Effect of respiratory syncytial virus on the global burden of lower respiratory infections: lessons from the Global Burden of Disease Study 1990-2021

Background: Respiratory syncytial virus (RSV) is a major cause of lower respiratory infections (LRIs), especially in children, the elderly, and immunocompromised individuals. Methods: Using GBD 1990–2021 data, we analyzed global RSV-related LRI deaths and DALYs. Trends were assessed via age-standardized rates and joinpoint regression. We also examined regional and demographic disparities and their association with the Sociodemographic Index (SDI). Results: In 2021, RSV-related LRIs caused 31,525.1 deaths and 2.59 million DALYs globally, marking a 78.9% decrease since 1990. The greatest decline occurred between 2020 and 2021. South Asia and Sub-Saharan Africa showed the highest burden. Children under 5 and the elderly (80+) were most affected, particularly males. A negative correlation was observed between SDI and disease burden. Conclusions: RSV burden has declined, but remains high in low-SDI regions. Sustained public health efforts and vaccination are critical to further reduce impact.