Document Type : Original Article
Authors
- Navid Omidifar 1
- Alireza Shahedi 2
- Parnia Ansari Jaberi 3
- Maryam Jalali 4
- Mansoureh Shokripour 5
- Bizhan Nomanpour 5
- Bahareh Nikmanesh 6
- Hassan Akrami 6
- Ali Shahsavari 6
- Yousef Nikmanesh 6
1 Biotechnology Research Center, Department of Pathology, Medical School, Shiraz University of Medical Sciences, Shiraz, Iran
2 Student Research Committee, Tehran University of Medical Sciences, Tehran, Iran
3 Student Research Committee, Shiraz University of Medical Sciences, Shiraz, Iran
4 Department of E-Learning in Medical Sciences, Virtual School and Center of Excellence in E-Learning, Shiraz University of Medical Sciences, Shiraz, Iran
5 Department of Pathology, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran
6 Gastroenterohepatology Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
Abstract
Introduction: Respiratory Syncytial Virus (RSV) is a major cause of acute respiratory infections, particularly in infants, young children, and patients with underlying diseases, where it may lead to severe bronchiolitis and pneumonia. Given the shifts in the epidemiological pattern of respiratory viruses following the COVID-19 pandemic and the limited local data in Iran, this study aimed to determine the prevalence of RSV infection among hospitalized patients at Namazi Hospital in Shiraz.
Methods: This descriptive-analytical cross-sectional study was conducted from 2024 to 2025 on patients hospitalized with acute respiratory symptoms at Namazi Hospital. Nasopharyngeal swab samples were tested for RSV using Reverse Transcription Polymerase Chain Reaction (RT-PCR). Demographic and clinical data were extracted from medical records and analyzed with SPSS software, version 26. Statistical tests, including Chi-square, Fisher’s exact, and t-test, were applied to assess associations between variables, with a significance level set at P<0.05.
Results: A total of 1,012 patients were enrolled, of whom 132 (13%) tested positive for RSV. The prevalence was significantly higher in the 0–5-year age group (20.1%, P<0.001). No significant difference was observed between men and women (P>0.05). Most positive cases occurred in winter (31.7%, P<0.001). Among clinical symptoms, fever and cough were most frequently associated with RSV positivity (16.5% and 16.4%, respectively).
Conclusion: RSV remained a leading cause of hospitalization for respiratory illness, particularly in young children, with a marked winter peak. The findings underscored the importance of strengthening seasonal surveillance, improving healthcare facility preparedness during cold months, and raising awareness among families and healthcare professionals for timely diagnosis and control.
Keywords
- Salimi V, Tavakoli-Yaraki M, Yavarian J, Bont L, Mokhtari-Azad T. Prevalence of human respiratory syncytial virus circulating in Iran. J Infect Public Health. 2016;9(2):125-35.
- Ravaglia C, Poletti V. Recent advances in the management of acute bronchiolitis. F1000Prime Rep. 2014;6:103.
- Fretzayas A, Moustaki M. Etiology and clinical features of viral bronchiolitis in infancy. World J Pediatr. 2017;13(4):293-9.
- Lambert L, Sagfors AM, Openshaw PJ, Culley FJ. Immunity to RSV in early-life. Front Immunol. 2014;5:466.
- Shafaati M, Shakoori Farahani A, Salehi M, Arabzadeh M, Bolouki Azari H, Soleimany A, et al. Clinical manifestations, para-clinical features and outcome of Iranian adults with respiratory syncytial virus (RSV) infection: a report from hospitalized patients. BMC Infect Dis. 2025;25(1):181.
- Mulholland EK, Olinsky A, Shann FA. Clinical findings and severity of acute bronchiolitis. Lancet. 1990;335(8700):1259-61.
- Celante H, Oubaya N, Fourati S, Beaune S, Khellaf M, Casalino E, et al. Prognosis of hospitalised adult patients with respiratory syncytial virus infection: a multicentre retrospective cohort study. Clin Microbiol Infect. 2023;29(7):943.e1-8.
- Talbot HK, Falsey AR. The diagnosis of viral respiratory disease in older adults. Clin Infect Dis. 2010;50(5):747-51.
- Murray J, Bottle A, Sharland M, Modi N, Aylin P, Majeed A, et al. Risk factors for hospital admission with RSV bronchiolitis in England: a population-based birth cohort study. PLoS One. 2014;9(2):e89186.
- Openshaw P, Edwards S, Helms P. Changes in rib cage geometry during childhood. Thorax. 1984;39(8):624-7.
- Mariani TJ, Qiu X, Chu C, Wang L, Thakar J, Holden-Wiltse J, et al. Association of dynamic changes in the CD4 T-cell transcriptome with disease severity during primary respiratory syncytial virus infection in young infants. J Infect Dis. 2017;216(8):1027-37.
- Meissner HC. Viral bronchiolitis in children. N Engl J Med. 2016;374(1):62-72.
- Shi T, Balsells E, Wastnedge E, Singleton R, Rasmussen ZA, Zar HJ, et al. Risk factors for respiratory syncytial virus associated with acute lower respiratory infection in children under five years: systematic review and meta-analysis. J Glob Health. 2015;5(2):020416.
- Walsh EE, Peterson DR, Falsey AR. Risk factors for severe respiratory syncytial virus infection in elderly persons. J Infect Dis. 2004;189(2):233-8.
- Onwuchekwa C, Atwell J, Moreo LM, Menon S, Machado B, Siapka M, et al. Pediatric respiratory syncytial virus diagnostic testing performance: a systematic review and meta-analysis. J Infect Dis. 2023;228(11):1516-27.
- Fauroux B, Simoes EAF, Checchia PA, Paes B, Figueras-Aloy J, Manzoni P, et al. The burden and long-term respiratory morbidity associated with respiratory syncytial virus infection in early childhood. Infect Dis Ther. 2017;6(2):173-97.
- Kenmoe S, Bigna JJ, Well EA, Simo FBN, Penlap VB, Vabret A, et al. Prevalence of human respiratory syncytial virus infection in people with acute respiratory tract infections in Africa: a systematic review and meta-analysis. Influenza Other Respir Viruses. 2018;12(6):793-803.
- Gil-Prieto R, Gonzalez-Escalada A, Marin-Garcia P, Gallardo-Pino C, Gil-de-Miguel A. Respiratory syncytial virus bronchiolitis in children up to 5 years of age in Spain: epidemiology and comorbidities: an observational study. Medicine (Baltimore). 2015;94(21):e831.
- Shi T, McAllister DA, O’Brien KL, Simoes EAF, Madhi SA, Gessner BD, et al. Global, regional, and national disease burden estimates of acute lower respiratory infections due to respiratory syncytial virus in young children in 2015: a systematic review and modelling study. Lancet. 2017;390(10098):946-58.
- Fleming DM, Taylor RJ, Lustig RL, Schuck-Paim C, Haguinet F, Webb DJ, et al. Modelling estimates of the burden of respiratory syncytial virus infection in adults and the elderly in the United Kingdom. BMC Infect Dis. 2015;15:443.
- Falsey AR, Walsh EE. Respiratory syncytial virus infection in adults. Clin Microbiol Rev. 2000;13(3):371-84.
- Reeves RM, Hardelid P, Gilbert R, Warburton F, Ellis J, Pebody RG. Estimating the burden of respiratory syncytial virus (RSV) on respiratory hospital admissions in children less than five years of age in England, 2007– Influenza Other Respir Viruses. 2017;11(2):122-9.
- Onwuchekwa C, Moreo LM, Menon S, Machado B, Curcio D, Kalina W, et al. Underascertainment of respiratory syncytial virus infection in adults due to diagnostic testing limitations: a systematic literature review and meta-analysis. J Infect Dis. 2023;228(2):173-84.
- Hardelid P, Verfuerden M, McMenamin J, Smyth RL, Gilbert R. The contribution of child, family and health service factors to respiratory syncytial virus (RSV) hospital admissions in the first 3 years of life: birth cohort study in Scotland, 2009 to 2015. Euro Surveill. 2019;24(1):1800046.
- Scheltema NM, Gentile A, Lucion F, Nokes DJ, Munywoki PK, Madhi SA, et al. Global respiratory syncytial virus-associated mortality in young children (RSV GOLD): a retrospective case series. Lancet Glob Health. 2017;5(10):e984-91.