tetano
Editor, Senior Moderator
Int J Infect Dis
. 2026 Jan 9:108381.
doi: 10.1016/j.ijid.2026.108381. Online ahead of print. Clinical Characteristics and Prognostic Differences Between RSV and Influenza A Virus Infections in Hospitalized Adult Patients
Rui Su[SUP] 1 [/SUP], Wei Li[SUP] 2 [/SUP], Xingyao Tang[SUP] 3 [/SUP], Minghui Shi[SUP] 3 [/SUP], Jisong Yan[SUP] 4 [/SUP], Binghuai Lu[SUP] 2 [/SUP], Ke Huang[SUP] 5 [/SUP], Ting Yang[SUP] 2 [/SUP]
Affiliations
Introduction: Respiratory syncytial virus (RSV) and influenza A virus are primary causes of lower respiratory tract infections in adults. However, there is limited comparative data on their clinical characteristics and prognostic impact in hospitalized patients. We aimed to describe the clinical characteristics and differences in prognosis among individuals aged 18 years and older admitted to the hospital with RSV, compared to influenza A.
Methods: This study was conducted at a teaching hospital in Beijing, China, across a respiratory season (November 1, 2023- January 30, 2024). All hospitalized adults with laboratory-confirmed RSV or influenza A infection were enrolled. Patients were divided into three groups: those with RSV infection, those with influenza A infection, and those with co-infection with both viruses. We compared clinical features, comorbidities, laboratory and radiological findings, treatments, complications, and outcomes across the groups. Multivariable logistic regression identified factors associated with adverse outcomes in inpatients with RSV infection.
Results: A total of 538 patients were included, comprising 162 (30.1%) with RSV infection, 355 (66.0%) with influenza A, and 21 (3.9%) with co-infection. Co-infected patients were older (72 years; p < 0.001), predominantly smokers (90.5%; p < 0.001), and more frequently presented with hypoxemia (71.4%; p = 0.007) and dyspnea (76.2%; p = 0.032). RSV patients showed higher rates of productive cough (62.3%; p = 0.014), whereas influenza A was associated with fever (64.8%; p = 0.002) and myalgia (14.6%; p = 0.028). Use of antiviral therapy was lowest in RSV (24.1%; p < 0.001), while influenza A had the highest complication burden (99.2%; p < 0.001). Mechanical ventilation was most frequently required in co-infections (42.9%; p = 0.013), although overall mortality and Intensive Care Unit (ICU) admission did not differ across groups. In multivariate analysis of RSV patients, current smoking (adjusted OR, 2.61; 95% CI, 1.98-6.91; p = 0.044), chronic obstructive pulmonary disease (COPD) (adjusted OR, 2.99; 95% CI, 1.21-7.35; p = 0.017), chronic heart failure (adjusted OR, 3.71; 95% CI, 1.62-8.46; p = 0.002), and pneumonia (adjusted OR, 3.14; 95% CI, 1.26-7.81; p = 0.014) independently predicted adverse outcomes.
Conclusion: RSV and influenza A infections share a high complication burden but exhibit distinct clinical features. RSV patients with COPD, heart failure, or pneumonia face greater risks, and co-infections further worsen severity, including an increased rate of mechanical ventilation, underscoring the need for tailored preventive and therapeutic strategies, including RSV vaccination.
Keywords: Adverse outcome; Clinical features; Influenza A; Respiratory syncytial virus.
. 2026 Jan 9:108381.
doi: 10.1016/j.ijid.2026.108381. Online ahead of print. Clinical Characteristics and Prognostic Differences Between RSV and Influenza A Virus Infections in Hospitalized Adult Patients
Rui Su[SUP] 1 [/SUP], Wei Li[SUP] 2 [/SUP], Xingyao Tang[SUP] 3 [/SUP], Minghui Shi[SUP] 3 [/SUP], Jisong Yan[SUP] 4 [/SUP], Binghuai Lu[SUP] 2 [/SUP], Ke Huang[SUP] 5 [/SUP], Ting Yang[SUP] 2 [/SUP]
Affiliations
- PMID: 41520773
- DOI: 10.1016/j.ijid.2026.108381
Introduction: Respiratory syncytial virus (RSV) and influenza A virus are primary causes of lower respiratory tract infections in adults. However, there is limited comparative data on their clinical characteristics and prognostic impact in hospitalized patients. We aimed to describe the clinical characteristics and differences in prognosis among individuals aged 18 years and older admitted to the hospital with RSV, compared to influenza A.
Methods: This study was conducted at a teaching hospital in Beijing, China, across a respiratory season (November 1, 2023- January 30, 2024). All hospitalized adults with laboratory-confirmed RSV or influenza A infection were enrolled. Patients were divided into three groups: those with RSV infection, those with influenza A infection, and those with co-infection with both viruses. We compared clinical features, comorbidities, laboratory and radiological findings, treatments, complications, and outcomes across the groups. Multivariable logistic regression identified factors associated with adverse outcomes in inpatients with RSV infection.
Results: A total of 538 patients were included, comprising 162 (30.1%) with RSV infection, 355 (66.0%) with influenza A, and 21 (3.9%) with co-infection. Co-infected patients were older (72 years; p < 0.001), predominantly smokers (90.5%; p < 0.001), and more frequently presented with hypoxemia (71.4%; p = 0.007) and dyspnea (76.2%; p = 0.032). RSV patients showed higher rates of productive cough (62.3%; p = 0.014), whereas influenza A was associated with fever (64.8%; p = 0.002) and myalgia (14.6%; p = 0.028). Use of antiviral therapy was lowest in RSV (24.1%; p < 0.001), while influenza A had the highest complication burden (99.2%; p < 0.001). Mechanical ventilation was most frequently required in co-infections (42.9%; p = 0.013), although overall mortality and Intensive Care Unit (ICU) admission did not differ across groups. In multivariate analysis of RSV patients, current smoking (adjusted OR, 2.61; 95% CI, 1.98-6.91; p = 0.044), chronic obstructive pulmonary disease (COPD) (adjusted OR, 2.99; 95% CI, 1.21-7.35; p = 0.017), chronic heart failure (adjusted OR, 3.71; 95% CI, 1.62-8.46; p = 0.002), and pneumonia (adjusted OR, 3.14; 95% CI, 1.26-7.81; p = 0.014) independently predicted adverse outcomes.
Conclusion: RSV and influenza A infections share a high complication burden but exhibit distinct clinical features. RSV patients with COPD, heart failure, or pneumonia face greater risks, and co-infections further worsen severity, including an increased rate of mechanical ventilation, underscoring the need for tailored preventive and therapeutic strategies, including RSV vaccination.
Keywords: Adverse outcome; Clinical features; Influenza A; Respiratory syncytial virus.