tetano
Editor, Senior Moderator
Open Forum Infect Dis
. 2026 Mar 26;13(4)
fag146.
doi: 10.1093/ofid/ofag146. eCollection 2026 Apr.
Clinical Characteristics and Severity of Rhinovirus/Enterovirus-Associated Hospitalizations: A Multicountry Analysis From the Global Influenza Hospital Surveillance Network, 2017-2024
Angelica M Revilla[SUP] 1 [/SUP], Sonia M Raboni[SUP] 2 [/SUP], Heloisa I G Giamberardino[SUP] 2 [/SUP], Melissa K Andrew[SUP] 3 [/SUP], Nazish Badar[SUP] 4 [/SUP], Vicky Baillie[SUP] 5 [/SUP], Elsa Baumeister[SUP] 6 [/SUP], Elena Burtseva[SUP] 7 [/SUP], Ghassan Dbaibo[SUP] 8 [/SUP], Ndongo Dia[SUP] 9 [/SUP], Anca Cristina Drăgănescu[SUP] 10 [/SUP], Parvaiz A Koul[SUP] 11 [/SUP], Viviana Simon[SUP] 12 [/SUP], Emilia Sordillo[SUP] 12 [/SUP], Harm van Bakel[SUP] 12 [/SUP], Anna Sominina[SUP] 13 [/SUP], Tao Zhang[SUP] 14 [/SUP], F Xavier López-Labrador[SUP] 15 16 17 [/SUP], Ainara Mira-Iglesias[SUP] 15 [/SUP], Alejandro Orrico-Sánchez[SUP] 15 17 18 [/SUP], Q Sue Huang[SUP] 19 [/SUP], Joseph Bresee[SUP] 20 [/SUP], Justin R Ortiz[SUP] 21 [/SUP], Marta C Nunes[SUP] 1 [/SUP], Sandra S Chaves[SUP] 22 [/SUP]
Affiliations
Background: Rhinoviruses and enteroviruses (RV/EV) are frequently detected in hospitalized patients with acute respiratory illness; yet, their clinical burden remains under-characterized, particularly across diverse populations and age groups.
Methods: We analyzed Global Influenza Hospital Surveillance Network data collected from November 2017 through October 2024 across 13 countries representing high-, upper-middle-, and lower-middle-income settings. Multivariable mixed-effects logistic regression models, stratified by age (<5, 5-64, ≥65 years) and adjusted for sex, comorbidities, influenza coinfection, country income level, and season, identified risk factors for mechanical ventilation and in-hospital death.
Results: Among 7929 RV/EV-positive patients, 62.7%, 24.3%, and 13.0% were aged <5, 5-64, and ≥65 years, respectively. In-hospital death was 6.3% among adults aged 65-74 years and 9.2% among those aged ≥75 years. In children aged <5 years, comorbidities strongly predicted mechanical ventilation (adjusted odds ratio [aOR] for ≥2 comorbidities = 4.62, 95% CI: 2.30-9.28) and death (aOR for 1 comorbidity = 3.38, 95% CI: 1.29-8.88). Among adults aged ≥65 years, age ≥75 years predicted in-hospital death (aOR = 2.66, 95% CI: 1.43-4.94). Children aged <5 years from lower-middle-income countries had 10-fold higher probability of in-hospital death than those from high-income countries (aOR = 9.94, 95% CI: 1.87-52.70), the same disparity was seen among older adults from lower-middle-income countries (aOR = 6.83, 95% CI: 1.80-25.88).
Conclusions: Rhinoviruses and enteroviruses infections contribute substantially to severe respiratory disease among hospitalized patients globally, with particularly severe outcomes at both extremes of age and marked inequalities in lower-middle-income countries. Rhinoviruses/enteroviruses warrant integration into respiratory virus surveillance and public health strategies.
Keywords: burden; clinical characteristics; rhinovirus; risk factors; severity.
. 2026 Mar 26;13(4)
fag146.doi: 10.1093/ofid/ofag146. eCollection 2026 Apr.
Clinical Characteristics and Severity of Rhinovirus/Enterovirus-Associated Hospitalizations: A Multicountry Analysis From the Global Influenza Hospital Surveillance Network, 2017-2024
Angelica M Revilla[SUP] 1 [/SUP], Sonia M Raboni[SUP] 2 [/SUP], Heloisa I G Giamberardino[SUP] 2 [/SUP], Melissa K Andrew[SUP] 3 [/SUP], Nazish Badar[SUP] 4 [/SUP], Vicky Baillie[SUP] 5 [/SUP], Elsa Baumeister[SUP] 6 [/SUP], Elena Burtseva[SUP] 7 [/SUP], Ghassan Dbaibo[SUP] 8 [/SUP], Ndongo Dia[SUP] 9 [/SUP], Anca Cristina Drăgănescu[SUP] 10 [/SUP], Parvaiz A Koul[SUP] 11 [/SUP], Viviana Simon[SUP] 12 [/SUP], Emilia Sordillo[SUP] 12 [/SUP], Harm van Bakel[SUP] 12 [/SUP], Anna Sominina[SUP] 13 [/SUP], Tao Zhang[SUP] 14 [/SUP], F Xavier López-Labrador[SUP] 15 16 17 [/SUP], Ainara Mira-Iglesias[SUP] 15 [/SUP], Alejandro Orrico-Sánchez[SUP] 15 17 18 [/SUP], Q Sue Huang[SUP] 19 [/SUP], Joseph Bresee[SUP] 20 [/SUP], Justin R Ortiz[SUP] 21 [/SUP], Marta C Nunes[SUP] 1 [/SUP], Sandra S Chaves[SUP] 22 [/SUP]
Affiliations
- PMID: 41929668
- PMCID: PMC13043072
- DOI: 10.1093/ofid/ofag146
Background: Rhinoviruses and enteroviruses (RV/EV) are frequently detected in hospitalized patients with acute respiratory illness; yet, their clinical burden remains under-characterized, particularly across diverse populations and age groups.
Methods: We analyzed Global Influenza Hospital Surveillance Network data collected from November 2017 through October 2024 across 13 countries representing high-, upper-middle-, and lower-middle-income settings. Multivariable mixed-effects logistic regression models, stratified by age (<5, 5-64, ≥65 years) and adjusted for sex, comorbidities, influenza coinfection, country income level, and season, identified risk factors for mechanical ventilation and in-hospital death.
Results: Among 7929 RV/EV-positive patients, 62.7%, 24.3%, and 13.0% were aged <5, 5-64, and ≥65 years, respectively. In-hospital death was 6.3% among adults aged 65-74 years and 9.2% among those aged ≥75 years. In children aged <5 years, comorbidities strongly predicted mechanical ventilation (adjusted odds ratio [aOR] for ≥2 comorbidities = 4.62, 95% CI: 2.30-9.28) and death (aOR for 1 comorbidity = 3.38, 95% CI: 1.29-8.88). Among adults aged ≥65 years, age ≥75 years predicted in-hospital death (aOR = 2.66, 95% CI: 1.43-4.94). Children aged <5 years from lower-middle-income countries had 10-fold higher probability of in-hospital death than those from high-income countries (aOR = 9.94, 95% CI: 1.87-52.70), the same disparity was seen among older adults from lower-middle-income countries (aOR = 6.83, 95% CI: 1.80-25.88).
Conclusions: Rhinoviruses and enteroviruses infections contribute substantially to severe respiratory disease among hospitalized patients globally, with particularly severe outcomes at both extremes of age and marked inequalities in lower-middle-income countries. Rhinoviruses/enteroviruses warrant integration into respiratory virus surveillance and public health strategies.
Keywords: burden; clinical characteristics; rhinovirus; risk factors; severity.