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A CDC analysis covering 18,301 adult RSV hospitalizations from 2014 to 2024 found that 8.6% of patients died in hospital or within 30 days after discharge. Of the post-discharge deaths, 467 occurred among patients discharged somewhere other than hospice; researchers say the preliminary findings point to a need for prevention and closer follow-up, but deaths were not necessarily caused by RSV.
A CDC analysis of 18,301 adults hospitalized with RSV found that 8.6% died in hospital or within 30 days of discharge across eight RSV seasons from 2014 to 2024. The findings, presented at the IDWeek annual meeting, draw attention to deaths after patients leave the hospital, although researchers cautioned that the deaths were not necessarily caused by RSV.
Of the 1,565 patients who died during the study’s defined period, 812 died in hospital and 753 died within 30 days after discharge. Among the post-discharge deaths, 286 patients had been discharged to hospice. Another 467 died after discharge to somewhere other than hospice, representing 2.6% of all adults in the analysis who had been hospitalized with RSV.
Michael Melgar, MD, of the CDC in Atlanta, presented the findings. He said the deaths among people discharged somewhere other than hospice were of particular concern because those patients may have gone home or received another level of care without an expectation that they would die within a month. The researchers said the results are preliminary and support attention to RSV prevention, discharge planning and early follow-up.
The percentage of hospitalized patients who died during hospitalization or within 30 days afterward was relatively steady across the eight seasons, ranging from 7.4% in 2018-2019 to 9.7% in 2015-2016. Deaths within 30 days after discharge to somewhere other than hospice ranged from 1.8% in 2022-2023 to 3.2% in 2019-2020. These are observed proportions in the study, not estimates that RSV caused every death.
Deaths After Hospital Discharge
The findings focus attention on a period that can receive less scrutiny than the hospital stay itself: the first month after discharge. Nearly half of all patients who died during hospitalization or within 30 days after discharge had been admitted to intensive care, and 29.1% received invasive mechanical ventilation. However, those who died after discharge were less likely than in-hospital decedents to have had an ICU admission or invasive ventilation. That contrast does not establish why they died, but it underlines that serious outcomes also occurred among people who survived their hospital stay.
For patients and care teams, the report supports discussion of follow-up after a severe RSV illness as well as prevention before infection. The study does not test whether a particular discharge plan or follow-up schedule would prevent deaths. Its findings identify a pattern for further attention, rather than proving that a specific intervention would change outcomes.
The CDC recommends a one-time dose of any of three FDA-licensed RSV vaccines for adults 75 and older, and for adults ages 50 to 74 at increased risk of severe RSV. The analysis supports the broader prevention message, but it did not compare outcomes by vaccination status.
RSV vaccine for adults 75 and older
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How the CDC Tracked RSV Outcomes
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. RSV hospitalizations in this analysis were identified using specified ICD-10 diagnosis codes for RSV pneumonia, acute bronchitis due to RSV or acute bronchiolitis due to RSV. The report covered eight RSV seasons between 2014 and 2024.
Adult RSV vaccination began in the 2023-2024 season. The source report notes that an earlier estimate found 75% vaccine effectiveness against RSV hospitalization. Melgar said the investigators did not examine vaccination status among the hospitalized patients in that season, so this analysis cannot show whether vaccination affected the deaths it recorded.
Among patients who died in hospital or within 30 days after discharge, 81.3% were 65 or older, 53.9% were female, and 89.0% had at least one underlying medical condition. These figures describe the patients who died; they do not show that those characteristics alone caused the outcomes.
“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, presenting at the IDWeek annual meeting
Limits on What the Results Show
The study counted deaths during hospitalization and within 30 days after discharge, but those deaths may not have been caused by RSV. The analysis also did not determine whether deaths after discharge resulted from RSV-related complications, underlying conditions or other causes. It did not assess vaccination status among hospitalized patients in the 2023-2024 season, leaving the vaccine’s relationship to these outcomes unknown.
The authors identified possible underdetection of hospitalizations because testing depended on clinicians ordering tests. The surveillance network covered 14 states, and the report cautioned that its results may not represent the entire U.S. The available findings also do not establish whether more intensive discharge planning or follow-up would reduce mortality.
Follow-Up and Prevention Questions
The findings were presented as preliminary results at IDWeek. The source report does not specify a date for a full publication or describe a planned follow-up study. Further research could clarify causes of post-discharge deaths, assess outcomes by vaccination status and test whether earlier follow-up or different discharge practices affect risk.
For now, the CDC’s stated vaccine recommendations remain the relevant prevention guidance for eligible adults. Patients recovering from RSV hospitalization can discuss their follow-up and vaccination eligibility with a health professional; this analysis alone does not prescribe a particular care plan.
Key Questions
How many adults in the analysis died after an RSV hospitalization?
Among 18,301 hospitalized adults, 753 died within 30 days after discharge. A further 812 died in hospital, making 1,565 deaths, or 8.6%, during hospitalization or within 30 days after discharge.
Does the analysis show RSV caused all of these deaths?
No. The report says deaths may not be attributable to RSV. The analysis counted deaths in a defined period around hospitalization but did not establish the cause of each death.
What does the report say about deaths after discharge?
Of the 753 patients who died within 30 days after discharge, 286 had been discharged to hospice. Another 467 died after discharge somewhere other than hospice, equal to 2.6% of all hospitalized adults in the analysis.
Who is eligible for an RSV vaccine under CDC recommendations cited in the report?
The report says the CDC recommends a one-time dose of any of three FDA-licensed RSV vaccines for all adults 75 or older and for adults ages 50 to 74 at increased risk of severe RSV. The analysis did not compare deaths by vaccination status.
Source: rss
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