Key result
Immunocompromised patients, particularly lung and bone marrow transplant recipients, had a significantly higher incidence of RSV infection and coinfections compared to non-immunocompromised controls.
Why the study?
RSV represents a main respiratory infection in immunocompromised patients, but its incidence, coinfections, and the efficacy of ribavirin treatment required evaluation across different immunocompromised populations compared to non-immunocompromised patients.
Does ribavirin treatment reduce mortality in immunocompromised patients with RSV infection compared to supportive therapy alone?
Observational (n=926)
No
Does ribavirin treatment reduce mortality in immunocompromised patients with RSV infection compared to supportive therapy alone?
Immunocompromised patients, particularly lung and bone marrow transplant recipients, have a higher incidence of RSV and coinfections, but ribavirin treatment did not significantly reduce mortality compared to supportive therapy.
Observational data do not support ribavirin mortality benefit over supportive care; leaves open need for randomized trials in immunocompromised RSV.
Respiratory syncytial virus (RSV) represents one of the main respiratory infections found among immunocompromised patients. Objective: The study analyzes the incidence of RSV infection in different populations of immunocompromised patients as organ transplant recipients (lung, other solid organs, hematopoietic stem cells) and oncologic patients (solid organ malignancy and hematological malignancy) compared to a group of non-immunocompromised patients. We also assessed the prevalence of viral, bacterial, and mycotic coinfection. Moreover, we aimed at evaluating the efficacy of ribavirin treatment in terms of mortality reduction. Methods: We conducted a retrospective analysis on a total of 466 transplant patients undergoing bronchoscopy with bronchoalveolar lavage for suspected viral disease or surveillance between 2016 and 2023, compared to 460 controls. Results: The incidence of RSV was significantly higher in immunocompromised patients, particularly in those with lung and bone marrow transplants. Among RSV+ patients, a higher prevalence of viral (influenza virus), bacterial (S. pneumoniae, M. pneumoniae, Nocardia spp.), and fungal (Aspergillus spp.) coinfections were observed. The efficacy of ribavirin in reducing mortality did not show significant differences compared to supportive therapy alone. Conclusions: The results of our exploratory study suggest that immunocompromised patients are particularly vulnerable to RSV infection and coinfections. Our hypothesis-generating data warrant the need for future studies aimed at exploring preventive and therapeutic strategies for RSV infection in these high-risk patient groups.
No takes yet. Share an insight, caveat, or question.
Solidoro et al. (2025) conducted an observational in Respiratory syncytial virus (RSV) infection (n=926). Immunocompromised status (transplant and oncologic patients) vs. Non-immunocompromised controls was evaluated on Incidence of RSV infection. Immunocompromised patients, particularly lung and bone marrow transplant recipients, had a significantly higher incidence of RSV infection and coinfections compared to non-immunocompromised controls.
Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context: