tetano
Editor, Senior Moderator
Clin Microbiol Infect
. 2025 Nov 26:S1198-743X(25)00574-9.
doi: 10.1016/j.cmi.2025.11.019. Online ahead of print. Prevalence of influenza and other respiratory viral infections in deceased persons: a population-based observational study over four influenza seasons
Camino Trobajo-Sanmartín[SUP] 1 [/SUP], Ana Navascués[SUP] 2 [/SUP], Maddi Olazábal-Arruiz[SUP] 2 [/SUP], Lucía Argente-Colas[SUP] 2 [/SUP], Irene Iniesta[SUP] 3 [/SUP], Itziar Casado[SUP] 1 [/SUP], Marcela Guevara[SUP] 1 [/SUP], Jesús Castilla[SUP] 4 [/SUP], Iván Martínez-Baz[SUP] 1 [/SUP]
Affiliations
Objective: Excess mortality during periods of respiratory virus circulation is very high compared to the number of reported deaths due to these infections. We aimed to estimate the prevalence of infection by influenza and other respiratory viruses in deceased persons during four influenza seasons.
Methods: Deceased persons, regardless the cause, were swabbed post-mortem and tested by PCR for respiratory viruses in the 2016/17 to 2019/20 seasons in Navarre, Spain. Post-mortem results were compared with the diagnoses from clinical PCR testing.
Results: Of 857 deceased persons with a valid test result, 312 (36.4%) were positive for respiratory viruses: 98 rhinovirus (11.4%), 94 influenza (11.0%), 61 human coronavirus (7.1%), 59 respiratory syncytial virus (6.9%), 14 parainfluenza (1.6%), 8 adenovirus (0.9%), 6 metapneumovirus (0.7%), 4 bocavirus (0.5%), 1 enterovirus (0.1%), and 1 SARS-CoV-2 (0.1%). The prevalence of any respiratory virus remained high throughout the seasons (78/263, 29.7% to 27/57, 47.4%). Among people who tested positive for influenza post-mortem, only 41.5% (39/94) had been hospitalised and 17.0% (16/94) had a positive test result for influenza within 30 days before death. The prevalence of influenza post-mortem (94/857, 11.0%) contrasted with the prevalence of pre-mortem diagnosis of influenza (23/857, 2.7%) and only 1.4% (12/857) of deaths recorded with influenza as the cause of death.
Conclusions: Respiratory viral infections were frequently detected in winter deaths, but most of them were not laboratory confirmed before death. The impact of influenza infection on mortality could be higher than the number of persons who are reported as dying from influenza or who die with a confirmed diagnosis of this infection.
Keywords: Cause of death; Influenza virus; Mortality; Older adults; Respiratory syncytial virus; Respiratory viral infection; Respiratory virus.
. 2025 Nov 26:S1198-743X(25)00574-9.
doi: 10.1016/j.cmi.2025.11.019. Online ahead of print. Prevalence of influenza and other respiratory viral infections in deceased persons: a population-based observational study over four influenza seasons
Camino Trobajo-Sanmartín[SUP] 1 [/SUP], Ana Navascués[SUP] 2 [/SUP], Maddi Olazábal-Arruiz[SUP] 2 [/SUP], Lucía Argente-Colas[SUP] 2 [/SUP], Irene Iniesta[SUP] 3 [/SUP], Itziar Casado[SUP] 1 [/SUP], Marcela Guevara[SUP] 1 [/SUP], Jesús Castilla[SUP] 4 [/SUP], Iván Martínez-Baz[SUP] 1 [/SUP]
Affiliations
- PMID: 41314604
- DOI: 10.1016/j.cmi.2025.11.019
Objective: Excess mortality during periods of respiratory virus circulation is very high compared to the number of reported deaths due to these infections. We aimed to estimate the prevalence of infection by influenza and other respiratory viruses in deceased persons during four influenza seasons.
Methods: Deceased persons, regardless the cause, were swabbed post-mortem and tested by PCR for respiratory viruses in the 2016/17 to 2019/20 seasons in Navarre, Spain. Post-mortem results were compared with the diagnoses from clinical PCR testing.
Results: Of 857 deceased persons with a valid test result, 312 (36.4%) were positive for respiratory viruses: 98 rhinovirus (11.4%), 94 influenza (11.0%), 61 human coronavirus (7.1%), 59 respiratory syncytial virus (6.9%), 14 parainfluenza (1.6%), 8 adenovirus (0.9%), 6 metapneumovirus (0.7%), 4 bocavirus (0.5%), 1 enterovirus (0.1%), and 1 SARS-CoV-2 (0.1%). The prevalence of any respiratory virus remained high throughout the seasons (78/263, 29.7% to 27/57, 47.4%). Among people who tested positive for influenza post-mortem, only 41.5% (39/94) had been hospitalised and 17.0% (16/94) had a positive test result for influenza within 30 days before death. The prevalence of influenza post-mortem (94/857, 11.0%) contrasted with the prevalence of pre-mortem diagnosis of influenza (23/857, 2.7%) and only 1.4% (12/857) of deaths recorded with influenza as the cause of death.
Conclusions: Respiratory viral infections were frequently detected in winter deaths, but most of them were not laboratory confirmed before death. The impact of influenza infection on mortality could be higher than the number of persons who are reported as dying from influenza or who die with a confirmed diagnosis of this infection.
Keywords: Cause of death; Influenza virus; Mortality; Older adults; Respiratory syncytial virus; Respiratory viral infection; Respiratory virus.