TL;DR
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A CDC analysis of 18,301 adults hospitalized with RSV from 2014 to 2024 found that 8.6% died in hospital or within 30 days after discharge. Of those deaths, 467 occurred after discharge to somewhere other than hospice. The preliminary findings point to risk after hospitalization, but the study cannot establish that RSV caused every death.
A CDC analysis spanning eight RSV seasons found that 8.6% of 18,301 adults hospitalized with respiratory syncytial virus died in the hospital or within 30 days after discharge. The findings, presented at the IDWeek annual meeting, include 467 patients who died after leaving the hospital for somewhere other than hospice, highlighting a period of risk that may warrant attention in discharge planning and follow-up.
Researchers counted 1,565 deaths during hospitalization or within 30 days after discharge among adults hospitalized with RSV between 2014 and 2024. More than half occurred in hospital: 812 deaths. The other 753 occurred after discharge, including 286 people discharged to hospice. The remaining 467 died after discharge to a destination other than hospice, equal to 2.6% of all adults in the analysis.
Michael Melgar, MD, of the CDC in Atlanta, presented the findings. He said the researchers considered deaths after discharge to somewhere other than hospice the most concerning category because patients may have gone home or to another care setting without an expectation of dying within a month. That interpretation does not establish where each patient was discharged or what caused each death.
The share of hospitalized adults who died in hospital or within 30 days of discharge remained within a range across the seasons: from 7.4% in 2018-2019 to 9.7% in 2015-2016. Deaths after discharge to somewhere other than hospice ranged from 1.8% in 2022-2023 to 3.2% in 2019-2020. These figures describe the study population; they are not estimates of an individual patient’s risk.
Risk May Continue After Discharge
The analysis draws attention to deaths occurring after patients leave the hospital, when care shifts from inpatient teams to families, outpatient clinicians, or other facilities. Melgar said the results support stronger discharge planning and early follow-up for people hospitalized with RSV. The study did not test whether particular follow-up practices would prevent deaths, so it points to a potential care gap rather than proving a solution.
The findings also add to prevention messaging for adults eligible for RSV vaccination. Adult RSV vaccines became available in the 2023-2024 season. The CDC recommends a one-time dose for adults aged 75 and older, and for adults aged 50 to 74 at increased risk of severe RSV. The analysis did not establish whether vaccination changed the observed death rates.
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How the CDC Counted RSV Deaths
CDC investigators used the 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 diagnosis codes for RSV pneumonia, acute bronchitis due to RSV, or acute bronchiolitis due to RSV. The findings cover adults hospitalized across eight RSV seasons, from 2014 through 2024.
Among people 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. Nearly half had been admitted to intensive care, and 29.1% received invasive mechanical ventilation. Those who died after discharge were older on average than those who died in hospital: 85.8% versus 77.1% were at least 65. In-hospital intensive care and ventilation were less common among the post-discharge group.
The CDC recommends a single dose of any of three FDA-licensed RSV vaccines for adults aged 75 or older, and for adults aged 50 to 74 at higher risk of severe disease. The source material reports vaccine effectiveness of 75% against RSV hospitalization; that figure concerns hospitalization prevention, not the study’s post-discharge mortality measure.
“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 IDWeek
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Limits on What the Findings Show
The analysis found deaths occurring after RSV hospitalization, but the deaths may not have been caused by RSV. The CDC researchers also did not examine vaccination status among hospitalized patients during the 2023-2024 season, when adult vaccines were introduced, so the analysis cannot show how vaccination may have affected its results.
RESP-NET covers 14 states, and the researchers cautioned that the findings may not represent the whole United States. Hospitalizations could also have been missed because the surveillance depends in part on clinicians ordering tests. The source report describes the results as preliminary; it does not provide a comparison group or establish why some patients died after discharge.
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Follow-Up and Vaccine Questions
The findings support attention to discharge planning and prompt post-hospital follow-up, according to Melgar, but the report does not specify a new CDC protocol or a schedule for follow-up care. Clinicians and health systems may use the results as a reason to review how recently hospitalized patients are monitored, while recognizing that this analysis did not evaluate a particular intervention.
Further research that includes patients’ vaccination status, causes of death, and outcomes across a broader population could help clarify the role of RSV and the effects of prevention or follow-up. For now, the CDC’s existing vaccine recommendations remain the guidance described in the report; the analysis does not announce a change to them.
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Key Questions
How many hospitalized adults died in the analysis?
Of 18,301 adults hospitalized with RSV from 2014 to 2024, 1,565, or 8.6%, died in hospital or within 30 days after discharge.
How many died after leaving the hospital?
There were 753 deaths within 30 days after discharge. Of those, 286 people had been discharged to hospice and 467 to somewhere other than hospice.
Does the analysis show RSV caused all these deaths?
No. The researchers cautioned that deaths may not be attributable to RSV. The analysis counted deaths by their timing in relation to hospitalization and did not establish a cause for each one.
Who is eligible for an RSV vaccine under CDC recommendations?
The recommendations described in the report call for a one-time dose for all adults aged 75 or older and adults aged 50 to 74 who are at increased risk of severe RSV. The study did not assess vaccination status among hospitalized patients in the 2023-2024 season.
Source: rss
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