Heart failure & cardiomyopathiesCohort study
Risk of new-onset heart failure and heart failure exacerbations following COVID-19, influenza, or respiratory syncytial virus hospitalization
- Retrospective cohort study
- population-based
- overlap-weighted competing-risks regression
- Heart-failure (HF) ascertained using national healthcare-claims data
Authors' conclusion
RVIs can contribute to post-acute risk of new-onset HF and HF readmissions.
Study context
- Population
- Adult Singaporeans (≥18 years) hospitalised for influenza/COVID-19/RSV, 01/01/2017–30/08/2023, stratified by pre-existing HF
- Exposure
- Hospitalisation for respiratory-viral-infection (RVI) vs orthopaedic hospitalisation
- Outcome
- Acute HF (new-onset/readmission)
- Follow-up
- Up to 180 days post-hospitalisation
Main finding
As reported in the abstract
Acute HF (new-onset in those without HF; readmission in those with HF)
RVI vs ControlsAdjusted hazard ratio (95% CI)
new-onset HF, no pre-existing HF (N=59,408)
1.45(1.26–1.67)
HF readmission, HF patients (N=4163)
1.28(1.08–1.52)
Observational data: associations, not effects.
Further findings
| Outcome | aHR (95% CI) | |
|---|---|---|
| New-onset HF, by RVI type · up to 180 days post-hospitalisation — RSV vs Controls | 2.03 (1.26–3.25) | |
| New-onset HF, by RVI type · up to 180 days post-hospitalisation — COVID-19 vs Controls | 1.36 (1.16–1.60) | |
| New-onset HF, by RVI type · up to 180 days post-hospitalisation — Influenza vs Controls | 1.62 (1.28–2.06) | |
| New-onset HF, by RVI type · up to 180 days post-hospitalisation — Influenza, vaccinated <365 days prior vs Controls · not significantly increased | 1.47 (0.82–2.64) | |
| HF readmission, by vaccination status (HF patients) — COVID-19, ≥4 vaccine doses vs Controls · no increased risk | 0.86 (0.59–1.27) | |
| HF readmission, by vaccination status (HF patients) — COVID-19, vaccinated <180 days prior vs Controls · no increased risk | 0.97 (0.79–1.20) | |
| HF readmission, by vaccination status (HF patients) — Influenza, vaccinated <365 days prior vs Controls · not significantly increased | 1.63 (0.94–2.82) | |
| 0.20.5125Adjusted hazard ratio (log scale) |
HF readmission, by age
- Elevated risk of HF readmission predominantly accrued in older patients (≥70 years)
Original publication
Risk of new-onset heart failure and heart failure exacerbations following COVID-19, influenza, or respiratory syncytial virus hospitalization. Eur J Prev Cardiol. Published 6 November 2025. doi:10.1093/eurjpc/zwaf714
Summarised from the published abstract; every number is checked against it