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Background <p>Respiratory syncytial virus (RSV) peaks in fall-winter and is well known in children. In adults, however, severe outcomes especially compared to influenza are less well-defined. With RSV vaccines newly available in 2024, this study evaluated RSV burden versus influenza.</p> Methods <p>Multicenter retrospective cohort study including adults ≥ 50 years with RT-PCR-confirmed influenza (A/B) or RSV during two pre-COVID-19 fall-winter seasons (2016–2018). Outcomes were hospital admission, length of stay, short-term favorable outcome (within 5 days), intensive care unit (ICU) admission, superinfection, and 90-day mortality.</p> Results <p>Of 386 patients, 288 (74.6%) had influenza (A: 190, B: 98), 98 (25.4%) had RSV. RSV patients exhibited more frequently chronic respiratory diseases (41.8% vs. 24.3%, <i>p</i> = 0.001) and prior hospitalized respiratory infections (39.8% vs. 25.7%, <i>p</i> = 0.01) than influenza patients. Admission rates trended higher for RSV (88.8%, <i>n</i> = 87) than influenza (80.2%, <i>n</i> = 231; <i>p</i> = 0.06). Among admissions (<i>n</i> = 318), RSV stays were significantly longer (median 12 days [IQR 8–18] vs. 9 days [IQR 4–15], <i>p</i> = 0.006), with lower short-term favorable outcomes than influenza B (13.8% vs. 41.4%, aOR 5.1 [1.53–16.86], <i>p</i> &lt; 0.01), but not influenza A (<i>p</i> = 0.34). ICU admissions were higher in younger age groups (50–64 years: aOR 13.4 [2.7–67.2], <i>p</i> = 0.002; 65–74 years: aOR = 4.17 [1.18–14.7], <i>p</i> = 0.03), regardless of viral etiology. Superinfection (10.2% vs. 12.5%, <i>p</i> = 0.57) and 90-day mortality (6.9% vs. 12.9%, <i>p</i> = 0.18) were similar.</p> Conclusion <p>RSV imposes a burden comparable to influenza in admission and mortality, with slower recovery than influenza B. These pre-COVID-19 data provide a critical baseline to support targeted RSV vaccination for adults with comorbidities and aged ≥ 50 years, informing future recommendations.</p>

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Burden of respiratory syncytial virus (RSV) vs. influenza (A/B) in adults ≥ 50 years: a Pre-COVID-19 multicenter retrospective study

  • 期刊论文

  • 发表日期：

    2025年11月22日

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  • Benjamin Davido,
  • Elyanne Gault,
  • Djillali Annane,
  • Sebastien Beaune,
  • Jennifer Dumoulin,
  • Pierre de Truchis,
  • Azzam Saleh-Mghir,
  • Karim Jaffal,
  • Benoit Lemarié

摘要

Background

Respiratory syncytial virus (RSV) peaks in fall-winter and is well known in children. In adults, however, severe outcomes especially compared to influenza are less well-defined. With RSV vaccines newly available in 2024, this study evaluated RSV burden versus influenza.

Methods

Multicenter retrospective cohort study including adults ≥ 50 years with RT-PCR-confirmed influenza (A/B) or RSV during two pre-COVID-19 fall-winter seasons (2016–2018). Outcomes were hospital admission, length of stay, short-term favorable outcome (within 5 days), intensive care unit (ICU) admission, superinfection, and 90-day mortality.

Results

Of 386 patients, 288 (74.6%) had influenza (A: 190, B: 98), 98 (25.4%) had RSV. RSV patients exhibited more frequently chronic respiratory diseases (41.8% vs. 24.3%, p = 0.001) and prior hospitalized respiratory infections (39.8% vs. 25.7%, p = 0.01) than influenza patients. Admission rates trended higher for RSV (88.8%, n = 87) than influenza (80.2%, n = 231; p = 0.06). Among admissions (n = 318), RSV stays were significantly longer (median 12 days [IQR 8–18] vs. 9 days [IQR 4–15], p = 0.006), with lower short-term favorable outcomes than influenza B (13.8% vs. 41.4%, aOR 5.1 [1.53–16.86], p < 0.01), but not influenza A (p = 0.34). ICU admissions were higher in younger age groups (50–64 years: aOR 13.4 [2.7–67.2], p = 0.002; 65–74 years: aOR = 4.17 [1.18–14.7], p = 0.03), regardless of viral etiology. Superinfection (10.2% vs. 12.5%, p = 0.57) and 90-day mortality (6.9% vs. 12.9%, p = 0.18) were similar.

Conclusion

RSV imposes a burden comparable to influenza in admission and mortality, with slower recovery than influenza B. These pre-COVID-19 data provide a critical baseline to support targeted RSV vaccination for adults with comorbidities and aged ≥ 50 years, informing future recommendations.