tetano
Editor, Senior Moderator
Eur J Clin Microbiol Infect Dis
. 2025 Nov 22.
doi: 10.1007/s10096-025-05342-y. Online ahead of print. Burden of respiratory syncytial virus (RSV) vs. influenza (A/B) in adults ≥ 50 years: a Pre-COVID-19 multicenter retrospective study
Benjamin Davido[SUP] 1 2 3 [/SUP], Elyanne Gault[SUP] 4 [/SUP], Djillali Annane[SUP] 5 [/SUP], Sebastien Beaune[SUP] 6 [/SUP], Jennifer Dumoulin[SUP] 7 [/SUP], Pierre de Truchis[SUP] 8 [/SUP], Azzam Saleh-Mghir[SUP] 9 [/SUP], Karim Jaffal[SUP] 8 [/SUP], Benoit Lemarié[SUP] 10 [/SUP]
Affiliations
Background: Respiratory syncytial virus (RSV) peaks in fall-winter and is well known in children. In adults, however, severe outcomes especially compared to influenza are less well-defined. With RSV vaccines newly available in 2024, this study evaluated RSV burden versus influenza.
Methods: Multicenter retrospective cohort study including adults ≥ 50 years with RT-PCR-confirmed influenza (A/B) or RSV during two pre-COVID-19 fall-winter seasons (2016-2018). Outcomes were hospital admission, length of stay, short-term favorable outcome (within 5 days), intensive care unit (ICU) admission, superinfection, and 90-day mortality.
Results: Of 386 patients, 288 (74.6%) had influenza (A: 190, B: 98), 98 (25.4%) had RSV. RSV patients exhibited more frequently chronic respiratory diseases (41.8% vs. 24.3%, p = 0.001) and prior hospitalized respiratory infections (39.8% vs. 25.7%, p = 0.01) than influenza patients. Admission rates trended higher for RSV (88.8%, n = 87) than influenza (80.2%, n = 231; p = 0.06). Among admissions (n = 318), RSV stays were significantly longer (median 12 days [IQR 8-18] vs. 9 days [IQR 4-15], p = 0.006), with lower short-term favorable outcomes than influenza B (13.8% vs. 41.4%, aOR 5.1 [1.53-16.86], p < 0.01), but not influenza A (p = 0.34). ICU admissions were higher in younger age groups (50-64 years: aOR 13.4 [2.7-67.2], p = 0.002; 65-74 years: aOR = 4.17 [1.18-14.7], p = 0.03), regardless of viral etiology. Superinfection (10.2% vs. 12.5%, p = 0.57) and 90-day mortality (6.9% vs. 12.9%, p = 0.18) were similar.
Conclusion: RSV imposes a burden comparable to influenza in admission and mortality, with slower recovery than influenza B. These pre-COVID-19 data provide a critical baseline to support targeted RSV vaccination for adults with comorbidities and aged ≥ 50 years, informing future recommendations.
Keywords: 50 years; Burden of disease; Influenza; Pre-Covid; RSV.
. 2025 Nov 22.
doi: 10.1007/s10096-025-05342-y. Online ahead of print. Burden of respiratory syncytial virus (RSV) vs. influenza (A/B) in adults ≥ 50 years: a Pre-COVID-19 multicenter retrospective study
Benjamin Davido[SUP] 1 2 3 [/SUP], Elyanne Gault[SUP] 4 [/SUP], Djillali Annane[SUP] 5 [/SUP], Sebastien Beaune[SUP] 6 [/SUP], Jennifer Dumoulin[SUP] 7 [/SUP], Pierre de Truchis[SUP] 8 [/SUP], Azzam Saleh-Mghir[SUP] 9 [/SUP], Karim Jaffal[SUP] 8 [/SUP], Benoit Lemarié[SUP] 10 [/SUP]
Affiliations
- PMID: 41273493
- DOI: 10.1007/s10096-025-05342-y
Background: Respiratory syncytial virus (RSV) peaks in fall-winter and is well known in children. In adults, however, severe outcomes especially compared to influenza are less well-defined. With RSV vaccines newly available in 2024, this study evaluated RSV burden versus influenza.
Methods: Multicenter retrospective cohort study including adults ≥ 50 years with RT-PCR-confirmed influenza (A/B) or RSV during two pre-COVID-19 fall-winter seasons (2016-2018). Outcomes were hospital admission, length of stay, short-term favorable outcome (within 5 days), intensive care unit (ICU) admission, superinfection, and 90-day mortality.
Results: Of 386 patients, 288 (74.6%) had influenza (A: 190, B: 98), 98 (25.4%) had RSV. RSV patients exhibited more frequently chronic respiratory diseases (41.8% vs. 24.3%, p = 0.001) and prior hospitalized respiratory infections (39.8% vs. 25.7%, p = 0.01) than influenza patients. Admission rates trended higher for RSV (88.8%, n = 87) than influenza (80.2%, n = 231; p = 0.06). Among admissions (n = 318), RSV stays were significantly longer (median 12 days [IQR 8-18] vs. 9 days [IQR 4-15], p = 0.006), with lower short-term favorable outcomes than influenza B (13.8% vs. 41.4%, aOR 5.1 [1.53-16.86], p < 0.01), but not influenza A (p = 0.34). ICU admissions were higher in younger age groups (50-64 years: aOR 13.4 [2.7-67.2], p = 0.002; 65-74 years: aOR = 4.17 [1.18-14.7], p = 0.03), regardless of viral etiology. Superinfection (10.2% vs. 12.5%, p = 0.57) and 90-day mortality (6.9% vs. 12.9%, p = 0.18) were similar.
Conclusion: RSV imposes a burden comparable to influenza in admission and mortality, with slower recovery than influenza B. These pre-COVID-19 data provide a critical baseline to support targeted RSV vaccination for adults with comorbidities and aged ≥ 50 years, informing future recommendations.
Keywords: 50 years; Burden of disease; Influenza; Pre-Covid; RSV.