, bronchitis or bronchiolitis.
Adult RSV vaccines became available during the 2023-2024 season. The CDC recommends a single dose of any of three FDA-licensed RSV vaccines for all adults 75 and older, and for adults ages 50 to 74 at increased risk of severe RSV. The source report cites vaccine effectiveness of 75% against RSV hospitalization, but investigators did not examine vaccination status among the hospitalized patients in this analysis.
“We think this latter category is the most concerning, as these patients were likely discharged home or to some higher level of care — but they were probably not expected to die within a month of the hospitalization with RSV infection.”
— Michael Melgar, MD, CDC researcher, speaking at IDWeek
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What the Analysis Cannot Establish
The findings do not prove that RSV caused deaths recorded after hospitalization. The source report says deaths may have resulted from other causes, and the study did not determine the specific cause of each post-discharge death. It also did not assess vaccination status among patients hospitalized during the 2023-2024 season, so it cannot show whether vaccination affected the results.
The surveillance system may have missed some hospitalizations because it depended on clinician-driven testing. RESP-NET includes 14 states, and its results may not represent the entire United States. The analysis also reports associations with age and hospital outcomes, not proof that those factors caused a later death.
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Vaccination and Follow-Up Measures
The findings were presented as preliminary results at IDWeek. The report does not give a date for further analysis or describe a planned change to CDC guidance. The existing recommendation remains a single RSV vaccine dose for adults 75 and older and adults 50 to 74 at increased risk of severe disease.
For clinicians and health systems, the researchers’ stated implications are to consider discharge planning and early follow-up for adults hospitalized with RSV, alongside vaccination for eligible people. Further work would be needed to clarify causes of post-discharge deaths, assess the role of vaccination and determine how broadly the findings apply beyond the states covered by RESP-NET.
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Key Questions
How many adults in the analysis died after an RSV hospitalization?
753 of 18,301 patients died within 30 days after discharge. Another 812 died during hospitalization, making 1,565 deaths in total during hospital care or the 30-day post-discharge period.
Were all post-discharge deaths unexpected?
No. Of the 753 deaths after discharge, 286 people had been discharged to hospice. The other 467 had been discharged somewhere other than hospice; the presenting researcher said those deaths were the most concerning, but the analysis does not establish what was expected in each individual case.
Does the study show that RSV caused these deaths?
No. The analysis counted deaths during hospitalization or within 30 days of discharge, but did not establish that RSV caused each death. Other causes may have contributed.
Who is eligible for an RSV vaccine under CDC recommendations?
The source report says the CDC recommends a one-time dose of an FDA-licensed RSV vaccine for all adults 75 and older and adults ages 50 to 74 who are at increased risk of severe RSV. The analysis did not determine whether vaccination changed mortality among the patients studied.
Source: rss
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