Post-Acute Sequelae and Long-Term Clinical Outcomes in Hantavirus Pulmonary Syndrome Survivors

Hantavirus pulmonary syndrome (HPS), also known as hantavirus cardiopulmonary syndrome (HCPS), is a severe rodent-borne zoonotic disease that may progress to pulmonary edema, respiratory failure, shock, and death. Although acute mortality and intensive management have been widely discussed, evidence on post-acute sequelae among survivors remains limited. This systematic review aimed to synthesize post-acute sequelae and long-term clinical outcomes in HPS/HCPS survivors. Literature searches were conducted in PubMed, ScienceDirect, PubMed Central, and publisher websites using terms related to HPS/HCPS, survivors, post-acute sequelae, follow-up, and long-term outcomes. Eligible studies were primary human studies reporting clinical outcomes after the acute phase, while reviews, animal studies, acute-only studies, and articles without follow-up data were excluded. Study selection followed PRISMA guidelines, and methodological quality was assessed using observational study quality assessment tools. From 27 identified records, 3 primary studies met the inclusion criteria. Narrative synthesis showed that survivors may experience respiratory impairment, renal sequelae, neuropsychological symptoms, reduced quality of life, and limitations in daily activities. The most consistent outcome was convalescent respiratory impairment, including exertional dyspnea and pulmonary function abnormalities. Evidence also suggests possible renal involvement and persistent physical or neuropsychological symptoms after hospital discharge. Because only three studies were included, generalizability remains limited. Nevertheless, available findings support multidisciplinary post-discharge follow-up for HPS/HCPS survivors.