Respiratory syncytial virus, or RSV, is a well-known threat to children. Now, a major systematic review confirms it poses a severe and dangerous burden for immunocompromised adults in high-income countries.
The analysis, published in the journal Infectious Disease and Therapy, reviewed 36 studies from 2000 to 2024. The evidence was concentrated on two vulnerable groups: solid organ transplant recipients, especially those who received a lung, and hematopoietic stem cell transplant recipients.
The findings are stark. Among lung transplant recipients who contracted RSV, hospitalization was required for 37.5% to 87.5%. Intensive care was needed for up to 11.7% of this group, with mechanical ventilation required for up to 10.4%.
For hematopoietic stem cell transplant recipients, the burden was even higher. Hospitalization rates ranged from 30.3% to 83.9%, and ICU admission was reported in up to 29.8% of cases. Mortality was significant; in some cohorts, all-cause death within one month of RSV infection reached 25.8%.
Experts say the degree of immunosuppression is a key factor in determining risk and outcomes. Factors like anti-rejection drugs, corticosteroid dosing, and time since transplant appear clinically relevant.
The review authors stress that RSV vaccination and other preventive strategies must be prioritized for this vulnerable adult population. They also point to a critical need for more research to better understand these risks and guide clinical and public health policy.