https://doi.org/10.4081/monaldi.2025.3410
Clinical features of respiratory syncytial virus and influenza infections in hospitalized adults across three Italian regions
Submitted: February 5, 2025
Accepted: March 6, 2025
Published: April 1, 2025
Accepted: March 6, 2025
Abstract Views: 266
PDF_EARLY VIEW: 106
SUPPLEMENTARY MATERIAL: 6
SUPPLEMENTARY MATERIAL: 6
Publisher's note
All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.
All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.
Authors
Acute respiratory infections (ARIs) are important causes of morbidity and mortality globally. Respiratory syncytial virus (RSV) is a highly transmissible viral pathogen that is associated with ARIs, with both RSV and influenza virus infections being leading causes of hospitalization in older (especially frail) individuals. However, prospectively collected data on the incidence of RSV infection are scarce. This prospective study sought to estimate the prevalence of and characterize RSV and influenza virus infection in hospitalized patients. Adult patients (≥18 years of age) who were admitted to the respiratory ward of three major hospitals in northern Italy were included in the study and, therefore, had a nasal swab and underwent routine clinical, laboratory, and imaging testing. The primary objective was to estimate the prevalence of influenza virus and RSV infection in these patients. A total of 246 patients were recruited, 36 of whom had a viral or bacterial respiratory infection. Of these, 9 (3.7% of the total included patients or 25.0% of those with any infection) tested positive for the influenza virus, 5 (55.6%) of whom developed acute respiratory failure, with one dying by 3 months post-discharge. A further 3 patients (1.2% of the total included patients or 8.3% of those with any infection) tested positive for RSV. The three patients with RSV had a greater level of dyspnea and greater severity than those with any infection, and all had pneumonia and developed acute respiratory failure, with one dying during hospitalization. Influenza and RSV infections were identified in patients hospitalized in respiratory wards in Northern Italy. The severe nature of the disease in these patients, including a high rate of pneumonia, emphasizes the importance of preventative measures to protect this vulnerable population and, in particular, vaccination.
World Health Organization. The top 10 causes of death. 2024. Available from: https://www.who.int/news-room/fact-sheets/detail/the-top-10-causes-of-death. Accessed on: 28/10/2024.
Hababou Y, Taleb A, Recoing A, et al. Molecular investigation of a RSV outbreak in a geriatric hospital. BMC Geriatr 2021;21:120.
DOI: https://doi.org/10.1186/s12877-021-02064-6
Centers for Disease Control and Prevention. RSV in older adults. 2024. Available from: https://www.cdc.gov/rsv/older-adults/. Accessed on: 5/11/2024.
Shi T, Vennard S, Jasiewicz F, et al. Disease burden estimates of respiratory syncytial virus related acute respiratory infections in adults with comorbidity: a systematic review and meta-analysis. J Infect Dis 2022;226:S17-21.
DOI: https://doi.org/10.1093/infdis/jiab040
Lee N, Lui GCY, Wong KT, et al. High morbidity and mortality in adults hospitalized for respiratory syncytial virus infections. Clin Infect Dis 2013;57:1069-77.
DOI: https://doi.org/10.1093/cid/cit471
Tanner AR, Dorey RB, Brendish NJ, Clark TW. Influenza vaccination: protecting the most vulnerable. Eur Respir Rev 2021;30:200258.
DOI: https://doi.org/10.1183/16000617.0258-2020
Walsh EE, Pérez Marc G, Zareba AM, et al. Efficacy and safety of a bivalent RSV prefusion F vaccine in older adults. N Engl J Med 2023;388:1465–77.
DOI: https://doi.org/10.1056/NEJMoa2213836
Papi A, Ison MG, Langley JM, et al. Respiratory syncytial virus prefusion F protein vaccine in older adults. N Engl J Med 2023;388:595-608.
DOI: https://doi.org/10.1056/NEJMoa2209604
Zeno EE, Nogareda F, Regan A, et al. Interim effectiveness estimates of 2024 Southern Hemisphere influenza vaccines in preventing influenza-associated hospitalization - REVELAC-i Network, Five South American Countries, March-July 2024. MMWR Morb Mortal Wkly Rep 2024;73:861-8.
DOI: https://doi.org/10.15585/mmwr.mm7339a1
O’Halloran AC, Millman AJ, Holstein R, et al. The burden of all-cause mortality following influenza-associated hospitalizations: Influenza Hospitalization Surveillance Network, 2010–2019. Clin Infect Dis 2025;80:e43-5.
DOI: https://doi.org/10.1093/cid/ciae547
Boattini M, Almeida A, Christaki E, et al. Severity of RSV infection in Southern European elderly patients during two consecutive winter seasons (2017–2018). J Med Virol 2021;93:5152-7.
DOI: https://doi.org/10.1002/jmv.26938
Ackerson B, Tseng HF, Sy LS, et al. Severe morbidity and mortality associated with respiratory syncytial virus versus influenza infection in hospitalized older adults. Clin Infect Dis 2019;69:197-203.
DOI: https://doi.org/10.1093/cid/ciy991
Charlson ME, Pompei P, Ales KL, MacKenzie CR. A new method of classifying prognostic comorbidity in longitudinal studies: development and validation. J Chronic Dis 1987;40:373-83.
DOI: https://doi.org/10.1016/0021-9681(87)90171-8
Papi A, Bellettato CM, Braccioni F, et al. Infections and airway inflammation in chronic obstructive pulmonary disease severe exacerbations. Am J Respir Crit Care Med 2006;173:1114-21.
DOI: https://doi.org/10.1164/rccm.200506-859OC
Zhu J, Mallia P, Footitt J, et al. Bronchial mucosal inflammation and illness severity in response to experimental rhinovirus infection in COPD. J Allergy Clin Immunol 2020;146:840-50.e7.
DOI: https://doi.org/10.1016/j.jaci.2020.03.021
Butler CC, Gillespie D, White P, et al. C-reactive protein testing to guide antibiotic prescribing for COPD exacerbations. N Engl J Med 2019;381:111-20.
DOI: https://doi.org/10.1056/NEJMoa1803185
Mallia P, Footitt J, Sotero R, et al. Rhinovirus infection induces degradation of antimicrobial peptides and secondary bacterial infection in chronic obstructive pulmonary disease. Am J Respir Crit Care Med 2012;186:1117-24.
DOI: https://doi.org/10.1164/rccm.201205-0806OC
Onwuchekwa C, Moreo LM, Menon S, et al. Underascertainment of respiratory syncytial virus infection in adults due to diagnostic testing limitations: a systematic literature review and meta-analysis. J Infect Dis 2023;228:173-84.
DOI: https://doi.org/10.1093/infdis/jiad012
Wiseman DJ, Thwaites RS, Ritchie AI, et al. Respiratory syncytial virus-related community chronic obstructive pulmonary disease exacerbations and novel diagnostics: A binational prospective cohort study. Am J Respir Crit Care Med 2024;210:994-1001.
DOI: https://doi.org/10.1164/rccm.202403-0649ED
Groves HE, Piché-Renaud PP, Peci A, et al. The impact of the COVID-19 pandemic on influenza, respiratory syncytial virus, and other seasonal respiratory virus circulation in Canada: A population-based study. Lancet Reg Health Am 2021;1:100015.
DOI: https://doi.org/10.1016/j.lana.2021.100015
Centers for Disease Control and Prevention. RSV vaccine guidance for older adults. 2024. Available from: https://www.cdc.gov/rsv/hcp/vaccine-clinical-guidance/older-adults.html. Accessed on: 4/02/2025.
Global Initiative for Chronic Obstructive Lung Disease. Global strategy for the diagnosis, management, and prevention of chronic obstructive pulmonary disease. 2025. Available from: https://goldcopd.org/2025-gold-report/. Accessed on: 4/02/2025.
Global Initiative For Asthma. Global strategy for asthma management and prevention. 2024. Available from: https://ginasthma.org/2024-report/. Accessed on: 4/02/2025.
Ethics Approval
The study was approved by the independent ethics committees at each institution (Ferrara, Comitato Etico Area Vasta Emilia Centro on 13th September 2023; Mantua, Comitato Etico Territoriale Lombardia 4, on 19th December 2023; Treviso, Comitato Etico Territoriale Area Nord Veneto, on 20th March 2024).How to Cite
Bigoni, Tommaso, Franco Alfano, Marta Vicentini, Maria João Fonseca, Elisa Turriani, Elisa Vian, Micaela Romagnoli, et al. 2025. “Clinical Features of Respiratory Syncytial Virus and Influenza Infections in Hospitalized Adults across Three Italian Regions”. Monaldi Archives for Chest Disease, April. https://doi.org/10.4081/monaldi.2025.3410.
Copyright (c) 2025 The Author(s)
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
PAGEPress has chosen to apply the Creative Commons Attribution NonCommercial 4.0 International License (CC BY-NC 4.0) to all manuscripts to be published.
Similar Articles
- Pedro Magalhães Ferreira, Mariana Ribeiro, Miguel Gonçalves, Carla Damas, Real-world data on home high-flow nasal cannula oxygen therapy in end-stage respiratory disease , Monaldi Archives for Chest Disease: Early Access
- Salvatore Andrea Sciurello, Francesca Graziano, Maria Marcella Laganà, Elena Compalati, Gabriele Pappacoda, Simone Gambazza, Jorge Navarro, Pietro Cecconi, Francesca Baglio, Paolo Banfi, Feasibility of high-frequency percussions in people with severe acquired brain injury and tracheostomy: an observational study , Monaldi Archives for Chest Disease: Early Access
- Federico Baraldi, Tommaso Bigoni, Maria Pia Foschino Barbaro, Claudio Micheletto, Giulia Scioscia, Alessandro Vatrella, Alberto Papi, Mucus production and chronic obstructive pulmonary disease, a possible treatment target: zooming in on N-acetylcysteine , Monaldi Archives for Chest Disease: Early Access
- Neeta Singla, Amitesh Gupta, U.K. Khalid, Ravindra Kumar Dewan, Rupak Singla, Clinical profile, risk factors, disease severity, and outcome for COVID-19 disease in patients with tuberculosis on treatment under the National Tuberculosis Elimination Program: a cohort of 1400 patients , Monaldi Archives for Chest Disease: Early Access
- Avneet Garg, Rakendra Singh, Hariharan Iyer, Mansimranjit Kaur, Surbhi Surbhi, Ashish Jindal, Saranpal Singh, Avtar Singh Bansal, Hem C. Sati, Vinita Jindal, To study heterogeneity in SARS-CoV-2 IgG response titre in patients recovered from COVID-19 , Monaldi Archives for Chest Disease: Vol. 92 No. 2 (2022)
- Iqbal Akhtar Khan, Paola Pierucci, Nicolino Ambrosino, COPD patients’ pre-flight check: A narrative review , Monaldi Archives for Chest Disease: Vol. 92 No. 4 (2022)
- Astha Guliani, Abhishek Tandon, Amartya Chakroborty, Prem Parkash Gupta, Predictors of post COVID complications in patients admitted with moderate to severe COVID symptoms: A single center, prospective, observational study , Monaldi Archives for Chest Disease: Vol. 93 No. 2 (2023)
- Naoto Ishimaru, Yohei Kanzawa, Takahiro Nakajima, Kayoko Okamura, Eiichiro Sando, Isao Ito, Saori Kinami , Hisashi Ohnishi, Specific antibody deficiency to pneumococcal polysaccharide in a young adult with recurrent respiratory infections: a case report , Monaldi Archives for Chest Disease: Vol. 93 No. 3 (2023)
- Davide Cavasin, Umberto Zanini, Laura Montelisciani, Maria Grazia Valsecchi, Laura Fabbri, Laura Antolini, Fabrizio Luppi, The impact of COVID-19 infection on idiopathic pulmonary fibrosis mortality: a systematic review and meta-analysis , Monaldi Archives for Chest Disease: Early Access
- Nidhi Girdhar, Karan Sharma, Satyajit Deshpande, Siddharth Sharma, Vishal Chopra, Anil Sontakke, Role of interleukin-4 receptor α polymorphism in patients with asthma and its correlation with asthma severity , Monaldi Archives for Chest Disease: Early Access
<< < 12 13 14 15 16 17 18 19 20 21 > >>
You may also start an advanced similarity search for this article.
