May 14, 2023/Infectious Disease

What Are the Long-Term Effects of RSV?

People with certain pre-existing medical conditions have increased risk factors

person using an inhaler

It’s estimated that respiratory syncytial virus (RSV) affects 64 million people worldwide each year.

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Most adults will only have cold-like symptoms like a runny nose, congestion, mild headache, sore throat, cough, fatigue or a fever when they have RSV.

But are there long-term effects of RSV in adults?

Medical conditions like chronic obstructive pulmonary disease (COPD), asthma or congestive heart failure can permanently impact your lungs, as well as your heart.

“When you get a virus that impacts the lungs, it really depends on how healthy your lungs are to begin with,” explains pediatric infectious disease specialist Frank Esper, MD. “While most infants have healthy lungs, there are plenty of adults around the world who have pre-existing medical conditions and can’t handle an infection from a bad germ like RSV.”

Dr. Esper explains RSV’s risk factors and complications and what kind of treatment is available.

Long-term effects of RSV in adults

It’s important to note that RSV usually doesn’t cause prolonged symptoms.

“Typically, RSV is what we call an ‘acute illness,’ which means that you’re sick and then you get well,” he says. “With RSV, about 99.9% of people are just going to get a short, quick illness that goes away in about a week.”

But for people who have pre-existing medical conditions that affect their lungs and heart, there may be some long-term issues that could even be permanent. Dr. Esper explains what risk factors you may encounter.

Pneumonia

Pneumonia is when your lungs become inflamed and fill with fluid after having a bacterial, viral or fungal infection. It can be hard to breathe and may be accompanied by a cough with yellow, green or bloody mucus.

“The RSV infection may be gone within five days, but you can have such bad pneumonia that you’re coughing for weeks and you feel run down for weeks,” Dr. Esper says.

Another lung infection that’s common with RSV is bronchiolitis, which causes inflammation in your airways. This occurs most often in children but can rarely be found in adults.

Asthma

If you have asthma, your airways can become swollen or blocked by mucus, making it hard to breathe. This chronic condition is typically treated with medication like an inhaler.

Researchers are looking at whether having an RSV infection may predispose someone to asthma.

“We haven’t completely figured out if that’s the case,” notes Dr. Esper. “There is research that says yes, while other studies say no — so the jury’s still out.”

But there are some things that healthcare providers do know about the link between asthma and RSV.

“We know that RSV can really impact people who already have asthma,” he adds. “When they get infected with RSV, they may experience worsening asthma symptoms or experience more frequent asthma attacks.”

COPD

Breathing can already be difficult for people who have chronic obstructive pulmonary disease (COPD), which includes chronic bronchitis and emphysema.

And much like asthma, those who have had an RSV infection may experience worsening COPD. You may find that it’s more difficult to breathe and that you’re wheezing and coughing more.

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Heart disease

“Every time you infect your lungs, then that’s also a strain on your heart,” Dr. Esper states. “If your heart muscle is already weakened from coronary artery disease or congestive heart failure, RSV can exacerbate those issues.”

And there’s research showing that RSV and other viral respiratory infections may increase your risk of heart disease.

Treatment options

The best way to protect yourself is to get the RSV vaccine, which was recently approved by the U.S. Food and Drug Administration (FDA). Right now, adults 60 and older qualify for the vaccine. Expect the rollout of the vaccine to happen in the fall. RSV vaccines for pregnant people and an immunization against RSV for babies have also been approved.

But if you experience long-term effects from RSV, there are ways to help.

“Most of the time, the issue is with breathing,” says Dr. Esper. “We may suggest supplemental oxygen or an inhaler, especially if they’re wheezing or have a history of asthma that seems to be triggered by RSV.”

In the worst situations, a ventilator will need to be used. “But that’s pretty uncommon,” he adds.

And what about using antivirals to combat RSV?

“We haven’t found an antiviral yet that works well or doesn’t have a lot of side effects,” says Dr. Esper. “There’s been numerous antiviral medicines that have been tested and even more than are still in development. But for the most part, the best thing for healthcare providers to do is offer supportive care.”

When to see a doctor

If you have RSV and you experience any of the following, it’s time to talk to a healthcare provider:

“It’s time to see your doctor if you’re air hungry — meaning you can’t breathe well or you feel like you’re not getting enough oxygen,” stresses Dr. Esper. “And if it hurts to breathe when you take a deep breath, you should seek medical treatment.”

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