Post-Acute Sequelae of Non-COVID-19 Respiratory Viral Infections: A Systematic Review.
Esther Hui-En Chong, Ian Jun Yan Wee, Jenny Guek Hong Low et al.
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In 30 seconds
This systematic review examined observational evidence on persistent or new health outcomes at least 4 weeks after non-COVID respiratory viral infections in adults. Thirteen studies involving 631,863 people met the criteria; heterogeneity required narrative synthesis. Influenza was most studied and was consistently associated with pulmonary dysfunction, reduced diffusion capacity, dyspnoea, fatigue, and poorer quality of life. RSV cohorts showed mainly cardiovascular sequelae, while one HMPV cohort reported persistent symptoms in 55% of adults at 90-270 days. The authors judged the evidence fragmented and of low certainty.
Key findings
- Thirteen observational studies (n = 631,863) met eligibility criteria; evidence was synthesised narratively because of heterogeneity.
- Influenza was consistently associated with long-term pulmonary dysfunction, reduced diffusion capacity, dyspnoea, fatigue, and poorer quality of life.
- Two RSV cohorts (n = 1553 and n = 471) showed a predominance of cardiovascular sequelae.
- One HMPV cohort (n = 92) reported persistent symptoms in 55% of adults at 90-270 days, most commonly dyspnoea, fatigue, and cough.
Why it matters
The review indicates that post-acute morbidity is not confined to COVID-19 and may involve multiple organ systems after other respiratory viral infections, particularly severe illness. Recognising these preliminary patterns can help frame assessment of ongoing symptoms and highlights the need for better evidence on pathogen-specific outcomes and follow-up.
What to keep in mind
Evidence was fragmented, with inconsistent study designs, limited pathogen coverage, and low certainty; heterogeneity also precluded quantitative synthesis.