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Health Conditions that Put You at Risk for Severe RSV

Conditions that affect the heart, lungs, and immune system increase a person’s risk of severe illness.

Conditions that affect the heart, the lungs, and the immune system can put a person of any age at risk for severe RSV infection.

Respiratory syncytial virus, better known as RSV, is one of the most common causes of respiratory infections in the United States. The majority of RSV infections cause mild illness similar to a common cold. However, RSV can lead to severe illness and complications—lower respiratory infections, like pneumonia, which make it difficult for a person to breathe. Each year, RSV results in tens of thousands of hospitalizations and thousands of deaths.

Certain factors put a person at greater risk for severe illness from an RSV infection. Age is one risk factor. Very young children (under the age of two years) and older adults (people 65 years or older) are both considered high risk groups. Risk increases significantly for any child born pre-term. It also increases significantly for elderly adults who are living in care homes, environments where infections spread easily.

People with certain existing health conditions are also at an increased risk for RSV.

What conditions are associated with RSV?

The following health conditions can put a person at higher risk for severe RSV illness, even if they are not in the over 65 age group. This includes conditions that affect the heart, the lungs, and the immune system.

  • Congenital heart defects (CHD). Congenital heart defects refer to structural abnormalities in the heart that are present at birth and can affect the heart’s normal function. Having CHD puts a person at greater risk for severe RSV illness and complications during childhood and throughout their life.
  • Chronic lung disease. A chronic condition is a health condition that lasts for a long time and requires ongoing treatment. In many cases, it refers to conditions that are lifelong. Chronic lung conditions include asthma, chronic obstructive pulmonary disease (COPD), and cystic fibrosis. It also includes bronchopulmonary dysplasia, a respiratory disorder that causes breathing problems in pre-term newborns and can be a risk factor for respiratory conditions later in life.
  • Weakened or compromised immune system. When the immune system is not functioning at full capacity, a person is at a greater risk of any infection becoming more severe. This includes RSV. An immune system can be weakened/compromised by chronic infections like HIV. It can also be temporarily weakened/compromised by medical treatments (like chemotherapy) or because of an infection (such as the flu or mononucleosis).
  • Cardiovascular disease. Also called heart disease, cardiovascular disease refers to a group of conditions that affect the function of the heart, arteries, and blood vessels—high blood pressure, coronary artery disease, and heart failure are all examples.
  • Unhealthy habits and lifestyle. Though they are not health conditions, habits like tobacco use, consuming excess amounts of alcohol, and poor nutrition can all weaken the immune system and increase the risk of many chronic diseases.

It’s also worth mentioning that RSV infections can make existing health conditions worse. COPD and heart failure may become more severe due to an RSV infection. A person with asthma may experience more frequent flares due to an RSV infection.

Are you at risk for severe illness from RSV?

This is not a comprehensive list, and chronic conditions as well as viral infections like RSV can affect different people in different ways. In other words, the best way to understand your risk of severe illness caused by RSV (or other types of respiratory infections) is to talk to your healthcare provider.

How can you protect yourself from RSV?

Basic precautions like hand washing, avoiding contact with sick people, and minimizing exposure to crowded places during RSV season can help a person avoid becoming sick. RSV season typically begins in the fall and lasts through the spring, but it can vary depending on where you live. Patterns have also shifted in recent years and have become harder to predict.

You can also ask your healthcare provider about RSV vaccination. In the spring of 2023, two vaccines for RSV were approved by the U.S. Food & Drug Administration. Both are indicated for adults ages 60 and over.

Article sources open article sources

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Sarah Hamid, Amber Winn, et al. Seasonality of Respiratory Syncytial Virus — United States, 2017–2023. Centers for Disease Control and Prevention Morbidity and Mortality Weekly Report (MMWR). April 7, 2023.
Hanish Jain, John W. Schweitzer, and Nathaniel A. Justice. Respiratory Syncytial Virus Infection. StatPearls. November 8, 2022.
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James Andrew Coultas, Rosalind Smyth, and Peter J. Openshaw. Respiratory syncytial virus (RSV): a scourge from infancy to old age. Thorax 2019. Vol. 74.
MedlinePlus. Congenital Heart Defects.
Chiara Ratti, Anna della Greca, et al. Prophylaxis protects infants with congenital heart disease from severe forms of RSV infection: an Italian observational retrospective study. Italian Journal of Pediatrics, 2023. Vol. 49.
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