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How does RSV disease severity compare to COVID-19 in older adults?

high confidence  ·  Last reviewed May 24, 2026

Both RSV and COVID-19 can cause serious illness in older adults, leading to hospitalization, intensive care, and death. A large 2024 study comparing hospitalized adults found that RSV, COVID-19, and influenza all carried similar risks of severe outcomes like needing a ventilator or dying 9. However, RSV may be more likely than COVID-19 to trigger acute cardiac events, such as heart failure or arrhythmias, in older adults 10.

What the research says

A 2024 study of nearly 8,000 hospitalized adults (median age 67) across 20 US states found that RSV disease severity was comparable to COVID-19 and influenza. The risk of needing invasive mechanical ventilation or dying in the hospital was similar for all three viruses 9. This means that for older adults, RSV is not necessarily milder than COVID-19; it can be just as dangerous.

Another study focusing on adults aged 50 and older found that RSV infection was linked to a high rate of acute cardiac events. Among those hospitalized with RSV, about 1 in 5 experienced a serious heart complication, such as new or worsening heart failure, heart attack, or arrhythmia. The risk of these cardiac events was higher than what has been reported for COVID-19 and influenza in other studies 10.

Vaccination is available for both RSV and COVID-19. For RSV, a single dose is recommended for adults aged 60 and older, especially those with underlying conditions like COPD, asthma, diabetes, or obesity. A 2025 study found that the RSV vaccine was effective at preventing hospitalization in older adults during two RSV seasons 11. Similarly, COVID-19 vaccines reduce the risk of severe disease. However, vaccination coverage for both viruses remains low among older adults and nursing home residents 56.

What to ask your doctor

  • Should I get the RSV vaccine? It is recommended for adults aged 60 and older, especially if I have chronic health conditions.
  • Am I up to date on my COVID-19 vaccines and boosters?
  • What symptoms of RSV should I watch for, and when should I seek medical care?
  • Given my heart health, am I at higher risk for cardiac complications from RSV?
  • If I get sick, how can I tell whether it is RSV, COVID-19, or flu, and does it matter for treatment?

This question is drawn from common patient questions about Pulmonology & Critical Care and answered using cited medical research. We do not provide individualized advice.