ArticleThe Journal of infectious diseases2025
Detection by Nasopharyngeal Swabs Alone Underestimates Respiratory Syncytial Virus-Related Hospitalization Incidence in Adults: The Multispecimen Study's Final Analysis.
Article in The Journal of infectious diseases, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 24 papers, 3 of them syntheses that pooled it.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
24 citing papers in PubMed, 3 syntheses or guidelines pooled it.
- Point-of-Care Nucleic Acid Amplification Tests for Respiratory Syncytial Virus Detection in Children and Adults: A Systematic Literature Review.Infectious diseases and therapy · 2026Pooled it
- The Global Burden of Human Metapneumovirus in High-Risk Adults: A Systematic Literature Review and Meta-Analysis.Journal of epidemiology and global health · 2026Pooled it
- Estimating the respiratory syncytial virus-associated hospitalisation burden in older adults in European countries: a systematic analysis.BMC medicine · 2025Pooled it
- Respiratory Syncytial Virus Hospitalizations in Adults ≥50 Years of Age and Those With Congestive Heart Failure or Chronic Obstructive Pulmonary Disease Exacerbations, 2018-2020.Clinical infectious diseases : an official publication of the Infectious Diseases Society of America · 2026Observational
- Viral Pathogen-Specific Severe Acute Respiratory Infections in Hospitalised Adults in Europe: Epidemiological Findings from the id.DRIVE Study 2024-2025.Infectious diseases and therapy · 2026Article
- The Impact of Respiratory Syncytial Virus Undertesting on Estimates of Disease Burden and Vaccine Effectiveness in a Large Integrated Healthcare System.Open forum infectious diseases · 2026Article
- Seasonal dynamics and burden of respiratory syncytial virus, influenza, and COVID-19 in Brazil: a national surveillance study (2019-2023).Journal of global health · 2026Observational
- Bivalent RSVpreF effectiveness against RSV-associated hospital or emergency department care over two seasons: a retrospective test-negative case control study.Lancet regional health. Americas · 2026Article
- Country-Level RSV-Related Hospitalisation Rates Among Adults in High-Income Countries From an Ensemble Model Based on Direct Viral Testing Incidence Data.Influenza and other respiratory viruses · 2026Article
- Clinical and human burden of respiratory syncytial virus in older adults: a narrative review with emphasis on Italian data.Aging clinical and experimental research · 2026Review
- Hospitalization Burden Estimates of Respiratory Syncytial Virus With Adjustment for Case Underascertainment in Adults Aged 18 to 65 Years in High-Income Countries: A Systematic Review, Meta-Analysis, and Modeling Study.Open forum infectious diseases · 2026Article
- Comparison of Human Metapneumovirus- and Respiratory Syncytial Virus-Associated Health Burden in Adults With Chronic Underlying Health Conditions: A Global Systematic Review and Meta-analysis.Open forum infectious diseases · 2026Article
- Clinical Outcomes Among Older Adults Hospitalized with Respiratory Syncytial Virus and Influenza Infection: A Retrospective Analysis.Infectious diseases and therapy · 2026Article
- Respiratory Syncytial Virus Immunization Strategies for Older Adults in Gulf Cooperation Council Countries: Expert Consensus and Recommendations.Infectious diseases and therapy · 2026Article
- Incidence of RSV- and Influenza-Associated Hospitalizations With Community-Acquired Pneumonia and Other Acute Respiratory Infection Among Adults in Japan in 2022-2024: APSG-J2 Study.Influenza and other respiratory viruses · 2026Article
- Outpatient RSV Testing Rates Among US Adults with Lower Respiratory Tract Disease, 2017-2024.Infectious diseases and therapy · 2026Article
- Estimated Vaccine Effectiveness for Respiratory Syncytial Virus-Related Acute Respiratory Illness in Older Adults: Findings From the First Postlicensure Season.Clinical infectious diseases : an official publication of the Infectious Diseases Society of America · 2026Article
- Article
- Risk of Cardiorespiratory Events Following Respiratory Syncytial Virus-Related Hospitalization.JAMA network open · 2026Article
- How do Recent Population-Level RSVpreF Vaccine-Impact Results from the United Kingdom Relate to Previously Reported Vaccine Effectiveness Results?Infectious diseases and therapy · 2026Article
Corrections and comments
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Authors and funding
26 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundMost epidemiologic studies and clinical testing use single nasal/nasopharyngeal swab (NPS) for respiratory syncytial virus (RSV) detection. Studies document that RSV detection improves if another specimen is added to NPS, but the impact of using multiple specimen types has not been assessed. We quantified RSV detection increase using multiple-specimen testing versus NPS alone.
methodsHospitalized adults aged ≥40 years with acute respiratory illness were prospectively enrolled in 7 US/Canadian hospitals. NPS, saliva, sputa, and acute/convalescent sera were collected and tested.
resultsAmong 3669 participants, 100% had NPS, 97.7% saliva, 33.0% sputum, and 33.4% paired serology. RSV detection was 112% higher (95% CI, 86%-141%) using all specimen types as compared with NPS alone. Serology test sensitivity was the highest (73.0%; 95% CI, 65.1%-80.8%), followed by sputum (70.1%; 95% CI, 62.1%-78.0%), saliva (61.4%; 95% CI, 55.4%-67.5%), and NPS (47.2%; 95% CI, 41.1%-53.4%). Among those with congestive heart failure exacerbations, additional specimens increased detection by 267% (95% CI, 85%-625%), and saliva detected more infections than NPS. Among 1013 participants with paired NPSs from different time points, specimens collected on average 1 day later detected 30% fewer RSV infections.
conclusionsRSV detection increased >100% using 4 specimen types, suggesting a 2-fold correction factor is appropriate for incidence and prevalence studies relying on NPS alone. Saliva was more sensitive than NPS, warranting further study, particularly in cardiac cases.
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