Respiratory Syncytial Virus Infection <-> Heart Failure

Comorbidity A_BEFORE_B CURATED

Directional trajectory: RSV hospitalization in older adults is associated with subsequent cardiovascular events, including heart failure, in the year after infection. The Intercept essay cited a ~1.3x heart-failure risk; the best verifiable primary source (Verschoor 2025, JAGS) reports a substantially LARGER and adjusted effect (HR range 1.48-3.74 across comparator groups), so this entry is curated to the verified source rather than the blog figure. Notably the same Ontario group (Kwong et al.) also reported RSV as a trigger of acute MI (incidence ratio 3.51) in the influenza-MI study.

Disease A

Respiratory Syncytial Virus Infection

Slug:Respiratory_Syncytial_Virus_Infection

Disease B

Heart Failure

Slug:Heart_Failure

Causal Mechanism Graphs

Respiratory Syncytial Virus Infection

graph LR
    Nirsevimab["Nirsevimab"]
    Respiratory_Epithelial_Infection_and_Airway_Inflammation["Respiratory Epithelial Infection and Airway Inflammation"]

    Nirsevimab --> Respiratory_Epithelial_Infection_and_Airway_Inflammation

    style Nirsevimab fill:#fce7f3
    style Respiratory_Epithelial_Infection_and_Airway_Inflammation fill:#dbeafe

Association Signals

Signal 1

Population:Retrospective matched cohort of adults aged >=65 hospitalized with RSV vs influenza, urinary tract infection, or fracture comparators, Ontario, Canada, 2011-2020; cardiovascular outcomes to 1 year post-discharge.

Temporal: A before B: , B before A: , Same time:

HR:

CI: -

FDR:

Adjusted hazard-ratio range 1.48-3.74 for subsequent heart failure in RSV-hospitalized patients relative to each comparator group, in patients with or without pre-existing cardiovascular conditions.

PMID:40696870 (SUPPORT)

Source: HUMAN_CLINICAL

"RSV hospitalization was associated with a greater rate of subsequent heart failure events relative to all other patient groups (HR range, 1.48-3.74), both in patients with or without pre-existing cardiovascular conditions."

Matched cohort shows RSV hospitalization is associated with a higher rate of subsequent heart failure across all comparator groups.

Hypotheses

Acute RSV infection imposes systemic inflammatory and cardiopulmonary stress (hypoxemia, increased cardiac workload, a procoagulant/inflammatory milieu) that can precipitate incident or worsening heart failure, particularly in older adults, analogous to the post-influenza cardiovascular trigger.

PMID:40696870 (SUPPORT)

Source: HUMAN_CLINICAL

"Our findings suggest that RSV is an important determinant of serious post-discharge cardiovascular outcomes in older adults."

Supports RSV as a determinant of serious post-discharge cardiovascular outcomes, including heart failure, in older adults.

Pathophysiology:

Infection-associated cardiopulmonary stress: RSV-driven systemic inflammation and respiratory compromise increase cardiac demand and can precipitate heart failure.

Biological processes:

PMID:40696870 (SUPPORT)

Source: HUMAN_CLINICAL

"Our findings suggest that RSV is an important determinant of serious post-discharge cardiovascular outcomes in older adults."

Supports a link from RSV infection to subsequent serious cardiovascular outcomes.

Raw YAML

Show YAML

name: com_Respiratory_Syncytial_Virus_Infection__Heart_Failure
creation_date: "2026-06-25T12:00:00Z"
curation_status: CURATED
notes: >-
  Directional trajectory: RSV hospitalization in older adults is associated with
  subsequent cardiovascular events, including heart failure, in the year after
  infection. The Intercept essay cited a ~1.3x heart-failure risk; the best
  verifiable primary source (Verschoor 2025, JAGS) reports a substantially
  LARGER and adjusted effect (HR range 1.48-3.74 across comparator groups), so
  this entry is curated to the verified source rather than the blog figure.
  Notably the same Ontario group (Kwong et al.) also reported RSV as a trigger
  of acute MI (incidence ratio 3.51) in the influenza-MI study.

disease_a:
  slug: Respiratory_Syncytial_Virus_Infection

disease_b:
  slug: Heart_Failure

directionality: A_BEFORE_B

association_signals:
- source: LITERATURE
  method: EHR_COHORT_ASSOCIATION
  population: >-
    Retrospective matched cohort of adults aged >=65 hospitalized with RSV vs
    influenza, urinary tract infection, or fracture comparators, Ontario,
    Canada, 2011-2020; cardiovascular outcomes to 1 year post-discharge.
  directionality: A_BEFORE_B
  statistics:
    metrics:
    - metric_type: HR
      notes: >-
        Adjusted hazard-ratio range 1.48-3.74 for subsequent heart failure in
        RSV-hospitalized patients relative to each comparator group, in patients
        with or without pre-existing cardiovascular conditions.
    evidence:
    - reference: PMID:40696870
      supports: SUPPORT
      evidence_source: HUMAN_CLINICAL
      snippet: "RSV hospitalization was associated with a greater rate of subsequent heart failure events relative to all other patient groups (HR range, 1.48-3.74), both in patients with or without pre-existing cardiovascular conditions."
      explanation: >-
        Matched cohort shows RSV hospitalization is associated with a higher
        rate of subsequent heart failure across all comparator groups.

hypotheses:
- description: >-
    Acute RSV infection imposes systemic inflammatory and cardiopulmonary stress
    (hypoxemia, increased cardiac workload, a procoagulant/inflammatory milieu)
    that can precipitate incident or worsening heart failure, particularly in
    older adults, analogous to the post-influenza cardiovascular trigger.
  evidence:
  - reference: PMID:40696870
    supports: SUPPORT
    evidence_source: HUMAN_CLINICAL
    snippet: "Our findings suggest that RSV is an important determinant of serious post-discharge cardiovascular outcomes in older adults."
    explanation: >-
      Supports RSV as a determinant of serious post-discharge cardiovascular
      outcomes, including heart failure, in older adults.
  pathophysiology:
  - name: Infection-associated cardiopulmonary stress
    description: >-
      RSV-driven systemic inflammation and respiratory compromise increase
      cardiac demand and can precipitate heart failure.
    biological_processes:
    - preferred_term: inflammatory response
      term:
        id: GO:0006954
        label: inflammatory response
    evidence:
    - reference: PMID:40696870
      supports: SUPPORT
      evidence_source: HUMAN_CLINICAL
      snippet: "Our findings suggest that RSV is an important determinant of serious post-discharge cardiovascular outcomes in older adults."
      explanation: Supports a link from RSV infection to subsequent serious cardiovascular outcomes.

Source:GitHub