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: 279
PDF_EARLY VIEW: 108
SUPPLEMENTARY MATERIAL: 8
SUPPLEMENTARY MATERIAL: 8
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
- Marco Ambrosetti, Gabriella Malfatto, Anna Maria Cremona, Marcello Arca, Pompilio Faggiano, Familial Hypercholesterolemia in Cardiac Rehabilitation: a new field of interest , Monaldi Archives for Chest Disease: Vol. 82 No. 2 (2014): Cardiac series
- Ivano Bonadei, Enrico Vizzardi, Antonio D’Aloia, Edoardo Sciatti, Edoardo Cervi, Stefano Bonardelli, Marco Metra, Stefano Maria Giulini, A drastic complex atheromatous aorta A case report , Monaldi Archives for Chest Disease: Vol. 80 No. 1 (2013): Cardiac series
- L. Dominioni, N. Rotolo, A. Poli, M. Castiglioni, M. Mangini, M. Spagnoletti, M. Paolucci, A. Paddeu, W. Mantovani, A. Zanini, A. Imperatori, Cost of a population-based programme of chest x-ray screening for lung cancer , Monaldi Archives for Chest Disease: Vol. 79 No. 2 (2013): Pulmonary series
- Guido Levi, Marco Umberto Scaramozzino, Stefania Cavallo, Giuliano Castignini, Michela Bezzi, Laura Pini, Frank Nania, Sheenam Sheenam, Pulmonary rehabilitation improves functional outcomes and quality of life in post-SARS-CoV-2 mild-to-moderate infection patients: a pilot study , Monaldi Archives for Chest Disease: Vol. 94 No. 1 (2024)
- Sônia Elvira dos Santos Marinho, Dulciane Nunes Paiva, Guacyra Magalhães Pires Bezerra, Thayse Neves dos Santos Silva, Cláudia Regina Oliveira de Paiva Lima, Maria Cristina Falcão Raposo, Patrícia Érika de Melo Marinho, Does the use of a diving mask adapted for non-invasive ventilation in hypoxemic acute respiratory failure in individuals with and without COVID-19 increase the ratio of arterial oxygen partial pressure to fractional inspired oxygen? A randomized clinical trial , Monaldi Archives for Chest Disease: Vol. 94 No. 1 (2024)
- Cristina Puricelli, Eleonora Volpato, Salvatore Sciurello, Antonello Nicolini, Paolo Banfi, Intermittent abdominal pressure ventilation: feasibility and efficacy in neuromuscular disease. A case report , Monaldi Archives for Chest Disease: Vol. 91 No. 4 (2021)
- Kapil Kumar, Prem Parkash Gupta, Arvind Kumar Verma, Rohtas Yadav, Assessment of prevalence and characteristics of asthma-COPD overlap among patients with chronic airflow obstruction , Monaldi Archives for Chest Disease: Vol. 93 No. 2 (2023)
- Amira Aishah Che Ani, Sakinah Mohd Akhir, Winnie Chiang Li-Xue, Nur Zurairah Shahidan, Azman Abd Hamid, Diffuse alveolar haemorrhage and myocardial infarction: life-threatening effects from self-injected hyaluronic acid dermal filler , Monaldi Archives for Chest Disease: Vol. 91 No. 4 (2021)
- Ornella Bettinardi, Giulio Vidotto, Loretta Moroni, Roberto F.E. Pedretti, Maurizio Maini, Alessandro Rosi, Giorgio Bertolotti, Measuring change in rehabilitative cardiology: reliability of a short questionnaire to assess an outcome , Monaldi Archives for Chest Disease: Vol. 78 No. 2 (2012): Cardiac series
- Furio Colivicchi, David Mocini, Massimo Uguccioni, Stefano Strano, Giuseppe Imperoli, Massimo Santini, Smoking cessation interventions after Acute Coronary Syndromes. Results of a cross-sectional survey in the Lazio Region of Italy , Monaldi Archives for Chest Disease: Vol. 78 No. 2 (2012): Cardiac series
<< < 32 33 34 35 36 37 38 39 40 41 > >>
You may also start an advanced similarity search for this article.
