Prevalence of RSV and risk factors for severe disease in adults aged 60 years and older presenting with acute respiratory tract infection symptoms

The aim of this study was to determine the prevalence of respiratory syncytial virus (RSV) and the risk factors associated with severe infections in patients aged 60 years and older presenting with acute respiratory infection (ARI) symptoms, thereby providing regional epidemiological data. Between January 1, 2024, and March 31, 2025, nasopharyngeal swab samples were collected from 200 patients aged ≥60 years who presented to our hospital with ARI symptoms. The samples were analyzed using the QIAstat-Dx Respiratory SARS-CoV-2 Panel (Qiagen, Germany). Demographic characteristics and potential risk factors were recorded via structured questionnaires. At least one viral pathogen was identified in 41% (82/200) of the study group, while RSV positivity was detected in 5.5% (11/200) of the patients. RSV was among the three most frequently detected viral agents, althogh Rhinovirus/Enterovirus (12.5%) and Influenza viruses (12.5%) were observed at higher rate. Unlike its typical seasonal pattern, RSV was more frequently observed during the winter and spring months (p=0.030). Among RSV-positive patients, 78.5% were diagnosed with lower respiratory tract infection (LRTI), and the incidence of LRTI increased significantly with age (p=0.018). Furthermore, the vast majority of patients with LRTI (81.8%) were hospitalized. The most reported symptoms among the patients were cough and sputum production. Notably, RSV positivity showed an inverse correlation with high fever (p=0.053) and was approaching statistical significance in its association with the presence of shortness of breath (p=0.054). Compared to patients infected with other viral agents, those with RSV were significantly more likely to be hospitalized (p=0.030), develop hypoxia (p=0.041), and require intensive care support (p=0.044). In conclusion, based on the relevant literature, our results indicate that RSV imposes a significant morbidity burden among older adults with comorbidities. In this population, the disease tends to follow a more severe course, frequently requiring hospitalization, admission to intensive care units and respiratory support. Therefore, to better understand the epidemiology of RSV infections and their clinical impact on public health, multicenter studies including different age groups, particularly high-risk populations, are needed.