Comparison of clinical outcomes associated with RSV and influenza infections in adults: a multicenter study from Türkiye (for AP-TR)

@article{akdemir2026comparison,
  title = {{Comparison of clinical outcomes associated with RSV and influenza infections in adults: a multicenter study from Türkiye (for AP-TR)}},
  author = {İrem Akdemir and Hasan Selçuk Özger and Tuğba Akkaya Hocagil and Bircan Kayaaslan and Handan Alay and Özge Özgen Top and Esra Kazak and Gamze Kalın Ünüvar and Ayşe Erbay and Güle Çınar and Sesin Kocagöz and Birsen Mutlu and Yasemin Çakır and Çiğdem Mermutluoğlu and Funda Memişoğlu and Seçil Deniz and Serap Şimşek Yavuz and Sema Alp and Derya Korkmaz and Heval Can Bilek and Ayşegül İnci Sezen and Faruk Karakeçili and Neşe Saltoğlu and Elif Hakko and Bedia Dinç and Hamidullah Uyanık and Gülendam Bozdayı and Harun Ağca and Ömür Mustafa Parkan and Zeynep Ceren Karahan and Neval Yurttutan and Aynur Karadenizli and Murşit Hasbek and Nida Özcan and Barış Otlu and İlknur Kaleli and Sevim Meşe and Arzu Sayıner and Yeliz Çetinkol and Yeliz Tanrıverdi Çaycı and Fatma Bayrak Erdem and Barış Gülhan and Ömer Küçükbasmacı and Melda Özdamar and Elif Naz Elmacı and Kerem Sancar and Berivan Şahin and Gülay Korukluoğlu and Sibel Aydoğan and Ali Ağaçfidan and Şebnem Eren Gök and Alpay Azap and Esin Şenol},
  journal = {International Journal of Infectious Diseases},
  year = {2026},
  month = oct,
  doi = {10.1016/j.ijid.2026.109071},
  url = {https://doi.org/10.1016/j.ijid.2026.109071},
  note = {CC BY},
}

TY  - JOUR
TI  - Comparison of clinical outcomes associated with RSV and influenza infections in adults: a multicenter study from Türkiye (for AP-TR)
AU  - İrem Akdemir
AU  - Hasan Selçuk Özger
AU  - Tuğba Akkaya Hocagil
AU  - Bircan Kayaaslan
AU  - Handan Alay
AU  - Özge Özgen Top
AU  - Esra Kazak
AU  - Gamze Kalın Ünüvar
AU  - Ayşe Erbay
AU  - Güle Çınar
AU  - Sesin Kocagöz
AU  - Birsen Mutlu
AU  - Yasemin Çakır
AU  - Çiğdem Mermutluoğlu
AU  - Funda Memişoğlu
AU  - Seçil Deniz
AU  - Serap Şimşek Yavuz
AU  - Sema Alp
AU  - Derya Korkmaz
AU  - Heval Can Bilek
AU  - Ayşegül İnci Sezen
AU  - Faruk Karakeçili
AU  - Neşe Saltoğlu
AU  - Elif Hakko
AU  - Bedia Dinç
AU  - Hamidullah Uyanık
AU  - Gülendam Bozdayı
AU  - Harun Ağca
AU  - Ömür Mustafa Parkan
AU  - Zeynep Ceren Karahan
AU  - Neval Yurttutan
AU  - Aynur Karadenizli
AU  - Murşit Hasbek
AU  - Nida Özcan
AU  - Barış Otlu
AU  - İlknur Kaleli
AU  - Sevim Meşe
AU  - Arzu Sayıner
AU  - Yeliz Çetinkol
AU  - Yeliz Tanrıverdi Çaycı
AU  - Fatma Bayrak Erdem
AU  - Barış Gülhan
AU  - Ömer Küçükbasmacı
AU  - Melda Özdamar
AU  - Elif Naz Elmacı
AU  - Kerem Sancar
AU  - Berivan Şahin
AU  - Gülay Korukluoğlu
AU  - Sibel Aydoğan
AU  - Ali Ağaçfidan
AU  - Şebnem Eren Gök
AU  - Alpay Azap
AU  - Esin Şenol
PY  - 2026
DA  - 2026/10/30
JO  - International Journal of Infectious Diseases
DO  - 10.1016/j.ijid.2026.109071
UR  - https://doi.org/10.1016/j.ijid.2026.109071
AB  - Objectives: Respiratory syncytial virus (RSV) is an increasingly recognized cause of serious respiratory illness in adults, yet data from middle-income countries remain scarce. This study aimed to compare clinical outcomes of RSV and influenza virus infections in hospitalized and outpatient adults in Türkiye. Methods: This retrospective multicenter study included 3299 adult patients (≥18 years) with polymerase chain reaction-confirmed RSV ( n = 628) or influenza ( n = 2671) from 21 centers across Türkiye between January 2022 and March 2024. The primary outcome was viral infection–related hospitalization. The secondary composite outcome was intensive care unit (ICU) admission and/or 30-day mortality among hospitalized patients. Propensity score–based overlap weighting was used to adjust for baseline differences including age, risk group, clinical severity, co-infection status, and study center. Results: After overlap weighting, RSV infection was not significantly associated with increased hospitalization risk compared to influenza (odds ratio [OR]: 0.96, 95% confidence interval [CI]: 0.77-1.20, P = 0.705). Similarly, no significant difference was observed in the composite outcome of ICU admission or 30-day mortality (OR: 1.40, 95% CI: 0.95-2.05, P = 0.088). Age ≥60 years, high-risk comorbidities, and severe acute respiratory infection presentation were the primary independent predictors of both hospitalization and worse outcomes. Bacterial or fungal co-infections and secondary infections were observed in 12.9% and 7.3% of hospitalized patients, respectively, with no significant difference between RSV and influenza groups. Conclusion: After adjustment for baseline characteristics, RSV and influenza were associated with comparable risks of hospitalization and severe clinical outcomes in adults. Host-related factors, particularly older age and underlying comorbidities, were the dominant determinants of adverse outcomes. These findings from a largely unvaccinated, middle-income country cohort highlight the need to expand RSV and influenza vaccination programs targeting high-risk adult populations.
SN  - 1201-9712
SN  - 1878-3511
ER  -