Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2025 May;19(5):e70107.
doi: 10.1111/irv.70107.

Unveiling the Spectrum of Respiratory Syncytial Virus Disease in Adults: From Community to Hospital

Koos Korsten  1 , Matthijs R A Welkers  1 , Thijs van de Laar  2 , Alex Wagemakers  2 , Peter van Hengel  3 , Peter C Wever  4 , Eva Kolwijck  4
Affiliations

Unveiling the Spectrum of Respiratory Syncytial Virus Disease in Adults: From Community to Hospital

Koos Korsten et al. Influenza Other Respir Viruses. 2025 May.

Abstract

Background: Respiratory syncytial virus can cause severe disease in the older adult population. Three vaccines for RSV are currently market approved but the risk of RSV-hospitalization in (older) adults from a community level remains elusive. We aimed to estimate the risk of RSV-hospitalization and characterize the patients that end up in hospital.

Methods: We manually analyzed records of adults aged ≥ 20 with RSV-infection between 2022 and 2024 in three hospitals in the Netherlands. These hospitals implemented routine RSV-testing at emergency departments. Using population-based data in combination with the in-hospital data, we estimated the population risk of RSV-hospitalization. Hospital records were analyzed to characterize the role RSV played in their course of disease.

Results: We analyzed 709 RSV cases of whom 503 (70.9%) were hospitalized. Five hundred twenty-six patients were ≥ 60, and 183 were < 60 years of age. The population RSV-hospitalization rate was 6-20 per 100.000 patients aged 20-59 years and 43-236 per 100.000 for those ≥ 60. The highest risks were observed in those with COPD (1702 per 100.000) and with congestive heart disease (2383 per 100.000). RSV caused clinically relevant infection in 88% of hospitalized cases but was only mentioned using specific ICD-codes in 4.4%. Comorbidity was prevalent (88.5%) and exacerbation of underlying disease caused of 46.3% of RSV-related hospital admissions. ICU admittance was 11.2% and in-hospital mortality was 8.1%.

Conclusion: The risk of RSV-hospitalization from the community is low but is increased substantially in those with underlying disease. RSV is often clinically relevant in hospitalized patients by causing exacerbation of underlying disease but is infrequently mentioned in specific ICD-codes.

Keywords: RSV; adults; epidemiology; respiratory syncytial virus.

PubMed Disclaimer

Conflict of interest statement

All authors have completed the ICMJE uniform disclosure form at www.icmje.org/coi_disclosure.pdf and declare: no support from any organization for the submitted work. K.K.; No personal fees received. The Amsterdam UMC has received funding for participation in the following activities; educational activities (expert speaker in Webinar, MedTalks; Webinar, PRIME education; RSV Podcast, Pfizer; and creation of an e‐learning module, Farmacotherapie‐online), participation on an advisory board on the RSV burden in older adults from Pfizer. No other relationships or activities that could appear to have influenced the submitted work.

Figures

FIGURE 1
FIGURE 1
Epidemiology of respiratory syncytial virus (RSV) during the study period for all hospitals combined. The red bars define the percentage of positive RSV tests as a fraction of all performed RSV tests (scale on the left). The grey bars define the absolute number of positive RSV tests (scale on the right).
FIGURE 2
FIGURE 2
Hospitalization rate from the community setting for various age groups. The bar width represents the lower and upper estimates while the red dots represent the individual estimates per site per season from Table S3.
FIGURE 3
FIGURE 3
Hospitalization rate from the community setting for various comorbidity groups, stratified by age. The bar width represents the lower and upper estimates while the dots represent the individual estimates per site from Table 3.
See this image and copyright information in PMC

References

    1. Langedijk A. C. and Bont L. J., “Respiratory Syncytial Virus Infection and Novel Interventions,” Nature Reviews. Microbiology 21, no. 11 (2023): 734–749. - PubMed
    1. Shi T., Denouel A., Tietjen A. K., et al., “Global Disease Burden Estimates of Respiratory Syncytial Virus‐Associated Acute Respiratory Infection in Older Adults in 2015: A Systematic Review and Meta‐Analysis,” Journal of Infectious Diseases 222, no. Suppl 7 (2020): S577–S583. - PubMed
    1. Falsey A. R., “Respiratory Syncytial Virus Infection in Elderly and High‐Risk Adults,” Experimental Lung Research 31, no. Suppl 1 (2005): 77. - PubMed
    1. Surie D., Yuengling K. A., DeCuir J., et al., “Disease Severity of Respiratory Syncytial Virus Compared with COVID‐19 and Influenza Among Hospitalized Adults Aged >/=60 Years—IVY Network, 20 U.S. States, February 2022–May 2023,” MMWR. Morbidity and Mortality Weekly Report 72, no. 40 (2023): 1083–1088. - PMC - PubMed
    1. Martinon‐Torres F., Gutierrez C., Cáceres A., Weber K., and Torres A., “How Does the Burden of Respiratory Syncytial Virus Compare to Influenza in Spanish Adults?,” Influenza and Other Respiratory Viruses 18, no. 6 (2024): e13341. - PMC - PubMed

LinkOut - more resources