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BMC Infect Dis . Frequency, lethality, and demographic trends of acute respiratory viruses in hospitalized patients: insights from a German tertiary

tetano

Editor, Senior Moderator
BMC Infect Dis


. 2025 Sep 16;25(1):1110.
doi: 10.1186/s12879-025-11521-1. Frequency, lethality, and demographic trends of acute respiratory viruses in hospitalized patients: insights from a German tertiary care hospital from july 2022 to april 2023

Juliane Mees[SUP] 1 2 3 [/SUP], Michael Eisenmann[SUP] 1 [/SUP], Anna Höhn[SUP] 1 [/SUP], Sina Ebert[SUP] 1 [/SUP], Tamara Pscheidl[SUP] 1 4 [/SUP], Nina Roth[SUP] 1 [/SUP], Gülmisal Güder[SUP] 5 [/SUP], Nils Petri[SUP] 5 [/SUP], Isabell Wagenhäuser[SUP] 1 5 2 [/SUP], Manuel Krone[SUP] 6 7 [/SUP]



Affiliations
Abstract

Background: Acute respiratory infections (ARI) exhibit varying lethality rates, influenced by individual and population factors. This retrospective study aimed to analyse infection frequency, clinical characteristics, and factors associated with lethality in hospitalized patients with seasonal ARI pathogens.
Methods: Virological and demographic data of hospitalized patients ≥ 18 years who tested positive for at least one ARI viral pathogen (Influenza, Adenovirus, Coronavirus, human Metapneumovirus (hMPV), Parainfluenza, Rhinovirus, Respiratory Syncytial Virus (RSV) and SARS-CoV-2) were collected from 07/2022 to 04/2023 at a German tertiary care hospital. Logistic regression analysis was used to analyse factors influencing lethality. Univariate comparisons examined pathogen-specific differences in length of stay and lethality.
Results: Among 1,657 hospitalized patients with at least one detected ARI pathogen, 89 (5.5%) passed away. Logistic regression analysis indicated a significant association between advanced age and lethality (OR = 1.05 per year, p < 0.0001). Patients infected with ARI pathogens other than SARS-CoV-2 or hMPV exhibited a heightened risk of lethality compared to those with Influenza. While statistical significance was reached only for Adenovirus (OR = 5.99, p = 0.049), elevated risk of lethality was also observed among hospitalized patients infected with Coronavirus (OR = 2.22), RSV (OR = 2.18), and more than one pathogen (OR = 2.07).
Conclusions: Lethality rates varied among the examined ARI pathogens. Compared to Influenza, Adenovirus, Coronavirus, and RSV showed elevated lethality rates and an increased risk of intrahospital death among ARI-infected patients. RSV emerged as a notable concern for hospitalized adults. Additionally, age also arises as a significant risk factor for lethality associated with ARI during hospitalization.
Trial registration: This study is a retrospective analysis of fully anonymized routinely collected patient data and does not require registration in a clinical trial registry.

Keywords: Acute respiratory infections; Infection control; Influenza; Lethality; RSV; Respiratory viruses; SARS-CoV-2; Surveillance.

 
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