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Infect Dis Ther . Viral Pathogen-Specific Severe Acute Respiratory Infections in Hospitalised Adults in Europe: Epidemiological Findings from the id

tetano

Editor, Senior Moderator
Infect Dis Ther


. 2026 Jul 7.
doi: 10.1007/s40121-026-01399-0. Online ahead of print.
Viral Pathogen-Specific Severe Acute Respiratory Infections in Hospitalised Adults in Europe: Epidemiological Findings from the id.DRIVE Study 2024-2025

Katherine Newell[SUP] 1 [/SUP], Nikki Vroom[SUP] 2 [/SUP], Cátia Marques[SUP] 3 [/SUP], Ekaterina Maslova[SUP] 4 [/SUP], Farid L Khan[SUP] 5 [/SUP], Kok-Yew Ngew[SUP] 6 [/SUP], Hannah R Volkman[SUP] 5 [/SUP], Chengbin Wang[SUP] 7 [/SUP], Juan V Hernandez-Villena[SUP] 6 [/SUP], Negar Aliabadi[SUP] 5 [/SUP], Elizabeth Begier[SUP] 8 [/SUP], Jennifer L Nguyen[SUP] 5 [/SUP], Hollie Dunford[SUP] 9 [/SUP], Somsuvro Basu[SUP] 6 [/SUP], Andrés Antón[SUP] 10 [/SUP], Susana Otero-Romero[SUP] 10 [/SUP], Irma Casas[SUP] 11 12 [/SUP], Elisa Martró[SUP] 11 12 [/SUP], Beate Grüner[SUP] 13 [/SUP], Giancarlo Icardi[SUP] 14 15 16 [/SUP], Federico Martinón-Torres[SUP] 17 18 19 [/SUP], Ainara Mira-Iglesias[SUP] 12 20 [/SUP], Carlos M Oñoro-López[SUP] 21 [/SUP], Alejandro Orrico-Sánchez[SUP] 12 20 22 [/SUP], Oleguer Parés-Badell[SUP] 10 [/SUP], Wolfgang Gleiber[SUP] 23 [/SUP], Antoni Torres[SUP] 24 [/SUP], Kaatje Bollaerts[SUP] 6 [/SUP]; id.DRIVE COLLABORATIVE AUTHORING GROUP


Collaborators, Affiliations
Abstract

Introduction: Lower respiratory tract infections represent a major public health burden, but adult data on respiratory viruses except influenza and COVID-19 are limited. Most European surveillance systems report aggregate data lacking patient-level detail.
Methods: We utilised the multicountry id.DRIVE surveillance study data to describe the epidemiology, clinical characteristics, and outcomes of adults hospitalised with pathogen-specific severe acute respiratory infections (SARI) during 2024-2025. Adults (≥ 18 years) hospitalised with SARI across 17 hospitals in Spain, Italy, and Germany between 1 September 2024 and 31 August 2025 were included. All participants were tested using reverse transcription polymerase chain reaction for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), respiratory syncytial virus (RSV), and influenza A/B (testing additional respiratory pathogens varied by hospital). Descriptive analyses were stratified by pathogen.
Results: Of 8730 included participants (median age, 77 years), 14.3% (n = 1249) tested positive for influenza A, 6.9% (n = 606) SARS-CoV-2, 6.4% (n = 554) RSV, and 0.8% (n = 74) for influenza B. Positivity peaked for influenza and RSV in December-January, and for SARS-CoV-2 in July. Comorbidity burden was substantial: 51.9% of all SARI participants had ≥ 3 chronic conditions, reaching 62.3% in those with RSV. RSV-positive SARI patients were older (median age, 80 years); oxygen therapy was required in 72.0%, non-invasive ventilation in 12.3%, and in-hospital mortality was 9.4%. Over 75.0% of SARI cases positive for a respiratory virus received antibiotics during hospitalisation.
Conclusion: Viral pathogens remain a major cause of adult SARI hospitalisations in Europe. Our findings highlight the continued burden and seasonal diversity of viral respiratory pathogens, supporting the value of integrated, pathogen-specific SARI surveillance guiding prevention strategies.

Keywords: Epidemiology; HMPV; Hospitalisation; Influenza; RSV; SARI; SARS-CoV-2; Surveillance.

 
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