ArticleInfectious diseases and therapy2025
A Cluster Randomized Study to Explore Case Definitions, Clinical Course and Consequences of RSV in Community-Dwelling Adults Aged ≥ 50 Years.
Article in Infectious diseases and therapy, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers.
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Who cites it
6 citing papers in PubMed.
- 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
- Exploring the Link Between RSV Infection and Antibiotic Prescriptions in Older Adults: A Systematic Review.Antibiotics (Basel, Switzerland) · 2026Review
- Comparative Diagnostic Performance of the 36-Minute STANDARD M10 Fast Assay for Molecular Diagnosis of SARS-CoV-2, Influenza A and B, and Respiratory Syncytial Virus in Near-Patient Settings.Infectious diseases and therapy · 2026Article
- Effect of Influenza Vaccination on the Disease Severity and Viral Load Among Adult Outpatients and Inpatients.Vaccines · 2025Article
- Epidemiology and Burden of Human Metapneumovirus Among Italian Adults in Outpatient and Inpatient Settings, 2014-2025.Influenza and other respiratory viruses · 2025Article
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19 authors.
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Abstract
introductionIn Europe, surveillance of respiratory syncytial virus (RSV) has been recently incorporated into existing influenza monitoring platforms that are based on influenza-like illness (ILI) or acute respiratory infection (ARI) case definitions. This study aims to compare RSV rates captured by ARI versus ILI case definitions and to describe the clinical and economic trajectories of RSV in older adults.
methodsThe study was conducted in Italy during the 2023/2024 and 2024/2025 seasons. Thirty-eight general practitioners were randomized 1:1 to enroll individuals ≥ 50 years presenting for care and meeting the European criteria for ARI or ILI, respectively. Alternative definitions were also explored. All subjects were tested for respiratory pathogens. RSV-positive individuals were followed for up to one month.
resultsOf 1431 patients (ARI: 741; ILI: 690) included, 5.2% tested positive for RSV. Odds of RSV in the ARI group (5.8%) was 26% higher than in the ILI group (4.6%) [odds ratio (OR) 1.26; 95% CI 0.60-2.65]. Exclusion of GPs with unexpectedly low enrollment rates increased the OR to 1.67 (95% CI 0.80-3.42). Conversely, adults in the ILI group showed higher rates of influenza A (OR 0.83; 95% CI 0.47-1.44) and SARS-CoV-2 (OR 0.57; 95% CI 0.34-0.95). A proposed alternative case definition, denoted as ARI with wheezing and/or productive cough and/or rhonchi and/or dyspnea was sensitive at 92.0% and specific at 30.8%. Among 75 RSV-positive outpatients, the case-complication, case-hospitalization and case-fatality rates were 30.7%, 2.7%, and 1.3%, respectively. The mean costs per RSV case were € 168.71 from the payer perspective and up to € 899.51 from the societal perspective.
conclusionsCompared to a highly sensitive ARI definition, ILI-based surveillance likely underestimates the incidence of RSV. Further qualifiers can enhance specificity of the ARI case definition. The study confirms a significant burden of RSV in older adults.
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