ArticleEuropean journal of clinical microbiology & infectious diseases : official publication of the European Society of Clinical Microbiology2026
Burden of respiratory syncytial virus (RSV) vs. influenza (A/B) in adults ≥ 50 years: a Pre-COVID-19 multicenter retrospective study.
Article in European journal of clinical microbiology & infectious diseases : official publication of the European Society of Clinical Microbiology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.
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Abstract
backgroundRespiratory 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.
methodsMulticenter 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.
resultsOf 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.
conclusionRSV 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.
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