Respiratory syncytial virus infection in adult and paediatric patients admitted to intensive care in Australia: A nation-wide comparison with COVID-19

Yaodong Tang^{1

2}, Peinan Zhao³, Allen C Cheng^{4

5}, Aaliya Ibrahim⁶, Jenna Hassall⁶, Edward Litton^{7

8}, Christopher R Andersen⁹, Cindy Liang¹⁰, Elissa M Milford^{11

12}, Morgan Rose², Mark Plummer¹³, Jing Kong¹⁴, Kerry Johnson¹⁵, Shailesh Bihari^{16

17}, Anis Chaba^{2

18

19}, Husna Begum¹⁸, Sherene Magana Cruz¹⁸, Sze Ng¹⁸, Tony Trapani¹⁸, Lewis Campbell^{20

21}, Mahesh Ramanan²², Richard McAllister²³, Jenipher Chumbes²⁴, Simon Erickson²⁴, Mark Kol²⁵, Winston Cheung²⁵, Andrew A Udy^{1

18}, Aidan Burrell^{1

18}

Affiliations

¹ Department of Intensive Care and Hyperbaric Medicine, The Alfred Hospital, Melbourne, VIC, Australia.
² Department of Intensive Care Medicine, The Austin Hospital, Melbourne, VIC, Australia.
³ School of Translational Medicine, Monash University, Melbourne, VIC, Australia.
⁴ School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, Australia.
⁵ Infectious Diseases, Monash Health and School of Clinical Sciences, Monash University, Clayton, VIC Australia.
⁶ Health Protection Policy and Surveillance Division, Interim Australian Centre for Disease Control (CDC), Australia Government Department of Health and Aged Care, Australia.
⁷ Intensive Care Unit, Fiona Stanley Hospital, Perth, WA, Australia.
⁸ Department of Intensive Care Medicine, St John of God Hospital Subiaco, Perth, WA, Australia.
⁹ Royal North Shore Hospital, NSW, Australia.
¹⁰ Royal Prince Alfred Hospital, NSW, Australia.
¹¹ Intensive Care Services, Royal Brisbane and Women's Hospital, QLD, Australia.
¹² University of Queensland, Brisbane, QLD, Australia.
¹³ Royal Adelaide Hospital, SA, Australia.
¹⁴ Westmead Hospital, NSW, Australia.
¹⁵ Queensland Children's Hospital, QLD, Australia.
¹⁶ Department of Intensive Care Medicine, Flinders Medical Centre, SA, Australia.
¹⁷ College of Medicine and Public Health, Flinders University, SA, Australia.
¹⁸ Australian and New Zealand Intensive Care Research Centre, Monash University, Melbourne, Victoria, Australia.
¹⁹ Department of Intensive Care Medicine, Saint Louis Hospital, Assistance Publique des Hôpitaux de Paris (APHP), Paris, France.
²⁰ Intensive Care Unit, Royal Darwin Hospital, Darwin, NT, Australia.
²¹ Menzies School of Health Research, Darwin, NT, Australia.
²² Intensive Care Unit, Caboolture Hospital, Caboolture, QLD, Australia.
²³ Department of Critical Care Medicine, Royal Hobart Hospital, Hobart, TAS, Australia.
²⁴ Perth Children's Hospital, Perth, WA, Australia.
²⁵ Department of Intensive Care Medicine, Concord Repatriation General Hospital, Sydney, NSW, Australia.

PMID: 40677677
PMCID: PMC12269388
DOI: 10.1016/j.ccrj.2025.100113

Respiratory syncytial virus infection in adult and paediatric patients admitted to intensive care in Australia: A nation-wide comparison with COVID-19

Yaodong Tang et al. Crit Care Resusc. 2025.

. 2025 Jun 27;27(2):100113.

doi: 10.1016/j.ccrj.2025.100113. eCollection 2025 Jun.

Authors

Affiliations

¹ Department of Intensive Care and Hyperbaric Medicine, The Alfred Hospital, Melbourne, VIC, Australia.
² Department of Intensive Care Medicine, The Austin Hospital, Melbourne, VIC, Australia.
³ School of Translational Medicine, Monash University, Melbourne, VIC, Australia.
⁴ School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, Australia.
⁵ Infectious Diseases, Monash Health and School of Clinical Sciences, Monash University, Clayton, VIC Australia.
⁶ Health Protection Policy and Surveillance Division, Interim Australian Centre for Disease Control (CDC), Australia Government Department of Health and Aged Care, Australia.
⁷ Intensive Care Unit, Fiona Stanley Hospital, Perth, WA, Australia.
⁸ Department of Intensive Care Medicine, St John of God Hospital Subiaco, Perth, WA, Australia.
⁹ Royal North Shore Hospital, NSW, Australia.
¹⁰ Royal Prince Alfred Hospital, NSW, Australia.
¹¹ Intensive Care Services, Royal Brisbane and Women's Hospital, QLD, Australia.
¹² University of Queensland, Brisbane, QLD, Australia.
¹³ Royal Adelaide Hospital, SA, Australia.
¹⁴ Westmead Hospital, NSW, Australia.
¹⁵ Queensland Children's Hospital, QLD, Australia.
¹⁶ Department of Intensive Care Medicine, Flinders Medical Centre, SA, Australia.
¹⁷ College of Medicine and Public Health, Flinders University, SA, Australia.
¹⁸ Australian and New Zealand Intensive Care Research Centre, Monash University, Melbourne, Victoria, Australia.
¹⁹ Department of Intensive Care Medicine, Saint Louis Hospital, Assistance Publique des Hôpitaux de Paris (APHP), Paris, France.
²⁰ Intensive Care Unit, Royal Darwin Hospital, Darwin, NT, Australia.
²¹ Menzies School of Health Research, Darwin, NT, Australia.
²² Intensive Care Unit, Caboolture Hospital, Caboolture, QLD, Australia.
²³ Department of Critical Care Medicine, Royal Hobart Hospital, Hobart, TAS, Australia.
²⁴ Perth Children's Hospital, Perth, WA, Australia.
²⁵ Department of Intensive Care Medicine, Concord Repatriation General Hospital, Sydney, NSW, Australia.

PMID: 40677677
PMCID: PMC12269388
DOI: 10.1016/j.ccrj.2025.100113

Abstract

Objective: To assess the characteristics, treatments and outcomes of paediatric and adult intensive care unit (ICU) patients with respiratory syncytial virus (RSV) infection, and compare these with coronavirus disease (COVID-19) during the same period.

Design setting and participants: We conducted a multicenter, prospective, observational study using data from the short period incidence study of severe acute respiratory infection (SPRINT SARI) Australia, in 38 Australian ICUs from 1 June 2022 to 1 September 2024. Demographic, treatment, and outcome data were analysed for patients with confirmed RSV or COVID-19. The primary outcome was in-hospital mortality.

Results: Of 4693 patients were recorded in the SPRINT-SARI database, 2540 met inclusion criteria. RSV was more common in paediatric patients (410/620, 62%) than in adults (249/1920, 13%). Adult with RSV had more chronic pulmonary conditions than those with COVID-19. Paediatric patients with RSV had fewer comorbidities and less invasive mechanical ventilation (IMV) compared to those with COVID-19 (P < 0.05), but required longer duration of IMV once intubated. In-hospital mortality was similar for both adult RSV and COVID-19 (36/249, 14.5%) vs (260/1671, 15.6%), and paediatric RSV(3/410 [0.7%] vs 7/210 [3.3%] P = 0.07). Mortality in adults was associated with male sex, older age, comorbidities, and IMV. Mortality in children was associated with IMV only.

Conclusions: RSV infection can result in an attributable number of ICU admission in Australia, especially in specific populations including young children and older adults with respiratory comorbidities. Mortality in patients admitted to ICU is similar to COVID-19.

Keywords: COVID-19; ICU mortality; Respiratory syncytial virus (RSV); Severe acute respiratory infection (SARI) intensive care unit (ICU).

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Conflict of interest statement

The authors declare the following financial interests/personal relationships which may be considered as potential competing interests: Andrew Udy, Aidan Burrell reports financial support was provided by Australian Government Department of Health and Aged Care. Andrew Udy, Aidan Burrell reports a relationship with Australian Government Department of Health and Aged Care that includes: funding grants. Co-authors Andrew Udy, Edward Litton, Mark Plummer all serve on the editorial board of Critical Care and Resuscitation. If there are other authors, they declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.

Figures

**Fig. 1**
Time flow diagram of RSV and COVID admissions in adult and paediatric populations. RSV, respiratory syncytial virus; COVID, coronavirus disease.

**Fig. 2**
Age distribution of COVID and RSV patients. COVID, coronavirus disease; RSV, respiratory syncytial virus.

**Fig. 3**
Multivariable analysis of risk factors for in-hospital mortality in adult patients.

**Fig. 4**
Multivariable analysis of risk factors for in-hospital mortality in paediatric patients.

See this image and copyright information in PMC

References

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Respiratory syncytial virus infection in adult and paediatric patients admitted to intensive care in Australia: A nation-wide comparison with COVID-19

Affiliations

Respiratory syncytial virus infection in adult and paediatric patients admitted to intensive care in Australia: A nation-wide comparison with COVID-19

Authors

Affiliations

Abstract

Conflict of interest statement

Figures

References

LinkOut - more resources

Full Text Sources

Miscellaneous