The New Contours of Respiratory Infections

Long COVID

To better understand the burden of long COVID, Emma van der Spek from the National Institute for Public Health and the Environment (Netherlands) followed up adults with long COVID. She found that chest tightness, dyspnoea and fatigue tended to ease over time, while memory problems increased. Her findings also suggested a heterogeneous effect of revaccination and reinfection on long COVID.

Influenza

Using a contemporary dataset, Wilhelmine Meeraus from the INFORM (INvestigation oF cOvid-19 Risk among iMmunocompromised populations) study at AstraZeneca found that the influenza burden in England remains significant despite the availability of influenza vaccination for at-risk individuals. The risk of influenza hospitalisation was highest among stem cell transplant recipients and individuals with cystic fibrosis, highlighting the need to better protect people with immunocompromising conditions and other comorbidities.

Influenza and RSV

Comparing the outcomes of RSV versus influenza in hospitalised adults aged ≥60 years, Prof. Michal Mandelboim from the Israel Ministry of Health found that clinical outcomes, including 90-day mortality and re-hospitalisation, were similar between the two groups. Patients with RSV, however, had significantly more comorbidities than those with influenza. She believes these findings support RSV vaccination for older adults to reduce severe clinical outcomes in Israel.

RSV in haematological malignancies

To assess the burden of RSV in patients with haematological malignancies, Justin Dutoit from the Wits Donald Gordon Medical Centre (South Africa) conducted a three-centre cohort study in the Netherlands and South Africa. He found that RSV incidence varied between 4.2% and 7.7% across centres, and that therapeutic strategies differed, underscoring the need for standardised care pathways and testing policies.

Hidden burden of RSV in younger adults

RSV poses a well-known burden on infants and older adults, but its impact on younger adults remains underexplored. Clarisse Demont at Moderna reported new data from France showing that RSV is not just a threat to infants and seniors. Among 29,162 RSV-related hospitalisations identified in adults, 16.4% were aged 18–59 years, of whom 27.6% had a cardiorespiratory comorbidity. She found that ICU admissions, lengths of stay and costs per hospitalisation were considerable. “The working-age adult population could be as severely impacted by RSV as the elderly, prompting us to think about targeted prevention strategies,” she said.

Severe acute respiratory infections in ICU

Sjoerd van der Bie from Spaarne Gasthuis presented a comparative assessment of clinical outcomes for ICU patients with severe acute respiratory infections. He found high hospital mortality rates among patients with RSV, human metapneumovirus, influenza virus, and parainfluenza virus, with similar mechanical ventilation parameters across groups. He believes a prospective follow-up study on the long-term burden of disease is needed.

With continued efforts to pinpoint how respiratory infections affect different at-risk populations, targeted prevention and disease management are coming into sharper focus, signalling a more promising future.