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BMC Infect Dis . Pre-COVID-19 epidemiology of community respiratory viruses at a single US center reveals sex differences in influenza A and a highe

tetano

Editor, Senior Moderator
BMC Infect Dis


. 2025 Jul 18;25(1):924.
doi: 10.1186/s12879-025-11307-5. Pre-COVID-19 epidemiology of community respiratory viruses at a single US center reveals sex differences in influenza A and a higher ICU incidence of human metapneumovirus in the elderly population

Bibek Koirala[SUP] #[/SUP][SUP] 1 [/SUP], Aline Azar[SUP] #[/SUP][SUP] 2 [/SUP], Brianna Fountain[SUP] 3 [/SUP], Melissa McGuirl[SUP] 3 [/SUP], Shannon Stock[SUP] 3 [/SUP], Marzena Galdzicka[SUP] 4 [/SUP], Richard T Ellison 3rd[SUP] 5 6 [/SUP]



Affiliations
Abstract

Background: Few studies have simultaneously examined the epidemiology and sex differences of diverse community respiratory viruses, including human metapneumovirus (HMPV), over more than one season.
Methods: Given that molecular testing for community respiratory viruses was widely performed on patients at UMass Memorial Medical Center between January 2010 and December 2013, a retrospective study was conducted to examine epidemiologic features of positive subjects. Initial testing was done with rapid influenza and respiratory syncytial (RSV) virus antigen testing, with negative testing reflexed to a multiplex nucleic acid amplification platform detecting nine respiratory viruses.
Results: Four thousand ninety-eight (50.6%) of 8092 patients tested positive for at least one virus. The majority (75.3%) of individuals testing positive were inpatients. Rhinovirus/enterovirus was most frequently detected; influenza A was more common in older adults and RSV incidence was highest among patients < 5 years of age. Pronounced seasonality was seen with influenza viruses, RSV, HMPV, and parainfluenza 3 virus. Influenza A was significantly more common in females (11.2% vs. 8.1%; p < 0.001), while parainfluenza 1 virus (2.0% vs. 1.2%; p < 0.01), rhinovirus/enterovirus (23.4% vs. 19.9%; p < 0.001) and adenovirus (2.1% vs. 1.5%; p < 0.05) were significantly higher in males. Of the ICU patients with HMPV, many (40.3%) were ≥ 65 years of age.
Conclusions: This pre-coronavirus disease 2019 (COVID-19) era study has one of the largest patient populations evaluated for community respiratory virus infections. It confirms known epidemiology, seasonality, and coinfections, and importantly shows a preponderance of influenza A infections among women, contrasting prior studies, which warrants further investigation. It also shows a high HMPV incidence in the ICU among the elderly, underscoring the importance of testing in this population.

Keywords: Epidemiology; Human metapneumovirus; Influenza A; Pre-COVID-19; Respiratory virus; Sex difference.

 
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