CDC Analysis: 8.6% of Adults Hospitalized With RSV Died in Hospital or Within 30 Days of Discharge

Nearly one in 10 adults hospitalized with respiratory syncytial virus died in the hospital or within a month of going home, according to a CDC analysis presented at the IDWeek annual meeting.

The numbers come from 18,301 adults hospitalized with RSV across eight seasons between 2014 and 2024. Of them, 8.6% (1,565 people) died during the stay or within 30 days after discharge.

The numbers

More than half of those deaths, 812, happened in the hospital. Another 753 came after discharge.

Of the 753 post-discharge deaths, 286 involved patients sent to hospice. That leaves 467 people who died within 30 days after being discharged somewhere other than hospice. That is 2.6% of everyone hospitalized with RSV in the data.

Michael Melgar, MD, of the CDC in Atlanta, presented the findings. He said the 467 are the group that worries him most.

"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," Melgar said.

The death rate barely moved from season to season. The share of hospitalized adults who died ranged from 7.4% in 2018-2019 to 9.7% in 2015-2016. The share who died within 30 days after leaving for a non-hospice destination ran from 1.8% in 2022-2023 to 3.2% in 2019-2020.

Who died

The patients who died skewed old and sick. Of those who died in the hospital or within 30 days, 81.3% were 65 or older and 53.9% were female. About 69.7% were white and non-Hispanic. A full 89.0% had at least one underlying medical condition, and nearly half spent time in the ICU.

That profile matters for reading the headline number. Death within 30 days of a hospital stay does not by itself establish that RSV caused the death. Most of these patients were elderly with other illnesses. Melgar described the results as preliminary.

The analysis also does not break out what killed the patients after discharge. Adults hospitalized with RSV can face a sharp risk of cardiorespiratory events afterward, such as heart attack or stroke.

How the data was built

The CDC pulled the figures from RESP-NET, its Respiratory Virus Hospitalization Surveillance Network. The network tracks hospitalizations with lab-confirmed flu, COVID-19 or RSV in 14 states. It is a sample of states, not a national count.

RSV cases were identified by ICD-10 codes for RSV pneumonia, acute bronchitis due to RSV, or acute bronchiolitis due to RSV.

Vaccine and discharge recommendations

Adult RSV vaccination began in the 2023-2024 season. The vaccines delivered 75% effectiveness against RSV hospitalization. The CDC recommends a single dose of any of three FDA-licensed vaccines for all adults 75 and older, and for adults 50 to 74 at greater risk of severe RSV.

Melgar said the results "speak to an increased mortality risk in the immediate post-hospitalization period and support overarching prevention messaging about prioritizing recommended RSV vaccination for eligible adults." He also said the findings support stronger discharge planning and early follow-up after discharge.

That second point puts the burden on hospitals and doctors, not only on patients. The vaccine data covers hospitalization risk, and the analysis presented does not test whether closer follow-up would have changed any of the 467 outcomes.

It is unclear how many of those deaths RSV or its complications actually drove, and how many reflect the underlying conditions nearly nine in 10 of these patients already had. Melgar's results are preliminary, and a cause-of-death breakdown would be needed to answer it.