Hongyu Liu, Ying Zheng, Xiaoyan Deng, Mengxue Li, Di He, Wenting Zuo, Yitian Xu, Xuhui Shen, Haibo Li, Bin Cao
Background
COVID-19 has caused over 7 million deaths worldwide and remains a critical public health threat. The marked heterogeneity in immune responses among patients poses challenges for targeted treatment. Molecular classification is essential for guiding precision therapies.
Methods
We performed unsupervised consensus clustering on blood transcriptomic data from 351 COVID-19 patients to identify molecular endotypes and validated the classification in an independent cohort of 56 patients. To identify robust endotype-specific biomarkers, we applied XGBoost, LASSO, and random forest algorithms.
Results
Three endotypes with distinct biological and clinical profiles were identified. Endotype 1, associated with favorable outcomes, showed enriched DNA replication pathways and elevated IL7 expression. Endotype 2 featured hypoxia and angiotensin-related pathways. Endotype 3 exhibited TLR4 activation, IL-1β upregulation, and impaired NK cytotoxicity, correlating with poor outcomes. All endotypes shared type I interferon activation. Predictive biomarker pairs included STAT4:S100A11 (endotype 1), SLC4A1:RPL31 (endotype 2), and RALB:MTR (endotype 3), enabling endotype classification with high accuracy. Importantly, these biomarker genes can be reliably measured in peripheral blood using RT-qPCR, making the classification model feasible for clinical application.
Conclusions
This molecular classification reveals heterogeneity in COVID-19 and proposes biomarker-guided strategies for patient stratification and management.
{"title":"Molecular Classification of Patients With COVID-19 Based on Transcriptional Profiling","authors":"Hongyu Liu, Ying Zheng, Xiaoyan Deng, Mengxue Li, Di He, Wenting Zuo, Yitian Xu, Xuhui Shen, Haibo Li, Bin Cao","doi":"10.1111/irv.70227","DOIUrl":"10.1111/irv.70227","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>COVID-19 has caused over 7 million deaths worldwide and remains a critical public health threat. The marked heterogeneity in immune responses among patients poses challenges for targeted treatment. Molecular classification is essential for guiding precision therapies.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We performed unsupervised consensus clustering on blood transcriptomic data from 351 COVID-19 patients to identify molecular endotypes and validated the classification in an independent cohort of 56 patients. To identify robust endotype-specific biomarkers, we applied XGBoost, LASSO, and random forest algorithms.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Three endotypes with distinct biological and clinical profiles were identified. Endotype 1, associated with favorable outcomes, showed enriched DNA replication pathways and elevated IL7 expression. Endotype 2 featured hypoxia and angiotensin-related pathways. Endotype 3 exhibited TLR4 activation, IL-1β upregulation, and impaired NK cytotoxicity, correlating with poor outcomes. All endotypes shared type I interferon activation. Predictive biomarker pairs included STAT4:S100A11 (endotype 1), SLC4A1:RPL31 (endotype 2), and RALB:MTR (endotype 3), enabling endotype classification with high accuracy. Importantly, these biomarker genes can be reliably measured in peripheral blood using RT-qPCR, making the classification model feasible for clinical application.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>This molecular classification reveals heterogeneity in COVID-19 and proposes biomarker-guided strategies for patient stratification and management.</p>\u0000 </section>\u0000 </div>","PeriodicalId":13544,"journal":{"name":"Influenza and Other Respiratory Viruses","volume":"20 2","pages":""},"PeriodicalIF":4.2,"publicationDate":"2026-02-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12887440/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146149635","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
<p>Since mid-2025, a newly designated variant of seasonal influenza A(H3N2), commonly referred to in sequence nomenclature as J.2.4.1 and aliased by Nextstrain as subclade K, has attracted intense attention from clinicians, virologists, and the public [<span>1</span>]. Genetically, subclade K differs from immediately preceding H3N2 viruses by a constellation of amino acid substitutions clustered in the haemagglutinin (HA) surface glycoprotein (notably T135K, K189R, and N158D among others), changes that alter antigenic sites and have produced reduced reactivity with ferret antisera raised against the 2025 vaccine strain [<span>1</span>]. These molecular shifts explain why subclade K is being monitored as a drifted H3N2 lineage rather than being treated as a fundamentally novel pathogen [<span>1</span>].</p><p>Global genomic surveillance indicates that influenza A(H3N2) subclade K increased rapidly in frequency from August to September 2025 and, by late 2025, had been detected across most continents, consistent with widespread dissemination rather than localized spread [<span>2</span>]. GISAID sequence metadata as of January 13, 2026 further show that subclade K is now well established in Asia, with clear signals of recent expansion [<span>2</span>]. The largest cumulative numbers of reported sequences or isolates were recorded in Thailand (229), followed by China (151), Korea (135), and Japan (113), reflecting substantial circulation in both East and Southeast Asia [<span>2</span>]. Importantly, recent reporting dominated in several settings: Korea documented 103 of 135 detections (96.3%) within the past 4 weeks, while Thailand (153/229; 62.2%), Japan (95/113; 60.5%), and China (135/151; 45.6%) also showed a high proportion of recent detections, consistent with rapid lineage replacement [<span>2</span>]. Although absolute counts were lower, Malaysia, Cambodia, Vietnam, Indonesia, and Brunei each reported that more than 80% of their cumulative detections occurred in the most recent 4-week period, suggesting recent introduction or intensified surveillance [<span>2</span>]. By contrast, India reported limited cumulative detections without recent additions, highlighting regional heterogeneity in transmission and sequencing activity [<span>2</span>]. Overall, the predominance of recent detections across multiple Asian countries supports ongoing expansion of subclade K, paralleling observations from the southern hemisphere in 2025, where its emergence coincided with prolonged influenza seasons [<span>3</span>].</p><p>Clinically, infections attributed to subclade K present with the spectrum of illness typical for seasonal influenza: abrupt onset of fever, cough, myalgia, sore throat, nasal congestion, and malaise; severe outcomes continue to cluster among older adults, infants, pregnant people, and those with chronic comorbidities [<span>1, 4</span>]. To date, aggregated epidemiological summaries from WHO and European public health agencies have not demo
自2025年年中以来，一种新发现的季节性甲型流感（H3N2）变种（通常按序列命名法称为J.2.4.1， Nextstrain别名为K亚支）引起了临床医生、病毒学家和公众的高度关注。遗传上，K亚枝与之前的H3N2病毒的不同之处在于，在血凝素（HA）表面糖蛋白（特别是T135K、K189R和N158D等）上聚集了一系列氨基酸取代，这些变化改变了抗原位点，并降低了对2025疫苗株[1]的雪貂抗血清的反应性。这些分子变化解释了为什么亚枝K被监测为一个漂移的H3N2谱系，而不是被视为一个基本的新病原体[1]。全球基因组监测表明，甲型流感（H3N2） K亚支在2025年8月至9月期间频率迅速增加，到2025年底，已在大多数大陆被发现，符合广泛传播而非局部传播的情况。截至2026年1月13日的GISAID序列元数据进一步表明，亚支K在亚洲已经很好地建立起来，近期有明显的扩张信号。报告的序列或分离株累积数量最多的是泰国（229），其次是中国（151）、韩国（135）和日本（113），反映了东亚和东南亚地区的大量传播。重要的是，最近的报告在几个国家占主导地位：韩国在过去4周内记录了135例检测中的103例（96.3%），而泰国（153/229;62.2%）、日本（95/113;60.5%）和中国（135/151;45.6%）也显示了近期检测的高比例，与快速谱系替换bb0一致。虽然绝对数量较低，但马来西亚、柬埔寨、越南、印度尼西亚和文莱各自报告称，其累计发现病例中有80%以上发生在最近4周期间，这表明最近采取了监测措施或加强了监测。相比之下，印度报告了有限的累积检测，没有最近的增加，突出了传播和测序活动[2]的区域异质性。总体而言，近期在多个亚洲国家发现的优势支持了K亚支的持续扩展，这与2025年南半球的观测结果相吻合，在南半球，K亚支的出现与延长的流感季节相吻合。临床，由K亚支引起的感染表现为季节性流感的典型症状：突然出现发热、咳嗽、肌痛、喉咙痛、鼻塞和不适；严重的结果继续集中在老年人、婴儿、孕妇和慢性合并症患者中[1,4]。迄今为止，来自世卫组织和欧洲公共卫生机构的汇总流行病学总结尚未显示出与其他当代H3N2病毒相比，K亚支具有更大内在毒力的一致信号，尽管高病例数和部分疫苗不匹配可能会放大公共卫生影响[1,4]。诊断检测依赖于与标准季节性流感相同的工具：用于确诊和分型的核酸扩增试验（NAAT/PCR），以及在许多临床环境中用于护理点决策的快速抗原检测[1,4]。在需要监测或研究的情况下，测序可以识别亚分支K基因组，并提供抗原和系统发育解释[1,4]。管理遵循既定的流感临床实践指南：对大多数患者进行支持性护理，对高危或重症患者进行早期抗病毒治疗（奥司他韦、帕拉米韦、扎那米韦或巴洛韦，如有可用和指示），理想情况下，在症状出现48小时内开始治疗，以最大限度地提高疗效[1,4]。公共卫生措施（疫苗接种、呼吸卫生、有症状时自愿隔离以及在高风险环境中适当使用口罩）仍然是一级预防工具[1,4]。由于相对于2025-2026年北半球疫苗所选择的H3N2成分，K亚枝含有抗原变化，在一些早期报告中，实验室分析显示K病毒对疫苗株抗血清的血清学反应性降低[b]。真实世界的疫苗有效性（VE）分析是异质的：来自英格兰和其他环境的早期监测的观察性VE估计显示，与更好匹配的季节相比，对H3N2亚分支K的轻度感染有一定的保护作用，但对轻度感染的有效性较低。重要的是，即使是部分匹配的疫苗也能缓解严重疾病并减轻医院压力；免疫接种仍然是目前最有效的人群干预措施。一些国家的媒体在有关K亚支系的头条新闻中普及了“超级流感”这个标签[6,7]。 这个词很容易唤起人们的共鸣，用一个简单的短语传达了一种上升的威胁，这对公众的可读性有好处，但也有很大的风险：它可能意味着前所未有的致病性，助长恐慌，或鼓励低风险个体过度使用紧急服务。强调新颖性而不传达细微差别的报道——亚枝K是一种漂移的季节性H3N2谱系，具有广泛传播的潜力，但没有证明毒性增加——可能扭曲公众的看法，使理性的公共卫生反应复杂化。公共卫生传播者和疫苗倡导者的分析已经注意到这种紧张关系，并敦促使用准确的语言区分快速传播（高发病率）和内在严重性。相比之下，同行评议的科学传播和正式监测报告统一使用技术名称（A（H3N2）亚支J.2.4.1，别名K）并报告测量的描述符——基因突变、抗原表征、疫苗反应性、VE估计和流行病学指标——而不使用耸人听闻的标签[3,5,8]。代表性的科学文章，包括《美国医学会杂志》（JAMA）最近的一篇观点和《欧洲监测》（Eurosurveillance）基于监测的分析，将K亚支视为一种抗原和流行病学发展，需要密切监测和校准公共卫生行动，而不是危言耸听[3,5,8]。这种差异——唤起媒体的速记与精确的科学框架——应该指导临床医生和公共卫生专业人员在与患者和媒体沟通时。综上所述，甲型流感（H3N2） K亚支最好被理解为一种漂流的季节性H3N2谱系，其传播对2025-2026年地区和全球流感季节的时间和强度产生了可测量的影响。主要问题是其快速传播性和部分抗原与当前疫苗株不匹配，没有明确证据表明毒性更大。保持高标准的基因组监测（GISAID/Nextstrain）、明确的临床测试和治疗途径以及谨慎的、非耸人听闻的公众沟通将减少不必要的警报，同时保护弱势群体。卫生当局应强调对高危人群的疫苗接种、早期检测和及时抗病毒治疗，媒体应避免使用“超级流感”等简称，除非有权威科学证据明确说明背景。Timotius Ivan Hariyanto：概念化、调查、资金获取、写作——原稿、写作——审查和编辑、可视化、验证、方法论、项目管理、形式分析、软件、资源、监督、数据管理。作者没有什么可报道的。作者没有什么可报道的。作者声明无利益冲突。作者确认在文章中有支持本研究结果的数据。
{"title":"Understanding Influenza A(H3N2) Subclade K (J.2.4.1): Asian Epidemiology, Clinical Features, and Public Communication Challenges","authors":"Timotius Ivan Hariyanto","doi":"10.1111/irv.70240","DOIUrl":"10.1111/irv.70240","url":null,"abstract":"<p>Since mid-2025, a newly designated variant of seasonal influenza A(H3N2), commonly referred to in sequence nomenclature as J.2.4.1 and aliased by Nextstrain as subclade K, has attracted intense attention from clinicians, virologists, and the public [<span>1</span>]. Genetically, subclade K differs from immediately preceding H3N2 viruses by a constellation of amino acid substitutions clustered in the haemagglutinin (HA) surface glycoprotein (notably T135K, K189R, and N158D among others), changes that alter antigenic sites and have produced reduced reactivity with ferret antisera raised against the 2025 vaccine strain [<span>1</span>]. These molecular shifts explain why subclade K is being monitored as a drifted H3N2 lineage rather than being treated as a fundamentally novel pathogen [<span>1</span>].</p><p>Global genomic surveillance indicates that influenza A(H3N2) subclade K increased rapidly in frequency from August to September 2025 and, by late 2025, had been detected across most continents, consistent with widespread dissemination rather than localized spread [<span>2</span>]. GISAID sequence metadata as of January 13, 2026 further show that subclade K is now well established in Asia, with clear signals of recent expansion [<span>2</span>]. The largest cumulative numbers of reported sequences or isolates were recorded in Thailand (229), followed by China (151), Korea (135), and Japan (113), reflecting substantial circulation in both East and Southeast Asia [<span>2</span>]. Importantly, recent reporting dominated in several settings: Korea documented 103 of 135 detections (96.3%) within the past 4 weeks, while Thailand (153/229; 62.2%), Japan (95/113; 60.5%), and China (135/151; 45.6%) also showed a high proportion of recent detections, consistent with rapid lineage replacement [<span>2</span>]. Although absolute counts were lower, Malaysia, Cambodia, Vietnam, Indonesia, and Brunei each reported that more than 80% of their cumulative detections occurred in the most recent 4-week period, suggesting recent introduction or intensified surveillance [<span>2</span>]. By contrast, India reported limited cumulative detections without recent additions, highlighting regional heterogeneity in transmission and sequencing activity [<span>2</span>]. Overall, the predominance of recent detections across multiple Asian countries supports ongoing expansion of subclade K, paralleling observations from the southern hemisphere in 2025, where its emergence coincided with prolonged influenza seasons [<span>3</span>].</p><p>Clinically, infections attributed to subclade K present with the spectrum of illness typical for seasonal influenza: abrupt onset of fever, cough, myalgia, sore throat, nasal congestion, and malaise; severe outcomes continue to cluster among older adults, infants, pregnant people, and those with chronic comorbidities [<span>1, 4</span>]. To date, aggregated epidemiological summaries from WHO and European public health agencies have not demo","PeriodicalId":13544,"journal":{"name":"Influenza and Other Respiratory Viruses","volume":"20 2","pages":""},"PeriodicalIF":4.2,"publicationDate":"2026-02-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12887220/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146149618","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Mvuyo Makhasi, Jocelyn Moyes, Daniela Paolotti, Mignon du Plessis, Fahima Moosa, Nicole Wolter, Phiwokuhle Ntombela, Siyabonga Mazibuko, Noluthando Duma, Jackie Kleynhans, Anne von Gottberg, Stefano Tempia, Sibongile Walaza, Cheryl Cohen
Background
Digital participatory surveillance (DPS) may provide information on reported influenza-like illnesses (ILI). Combining DPS with laboratory testing allows pathogen identification. We assessed the feasibility of DPS and home-based self-swabbing (HBSS) in South Africa.
Methods
We enrolled a cohort of individuals aged ≥ 18 years who completed weekly respiratory symptoms questionnaires from March to October 2022. We calculated the weekly percentage of reported ILI and COVID-19 and compared it with weekly private sector respiratory consultations (WPSRC). Symptomatic participants were offered HBSS for influenza and SARS-CoV-2 detection by polymerase chain reaction (PCR). We assessed six feasibility indicators.
Results
Recruitment capability: Twenty-six percent (249/954) of participants accessed the platform and enrolled, and 92% (81/88) of participants eligible for HBSS were enrolled. Acceptability: Fifteen percent (32/249) completed the acceptability questionnaire with 100% (32/32) willing to participate in future studies, and 16% (39/249) withdrew from the study. Representativeness: Fifty percent (125/249) were aged 18–39 years, predominantly female 71%, and 79% had a tertiary qualification. Reliability: Thirty-eight percent (80/210) were active participants, median weekly active participation of 23% (interquartile range [IQR]: 19%–29%). Accuracy: Two percent (31/1440) and 25% (359/1440) of reports met ILI and COVID-19, respectively. Influenza and SARS-CoV-2 were detected in 7% (6/81) and 32% (26/81) of tested samples, respectively. There was low correlation with WPSRC (0.08, 95% CI, 0.27–0.43) for ILI and (0.36, 95% CI, 0.11–0.62) for COVID19. Usefulness: Symptoms were reported in 32% (459/1440) of reports, and 11% (49/459) sought medical care.
Conclusion
The study was feasible; however, low enrolment numbers limit power. Linkage to HBSS was successful and demonstrates the potential for pathogen confirmation.
{"title":"Feasibility of a Pilot Crowdsourced Syndromic and Virological Surveillance Platform for Respiratory Illness in South Africa, CoughWatchSA, 2022","authors":"Mvuyo Makhasi, Jocelyn Moyes, Daniela Paolotti, Mignon du Plessis, Fahima Moosa, Nicole Wolter, Phiwokuhle Ntombela, Siyabonga Mazibuko, Noluthando Duma, Jackie Kleynhans, Anne von Gottberg, Stefano Tempia, Sibongile Walaza, Cheryl Cohen","doi":"10.1111/irv.70225","DOIUrl":"10.1111/irv.70225","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Digital participatory surveillance (DPS) may provide information on reported influenza-like illnesses (ILI). Combining DPS with laboratory testing allows pathogen identification. We assessed the feasibility of DPS and home-based self-swabbing (HBSS) in South Africa.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We enrolled a cohort of individuals aged ≥ 18 years who completed weekly respiratory symptoms questionnaires from March to October 2022. We calculated the weekly percentage of reported ILI and COVID-19 and compared it with weekly private sector respiratory consultations (WPSRC). Symptomatic participants were offered HBSS for influenza and SARS-CoV-2 detection by polymerase chain reaction (PCR). We assessed six feasibility indicators.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Recruitment capability: Twenty-six percent (249/954) of participants accessed the platform and enrolled, and 92% (81/88) of participants eligible for HBSS were enrolled. Acceptability: Fifteen percent (32/249) completed the acceptability questionnaire with 100% (32/32) willing to participate in future studies, and 16% (39/249) withdrew from the study. Representativeness: Fifty percent (125/249) were aged 18–39 years, predominantly female 71%, and 79% had a tertiary qualification. Reliability: Thirty-eight percent (80/210) were active participants, median weekly active participation of 23% (interquartile range [IQR]: 19%–29%). Accuracy: Two percent (31/1440) and 25% (359/1440) of reports met ILI and COVID-19, respectively. Influenza and SARS-CoV-2 were detected in 7% (6/81) and 32% (26/81) of tested samples, respectively. There was low correlation with WPSRC (0.08, 95% CI, 0.27–0.43) for ILI and (0.36, 95% CI, 0.11–0.62) for COVID19. Usefulness: Symptoms were reported in 32% (459/1440) of reports, and 11% (49/459) sought medical care.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>The study was feasible; however, low enrolment numbers limit power. Linkage to HBSS was successful and demonstrates the potential for pathogen confirmation.</p>\u0000 </section>\u0000 </div>","PeriodicalId":13544,"journal":{"name":"Influenza and Other Respiratory Viruses","volume":"20 2","pages":""},"PeriodicalIF":4.2,"publicationDate":"2026-02-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12886190/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146149673","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Yusuke Ichikawa, Reiko Saito, Irina Chon, Wint Wint Phyu, Yadanar Kyaw, Su Mon Kyaw Win, Japanese Influenza Collaborative Study Group, Sayaka Yoshioka, Yuyang Sun, Jiaming Li, Tri Bayu Purnama, Keita Wagatsuma, Tsutomu Tamura, Hisami Watanabe, Moe Myat Aye, Swe Setk, Htay Htay Tin
Background
Influenza B virus (IBV) contributes to seasonal epidemics, but its molecular evolution is less defined than influenza A. We analyzed IBVs collected in Japan and Myanmar (2016–2020) to investigate lineage dynamics, reassortment, and genetic mismatch with vaccine strains.
Methods
Respiratory specimens from patients with influenza-like illness were collected in Japan (January 2016–March 2020) and Myanmar (June 2016–October 2019). Lineages were determined by RT-PCR, isolates cultured in MDCK-based cells, and whole-genome sequencing performed on the Illumina iSeq 100. Phylogenetic analyses of all eight segments and hemagglutinin (HA) comparisons with WHO-recommended vaccine strains were conducted.
Results
Of 4703 specimens, 1164 were IBV-positive: 632 B/Victoria (322 Japan and 310 Myanmar) and 532 B/Yamagata (452 Japan and 80 Myanmar). Whole-genome sequences were obtained for 148 isolates. Despite differing seasonality, both countries showed parallel transitions: B/Yamagata predominated in 2017–2018 but disappeared after 2019, while B/Victoria shifted from clade V1A to emerging clade V1A.3 with a three–amino acid deletion in HA (Δ162–164). Two 2018 B/Victoria reassortants in Japan contained four internal genes from B/Yamagata. Multiple HA substitutions were observed among V1A.3 viruses, differing from contemporaneous vaccine strains (clade V1A.1), indicating potential antigenic mismatch. Mutations related to antiviral resistance in polymerase acidic and neuraminidase genes were also assessed.
Conclusions
This study reveals synchronized lineage shifts, inter-lineage reassortment, and vaccine mismatches of IBVs in two distinct countries. The disappearance of B/Yamagata and emergence of divergent B/Victoria clades highlight the need for sustained molecular surveillance to guide vaccine strain selection.
{"title":"Molecular Epidemiology and Genetic Diversity of Influenza B Viruses Based on Whole-Genome Analysis in Japan and Myanmar, 2016–2020","authors":"Yusuke Ichikawa, Reiko Saito, Irina Chon, Wint Wint Phyu, Yadanar Kyaw, Su Mon Kyaw Win, Japanese Influenza Collaborative Study Group, Sayaka Yoshioka, Yuyang Sun, Jiaming Li, Tri Bayu Purnama, Keita Wagatsuma, Tsutomu Tamura, Hisami Watanabe, Moe Myat Aye, Swe Setk, Htay Htay Tin","doi":"10.1111/irv.70234","DOIUrl":"10.1111/irv.70234","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Influenza B virus (IBV) contributes to seasonal epidemics, but its molecular evolution is less defined than influenza A. We analyzed IBVs collected in Japan and Myanmar (2016–2020) to investigate lineage dynamics, reassortment, and genetic mismatch with vaccine strains.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Respiratory specimens from patients with influenza-like illness were collected in Japan (January 2016–March 2020) and Myanmar (June 2016–October 2019). Lineages were determined by RT-PCR, isolates cultured in MDCK-based cells, and whole-genome sequencing performed on the Illumina iSeq 100. Phylogenetic analyses of all eight segments and hemagglutinin (HA) comparisons with WHO-recommended vaccine strains were conducted.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Of 4703 specimens, 1164 were IBV-positive: 632 B/Victoria (322 Japan and 310 Myanmar) and 532 B/Yamagata (452 Japan and 80 Myanmar). Whole-genome sequences were obtained for 148 isolates. Despite differing seasonality, both countries showed parallel transitions: B/Yamagata predominated in 2017–2018 but disappeared after 2019, while B/Victoria shifted from clade V1A to emerging clade V1A.3 with a three–amino acid deletion in HA (Δ162–164). Two 2018 B/Victoria reassortants in Japan contained four internal genes from B/Yamagata. Multiple HA substitutions were observed among V1A.3 viruses, differing from contemporaneous vaccine strains (clade V1A.1), indicating potential antigenic mismatch. Mutations related to antiviral resistance in polymerase acidic and neuraminidase genes were also assessed.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>This study reveals synchronized lineage shifts, inter-lineage reassortment, and vaccine mismatches of IBVs in two distinct countries. The disappearance of B/Yamagata and emergence of divergent B/Victoria clades highlight the need for sustained molecular surveillance to guide vaccine strain selection.</p>\u0000 </section>\u0000 </div>","PeriodicalId":13544,"journal":{"name":"Influenza and Other Respiratory Viruses","volume":"20 2","pages":""},"PeriodicalIF":4.2,"publicationDate":"2026-02-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12886744/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146149647","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Leigh M. Howard, Ana I. Gil, Lucie Ecker, Huiding Chen, Qingxia Chen, Rubelio Cornejo, Stefano Rios, Mayra Ochoa, Bia Peña, Omar Flores, Claudio F. Lanata, Carlos G. Grijalva
In a household cohort enrolled during the COVID-19 pandemic in Lima, Peru, detections of human rhinovirus, endemic coronaviruses, and parainfluenza viruses were significantly lower compared to these viral detections in a similar household cohort followed during the same seven epidemiological weeks in a period immediately preceding the COVID-19 pandemic.
{"title":"Declines in Human Rhinovirus, Coronavirus, Parainfluenza, and Adenovirus Infections During the COVID-19 Pandemic: Evidence From Household-Based Cohort Studies in Lima, Peru","authors":"Leigh M. Howard, Ana I. Gil, Lucie Ecker, Huiding Chen, Qingxia Chen, Rubelio Cornejo, Stefano Rios, Mayra Ochoa, Bia Peña, Omar Flores, Claudio F. Lanata, Carlos G. Grijalva","doi":"10.1111/irv.70233","DOIUrl":"10.1111/irv.70233","url":null,"abstract":"<p>In a household cohort enrolled during the COVID-19 pandemic in Lima, Peru, detections of human rhinovirus, endemic coronaviruses, and parainfluenza viruses were significantly lower compared to these viral detections in a similar household cohort followed during the same seven epidemiological weeks in a period immediately preceding the COVID-19 pandemic.</p>","PeriodicalId":13544,"journal":{"name":"Influenza and Other Respiratory Viruses","volume":"20 2","pages":""},"PeriodicalIF":4.2,"publicationDate":"2026-02-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/irv.70233","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146154749","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Savuth Chin, Chansovannara Soputhy, Heng Seng, Sokly Mom, Borann Sar, Alyssa Finlay, Kathrine R. Tan, Philip L. Gould, Jurre Y. Siegers, Erik A. Karlsson, Sonja J. Olsen, Timothy M. Uyeki, William W. Davis, Darapheak Chau, Sovann Ly
In February 2023, an 11-year-old girl in Cambodia developed severe respiratory symptoms and died of pneumonia and respiratory failure after testing positive for influenza A(H5). Contract tracing and testing identified her father as positive for influenza A(H5). Investigations revealed both were likely exposed to the same sick and dead poultry. Control measures included culling sick poultry and providing health education in the community on handling infected birds. Highly pathogenic avian influenza A(H5N1) viruses continue to pose public health risks in Cambodia.
{"title":"Investigation of a Family Cluster of Human Infections With Highly Pathogenic Avian Influenza A(H5N1) Virus, Clade 2.3.2.1e, in Cambodia, February 2023","authors":"Savuth Chin, Chansovannara Soputhy, Heng Seng, Sokly Mom, Borann Sar, Alyssa Finlay, Kathrine R. Tan, Philip L. Gould, Jurre Y. Siegers, Erik A. Karlsson, Sonja J. Olsen, Timothy M. Uyeki, William W. Davis, Darapheak Chau, Sovann Ly","doi":"10.1111/irv.70231","DOIUrl":"10.1111/irv.70231","url":null,"abstract":"<p>In February 2023, an 11-year-old girl in Cambodia developed severe respiratory symptoms and died of pneumonia and respiratory failure after testing positive for influenza A(H5). Contract tracing and testing identified her father as positive for influenza A(H5). Investigations revealed both were likely exposed to the same sick and dead poultry. Control measures included culling sick poultry and providing health education in the community on handling infected birds. Highly pathogenic avian influenza A(H5N1) viruses continue to pose public health risks in Cambodia.</p>","PeriodicalId":13544,"journal":{"name":"Influenza and Other Respiratory Viruses","volume":"20 2","pages":""},"PeriodicalIF":4.2,"publicationDate":"2026-02-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12875686/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146124825","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Acute otitis media (AOM) affects over 709 million individuals globally each year, more than half of whom are children < 5 years. Respiratory syncytial virus (RSV) is a leading viral cause of pediatric respiratory illness. We aimed to estimate the burden of RSV in children < 5 years with AOM
Methods
We performed a systematic review of studies reporting RSV identified through laboratory testing in children < 5 years with AOM. We searched eight databases from January 1, 1996, to May 9, 2025. We extracted data on RSV proportion in AOM and on co-detection of bacterial pathogens. We reported pooled proportions using random-effects meta-analysis.
Results
We included 27 studies encompassing 8342 children with AOM. The pooled proportion of RSV in children with AOM was 16.9% (95% CI 11.0–23.8, I2 = 94.9%). RSV proportion was higher in inpatient-based studies, in studies conducted during peak RSV seasons, and in children aged < 12 months. Among RSV-positive AOM cases, an estimated 67.4% (95% CI 15.4–100) had at least one bacterial co-detection. The most frequent bacteria co-detected were Streptococcus pneumoniae, followed by Haemophilus influenzae and Moraxella catarrhalis.
Conclusion
RSV is a common contributor to AOM in children < 5 years. Our findings indicate that RSV-associated AOM often involves concurrent bacterial detection. These results highlight the potential impact of recently introduced passive RSV immunization, such as maternal immunization and long-acting monoclonal antibody, in reducing AOM incidence and its complications. Preventing RSV in early childhood could lower the overall burden of AOM and decrease the need for antibiotics.
背景：急性中耳炎（AOM）每年影响全球超过7.09亿人，其中一半以上是儿童。结果：我们纳入了27项研究，包括8342名患有AOM的儿童。AOM患儿RSV合并比例为16.9% （95% CI 11.0 ~ 23.8, I2 = 94.9%）。基于住院患者的研究、RSV高发季节进行的研究以及年龄较大的儿童RSV比例较高。结论：RSV是儿童AOM的常见诱因
{"title":"The Burden of Respiratory Syncytial Virus in Children With Acute Otitis Media: A Systematic Review and Meta-Analysis","authors":"Sebastien Kenmoe, Marshall Dozier, Jingyi Liang, Ruth Jenkins, Harish Nair","doi":"10.1111/irv.70223","DOIUrl":"10.1111/irv.70223","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Acute otitis media (AOM) affects over 709 million individuals globally each year, more than half of whom are children < 5 years. Respiratory syncytial virus (RSV) is a leading viral cause of pediatric respiratory illness. We aimed to estimate the burden of RSV in children < 5 years with AOM</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We performed a systematic review of studies reporting RSV identified through laboratory testing in children < 5 years with AOM. We searched eight databases from January 1, 1996, to May 9, 2025. We extracted data on RSV proportion in AOM and on co-detection of bacterial pathogens. We reported pooled proportions using random-effects meta-analysis.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>We included 27 studies encompassing 8342 children with AOM. The pooled proportion of RSV in children with AOM was 16.9% (95% CI 11.0–23.8, <i>I</i><sup>2</sup> = 94.9%). RSV proportion was higher in inpatient-based studies, in studies conducted during peak RSV seasons, and in children aged < 12 months. Among RSV-positive AOM cases, an estimated 67.4% (95% CI 15.4–100) had at least one bacterial co-detection. The most frequent bacteria co-detected were <i>Streptococcus pneumoniae</i>, followed by <i>Haemophilus influenzae</i> and <i>Moraxella catarrhalis</i>.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>RSV is a common contributor to AOM in children < 5 years. Our findings indicate that RSV-associated AOM often involves concurrent bacterial detection. These results highlight the potential impact of recently introduced passive RSV immunization, such as maternal immunization and long-acting monoclonal antibody, in reducing AOM incidence and its complications. Preventing RSV in early childhood could lower the overall burden of AOM and decrease the need for antibiotics.</p>\u0000 </section>\u0000 </div>","PeriodicalId":13544,"journal":{"name":"Influenza and Other Respiratory Viruses","volume":"20 2","pages":""},"PeriodicalIF":4.2,"publicationDate":"2026-02-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12873495/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146118902","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Influenza transmission is influenced by both individual characteristics and community-level drivers. Understanding how these drivers jointly influence transmission is important to predicting outbreaks and guiding influenza prevention strategies. Our study aimed to assess individual and colony-level influences, including vaccination and environmental factors, on influenza transmission in the Hutterite communities.
Methods
We analyzed data from 3271 individuals in 46 Canadian Hutterite colonies during the 2008 influenza season. Weekly PCR-confirmed Influenza A and B outcomes were examined in relation to demographic, vaccination, geographic, and weather variables using multilevel Bayesian hierarchical models in Integrated Nested Laplace Approximations (INLA), which accounted for colony clustering and temporal autocorrelation.
Results
Of the 3271 participants, 239 (7.3%) had PCR-confirmed influenza (128 Influenza A and 111 Influenza B cases). Older age was found to be protective, especially for Influenza B, while males had slightly lower odds than females. Individual vaccination showed little effect, while colony assignment to influenza vaccination was associated with a lower risk of Influenza A and overall Influenza (A/B). Higher weekly mean temperatures were associated with lower odds of Influenza A but with higher odds of Influenza B. Precipitation showed weak associations, and geographic factors such as elevation and distance to the nearest city suggested possible protective effects, but results were imprecise.
Conclusions
Our findings suggest that influenza risk in Hutterite colonies is associated with local environmental and geographic characteristics in addition to the individual drivers. Incorporating the community-level environmental setting in influenza surveillance may improve preparedness for future outbreaks.
{"title":"Individual and Environmental Factors Influencing Influenza Transmission: A Multilevel Analysis","authors":"Nushrat Nazia, Eleanor Pullenayegum, Mark Loeb","doi":"10.1111/irv.70232","DOIUrl":"10.1111/irv.70232","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Influenza transmission is influenced by both individual characteristics and community-level drivers. Understanding how these drivers jointly influence transmission is important to predicting outbreaks and guiding influenza prevention strategies. Our study aimed to assess individual and colony-level influences, including vaccination and environmental factors, on influenza transmission in the Hutterite communities.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We analyzed data from 3271 individuals in 46 Canadian Hutterite colonies during the 2008 influenza season. Weekly PCR-confirmed Influenza A and B outcomes were examined in relation to demographic, vaccination, geographic, and weather variables using multilevel Bayesian hierarchical models in Integrated Nested Laplace Approximations (INLA), which accounted for colony clustering and temporal autocorrelation.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Of the 3271 participants, 239 (7.3%) had PCR-confirmed influenza (128 Influenza A and 111 Influenza B cases). Older age was found to be protective, especially for Influenza B, while males had slightly lower odds than females. Individual vaccination showed little effect, while colony assignment to influenza vaccination was associated with a lower risk of Influenza A and overall Influenza (A/B). Higher weekly mean temperatures were associated with lower odds of Influenza A but with higher odds of Influenza B. Precipitation showed weak associations, and geographic factors such as elevation and distance to the nearest city suggested possible protective effects, but results were imprecise.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Our findings suggest that influenza risk in Hutterite colonies is associated with local environmental and geographic characteristics in addition to the individual drivers. Incorporating the community-level environmental setting in influenza surveillance may improve preparedness for future outbreaks.</p>\u0000 </section>\u0000 </div>","PeriodicalId":13544,"journal":{"name":"Influenza and Other Respiratory Viruses","volume":"20 2","pages":""},"PeriodicalIF":4.2,"publicationDate":"2026-02-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12869838/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146118839","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Ali Soleimaninejad, Mouhebat Vali, Mohammad Al Qadire, Abdolrahim Asadollahi
Background
Industrial and coastal regions may experience unique pandemic-related mortality patterns, yet data from Middle Eastern occupational cohorts are extremely limited.
Methods
In this retrospective cohort study, we analyzed 58,976 deaths in Bushehr Province, Iran (2014–2023). Autoregressive integrated moving average (ARIMA) models were used to estimate excess mortality, and Poisson regression calculated standardized mortality ratios (SMRs) by occupation and sex.
Results
During the pandemic period (2020–2022), excess mortality reached 15.1%, peaking at 75% during the Delta wave. Males had 2.2 times higher mortality than females. The highest occupational mortality was among fishermen (SMR = 1.89, 95% CI: 1.75–2.04). Despite 78% vaccination coverage, acute myocardial infarction deaths increased by 27.3% (p < 0.001), comprising 41% of deaths during the BA.5 wave.
Conclusion
Significant disparities in COVID-19 mortality were observed by sex and occupation. Industrial workers, particularly males, require targeted public health strategies, including workplace-based vaccination and cardiovascular screening.
{"title":"Impact of the COVID-19 Pandemic on Mortality Patterns in Bushehr Port of Iran: A Comparative Analysis of the Prepandemic Period (2014–2019) and the Pandemic Era (2020–2023)","authors":"Ali Soleimaninejad, Mouhebat Vali, Mohammad Al Qadire, Abdolrahim Asadollahi","doi":"10.1111/irv.70220","DOIUrl":"10.1111/irv.70220","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Industrial and coastal regions may experience unique pandemic-related mortality patterns, yet data from Middle Eastern occupational cohorts are extremely limited.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>In this retrospective cohort study, we analyzed 58,976 deaths in Bushehr Province, Iran (2014–2023). Autoregressive integrated moving average (ARIMA) models were used to estimate excess mortality, and Poisson regression calculated standardized mortality ratios (SMRs) by occupation and sex.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>During the pandemic period (2020–2022), excess mortality reached 15.1%, peaking at 75% during the Delta wave. Males had 2.2 times higher mortality than females. The highest occupational mortality was among fishermen (SMR = 1.89, 95% CI: 1.75–2.04). Despite 78% vaccination coverage, acute myocardial infarction deaths increased by 27.3% (<i>p</i> < 0.001), comprising 41% of deaths during the BA.5 wave.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Significant disparities in COVID-19 mortality were observed by sex and occupation. Industrial workers, particularly males, require targeted public health strategies, including workplace-based vaccination and cardiovascular screening.</p>\u0000 </section>\u0000 </div>","PeriodicalId":13544,"journal":{"name":"Influenza and Other Respiratory Viruses","volume":"20 2","pages":""},"PeriodicalIF":4.2,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12862235/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146100068","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Erika Uusitupa, Matti Waris, Tytti Vuorinen, Terho Heikkinen
Background
Male sex is a well-known risk factor for respiratory syncytial virus (RSV) hospitalization in children, but there are no data on potential differences in clinical features between boys and girls hospitalized with RSV infection.
Methods
We compared the average population-based rates of hospitalization and the clinical features of the illness between boys and girls hospitalized with virologically confirmed RSV infection during 2006–2020 at Turku University Hospital, Finland. During this period, testing for RSV was routine in all children admitted with respiratory infections. The comparisons were performed in different age groups of children up to 5 years of age.
Results
Among all 1204 children < 5 years of age hospitalized with RSV, the average annual RSV hospitalization rates were 4.0/1000 in boys and 3.3/1000 in girls (incidence rate ratio [IRR] 1.21; 95% CI, 1.07–1.35; p = 0.001). The difference was greatest in children aged 3–23 months, among whom the corresponding rates were 5.4/1000 in boys and 3.6/1000 in girls (IRR, 1.50; 95% CI, 1.25–1.80; p < 0.001). The occurrence of respiratory distress was consistently higher in boys than in girls among children aged 6–17 months. In this group of 233 children, 128 of 141 (90.8%) boys had documented respiratory distress, compared with 70 of 92 (76.1%) girls (p = 0.002).
Conclusions
Except for the first 3 months after birth, boys have a 50% higher risk of RSV hospitalization than girls during the first 2 years of life. In that same age group, boys hospitalized with RSV have also significantly more respiratory distress than girls.
{"title":"Comparison of Hospitalization Rates and Clinical Features Between Boys and Girls With Respiratory Syncytial Virus Infection","authors":"Erika Uusitupa, Matti Waris, Tytti Vuorinen, Terho Heikkinen","doi":"10.1111/irv.70235","DOIUrl":"10.1111/irv.70235","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Male sex is a well-known risk factor for respiratory syncytial virus (RSV) hospitalization in children, but there are no data on potential differences in clinical features between boys and girls hospitalized with RSV infection.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We compared the average population-based rates of hospitalization and the clinical features of the illness between boys and girls hospitalized with virologically confirmed RSV infection during 2006–2020 at Turku University Hospital, Finland. During this period, testing for RSV was routine in all children admitted with respiratory infections. The comparisons were performed in different age groups of children up to 5 years of age.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Among all 1204 children < 5 years of age hospitalized with RSV, the average annual RSV hospitalization rates were 4.0/1000 in boys and 3.3/1000 in girls (incidence rate ratio [IRR] 1.21; 95% CI, 1.07–1.35; <i>p</i> = 0.001). The difference was greatest in children aged 3–23 months, among whom the corresponding rates were 5.4/1000 in boys and 3.6/1000 in girls (IRR, 1.50; 95% CI, 1.25–1.80; <i>p</i> < 0.001). The occurrence of respiratory distress was consistently higher in boys than in girls among children aged 6–17 months. In this group of 233 children, 128 of 141 (90.8%) boys had documented respiratory distress, compared with 70 of 92 (76.1%) girls (<i>p</i> = 0.002).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Except for the first 3 months after birth, boys have a 50% higher risk of RSV hospitalization than girls during the first 2 years of life. In that same age group, boys hospitalized with RSV have also significantly more respiratory distress than girls.</p>\u0000 </section>\u0000 </div>","PeriodicalId":13544,"journal":{"name":"Influenza and Other Respiratory Viruses","volume":"20 2","pages":""},"PeriodicalIF":4.2,"publicationDate":"2026-01-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12859523/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146093034","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
扫码关注我们
求助内容：
应助结果提醒方式：
京公网安备 11010802042870号