---
title: "Burden of RSV Hospitalizations in Brazilian Adults Aged ≥60 Years (2013–2024)"
id: "pubmed-42758792"
canonical_url: "https://medichelpline.com/clinical-feed/pubmed-42758792"
content_type: "clinical_feed_article"
specialty: "Critical Care"
source_name: "PubMed / NCBI"
source_url: "https://pubmed.ncbi.nlm.nih.gov/42758792/"
doi: "10.1371/journal.pone.0357303"
published_at: "2026-09-18T00:00:00.000Z"
evidence_level: "Journal Article"
license: "CC-BY-NC-4.0 / Informational Use"
---
# Burden of RSV Hospitalizations in Brazilian Adults Aged ≥60 Years (2013–2024)
## Provenance & Clinical Metadata
- **Canonical URL:** https://medichelpline.com/clinical-feed/pubmed-42758792
- **Specialty:** [Critical Care](https://medichelpline.com/clinical-feed/critical-care.md)
- **Primary Source:** PubMed / NCBI
- **Source URL:** [Original Journal Publication](https://pubmed.ncbi.nlm.nih.gov/42758792/)
- **DOI:** [10.1371/journal.pone.0357303](https://doi.org/10.1371%2Fjournal.pone.0357303)
- **Published At:** 2026-09-18T00:00:00.000Z
- **Evidence Rating:** Journal Article
## Executive GIST (TL;DR)
- This retrospective surveillance analysis describes **respiratory syncytial virus (RSV)**–associated severe acute respiratory infection (**SARI**) hospitalizations in Brazilian adults aged ≥60 years from 2013 through 2024 using the national Influenza Epidemiological Surveillance Information System - Gripe. - A total of **4,636** RSV-related hospitalizations were reported in this age group over the study period, with a marked increase after the COVID-19 pandemic (2020–2024). - Annual hospitalization rates rose from under 1 per 100,000 population in 2013 to over 15 per 100,000 in 2024, reflecting increased detection and/or transmission in the post-pandemic years. - Women comprised 59% of reported cases; hospitalizations were concentrated in the South and Southeast regions, partly attributed to greater test availability in those areas. - In-hospital mortality increased over time; mean in-hospital mortality was nearly fivefold higher after the pandemic compared with pre-pandemic years. - Case fatality rates (CFRs) remained high overall (21–31%), with the highest CFRs in adults aged ≥80 years. - The mean length of stay was 12.9 days. Approximately one-third of cases required intensive care unit (**ICU**) admission; of those admitted to ICU, more than two-thirds needed **ventilatory support**. - Comorbidities were documented in 71% of cases. The most frequent comorbid conditions were **cardiovascular** disease (65%) and **diabetes** (33%), both associated with higher mortality and greater healthcare utilization. - The authors conclude RSV imposes a substantial and increasing burden among older adults in Brazil, with prolonged hospitalizations, high CFRs, and intensive resource use, and recommend strengthened surveillance and consideration of adult vaccination strategies. - Conflict of interest disclosures note multiple authors affiliated with or receiving support from vaccine and pharmaceutical companies; details are reported in the original article.
## Clinical Analysis & Structured Key Points
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Affiliations Expand ### Affiliations * 1 Fiocruz, Rio de Janeiro, Brazil. * 2 GSK, Rio de Janeiro, Brazil. * 3 School of Medicine, Federal University of Mato Grosso do Sul, Brazil. * 4 Oswaldo Cruz Foundation, Mato Grosso do Sul, Brazil. * 5 IQVIA, São Paulo, Brazil. * 6 Universidade Federal de Santa Catarina (UFSC), Florianópolis, Brazil. * 7 GSK, London, United Kingdom. * PMID: **42758792** * DOI: [ 10.1371/journal.pone.0357303 ](https://doi.org/10.1371/journal.pone.0357303) Item in Clipboard # Burden of respiratory syncytial virus (RSV) hospitalizations among adults aged 60 years or more in Brazil: A retrospective surveillance database analysis (2013-2024) Bruna Medeiros Gonçalves de Veras et al. PLoS One. 2026. Show details Display options Display options Format Abstract PubMed PMID PLoS One Actions * [ Search in PubMed ](https://pubmed.ncbi.nlm.nih.gov/?term=%22PLoS+One%22%5Bjour%5D&sort=date&sort_order=desc) * [ Search in NLM Catalog ](https://www.ncbi.nlm.nih.gov/nlmcatalog?term=%22PLoS+One%22%5BTitle+Abbreviation%5D) * [ Add to Search ](https://pubmed.ncbi.nlm.nih.gov/42758792/) . 2026 Sep 18;21(9):e0357303. doi: 10.1371/journal.pone.0357303. eCollection 2026. ### Authors [Bruna Medeiros Gonçalves de Veras](https://pubmed.ncbi.nlm.nih.gov/?term=de+Veras+BMG&cauthor_id=42758792)[ 1 ](https://pubmed.ncbi.nlm.nih.gov/42758792/#short-view-affiliation-1 "Fiocruz, Rio de Janeiro, Brazil."), [Lessandra Michelin](https://pubmed.ncbi.nlm.nih.gov/?term=Michelin+L&cauthor_id=42758792)[ 2 ](https://pubmed.ncbi.nlm.nih.gov/42758792/#short-view-affiliation-2 "GSK, Rio de Janeiro, Brazil."), [Julio Croda](https://pubmed.ncbi.nlm.nih.gov/?term=Croda+J&cauthor_id=42758792)[ 3 ](https://pubmed.ncbi.nlm.nih.gov/42758792/#short-view-affiliation-3 "School of Medicine, Federal University of Mato Grosso do Sul, Brazil.")[ 4 ](https://pubmed.ncbi.nlm.nih.gov/42758792/#short-view-affiliation-4 "Oswaldo Cruz Foundation, Mato Grosso do Sul, Brazil."), [Thaís Zamboni Berra](https://pubmed.ncbi.nlm.nih.gov/?term=Berra+TZ&cauthor_id=42758792)[ 5 ](https://pubmed.ncbi.nlm.nih.gov/42758792/#short-view-affiliation-5 "IQVIA, São Paulo, Brazil."), [Gustavo Pires-Matheus](https://pubmed.ncbi.nlm.nih.gov/?term=Pires-Matheus+G&cauthor_id=42758792)[ 5 ](https://pubmed.ncbi.nlm.nih.gov/42758792/#short-view-affiliation-5 "IQVIA, São Paulo, Brazil."), [Igor Sampietri](https://pubmed.ncbi.nlm.nih.gov/?term=Sampietri+I&cauthor_id=42758792)[ 2 ](https://pubmed.ncbi.nlm.nih.gov/42758792/#short-view-affiliation-2 "GSK, Rio de Janeiro, Brazil."), [Magda Araujo](https://pubmed.ncbi.nlm.nih.gov/?term=Araujo+M&cauthor_id=42758792)[ 2 ](https://pubmed.ncbi.nlm.nih.gov/42758792/#short-view-affiliation-2 "GSK, Rio de Janeiro, Brazil."), [Rosemeri Maurici da Silva](https://pubmed.ncbi.nlm.nih.gov/?term=da+Silva+RM&cauthor_id=42758792)[ 6 ](https://pubmed.ncbi.nlm.nih.gov/42758792/#short-view-affiliation-6 "Universidade Federal de Santa Catarina \(UFSC\), Florianópolis, Brazil."), [Adriana Guzmán-Holst](https://pubmed.ncbi.nlm.nih.gov/?term=Guzm%C3%A1n-Holst+A&cauthor_id=42758792)[ 7 ](https://pubmed.ncbi.nlm.nih.gov/42758792/#short-view-affiliation-7 "GSK, London, United Kingdom.") ### Affiliations * 1 Fiocruz, Rio de Janeiro, Brazil. * 2 GSK, Rio de Janeiro, Brazil. * 3 School of Medicine, Federal University of Mato Grosso do Sul, Brazil. * 4 Oswaldo Cruz Foundation, Mato Grosso do Sul, Brazil. * 5 IQVIA, São Paulo, Brazil. * 6 Universidade Federal de Santa Catarina (UFSC), Florianópolis, Brazil. * 7 GSK, London, United Kingdom. * PMID: **42758792** * DOI: [ 10.1371/journal.pone.0357303 ](https://doi.org/10.1371/journal.pone.0357303) Item in Clipboard Cite Display options Display options Format Abstract PubMed PMID ## Abstract **Background:** Globally, respiratory syncytial virus (RSV) is a leading cause of severe respiratory illness in adults aged ≥60 years. Risk increases with advancing age and comorbidities, particularly cardiopulmonary disease and diabetes. RSV disease burden in adults is often underestimated due to non-specific presentation and limited testing. In Brazil, RSV is a recognized driver of hospitalizations and deaths in older adults, yet comprehensive epidemiological data remain scarce. Here, we describe RSV-associated severe acute respiratory infection (SARI) hospitalizations among adults aged ≥60 years in Brazil between 2013 and 2024. **Methods:** We retrospectively analyzed RSV-associated SARI hospitalizations reported to the national Influenza Epidemiological Surveillance Information System -Gripe. Outcomes included hospitalization frequency, in-hospital mortality, case fatality rates (CFRs), seasonality, healthcare resource utilization, and comorbidities. **Results:** Between 2013 and 2024, 4,636 RSV-related hospitalizations occurred in adults aged ≥60 years, increasing sharply after the COVID-19 pandemic (2020-2024). Hospitalization rates increased from 15 per 100,000 in 2024. Women accounted for most cases (59%), and hospitalizations were concentrated in the South and Southeast regions partly due to test availability. In-hospital mortality increased over time, with mean rates nearly fivefold higher post-pandemic than pre-pandemic. CFRs remained consistently high (21-31%), particularly in adults aged ≥80 years. The mean length of hospital stay was 12.9 days. Almost one-third of cases required intensive care unit admission, of whom more than two-thirds needed ventilatory support. Comorbidities were present in 71% of cases, most commonly cardiovascular (65%) and diabetes (33%)were strongly associated with increased mortality and healthcare resource utilization. **Conclusions:** RSV poses a substantial and increasing burden among Brazilian adults aged ≥60 years, with a high CFR, prolonged hospitalizations, and intensive healthcare resource utilization. These findings highlight the need to strengthen RSV surveillance and discuss vaccination strategies for adults aged older in Brazil. Copyright: © 2026 Medeiros Gonçalves de Veras et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. [PubMed Disclaimer](https://pubmed.ncbi.nlm.nih.gov/disclaimer/) ## Conflict of interest statement The authors have read the journal’s policy and have the following competing interests: LM, IS, MA, and AGH are employees of GSK [https://www.gsk.com]. BMG is a former GSK employee. LM and AGH hold financial equities in GSK. TZB and GPM are employees of IQVIA Brazil [https://www.iqvia.com]. JC declares having grants or contracts from Valneva [https://valneva.com] for a Chikungunya Vaccine study in Adolescents, CEPI (Coalition for Epidemic Preparedness)/Sabin Institute [https://www.sabin.org] for a COVID-19 phase 4 fractional vaccine study, MSD [https://www.msd.com] for a COVID-19 drug phase 3 study, Takeda [https://www.takeda.com] for a study on the impact of dengue vaccination in Mato Grosso do Sul (Brazil), Sanofi Pasteur [https://www.sanofi.us] for a COVID-19 mRNA phase 1 study, and the National Institutes of Health (NIH) [https://www.nih.gov] for a study on strategies for controlling tuberculosis in prisons, outside of the submitted study. JC also declares receiving honoraria from Pfizer [https://www.pfizer.com] for a lecture in Foro Latinoamericano para Asesores Médicos en Vacunas 2023, for a lecture at Inspirar Event 2024, and for a lecture for Pfizer Emerging Markets Advance Speaker Training 2024, outside of the submitted study. JC also declares receiving honoraria from Takeda for lectures at the Asian Dengue Summit 2024, Infecto Rio 2024, and the Brazilian Congress of Tropical Medicine 2023, outside of the submitted study. JC participated in the Brazil Advisory Board for the mRNA-1273 vaccine organized by Moderna/Zodiac [https://www.modernatx.com], the Brazil Advisory Board RSV maternal vaccine organized by Pfizer, the Brazil Advisory Board Qdenga vaccine organized by Takeda, the Latin America and Brazilian Advisory Board Nirmatrelevir/Ritonavir-Paxlovid organized by Pfizer, the Brazil Advisory Board RSV elderly vaccine organized by GSK, and the Takeda Global Dengue Steering Committee, outside of the submitted study. RMdS received consulting fees and support for attending meetings and/or travel from GSK and Pfizer, as well as payments from GSK, Pfizer, and AstraZeneca [https://www.astrazeneca.com] for lectures, outside the submitted study. All authors declare no other financial or non-financial relationships and activities. There are no patents, products in development or marketed products associated with this research to declare. This does not alter our adherence to PLOS ONE and GSK policies on sharing data and materials. ## MeSH terms * Aged Actions * [ Search in PubMed ](https://pubmed.ncbi.nlm.nih.gov/?term=%22Aged%22%5BMeSH%5D&sort=date&sort_order=desc) * [ Search in MeSH ](https://www.ncbi.nlm.nih.gov/mesh?term=Aged) * [ Add to Search ](https://pubmed.ncbi.nlm.nih.gov/42758792/) * Aged, 80 and over Actions * [ Search in PubMed ](https://pubmed.ncbi.nlm.nih.gov/?term=%22Aged%2C+80+and+over%22%5BMeSH%5D&sort=date&sort_order=desc) * [ Search in MeSH ](https://www.ncbi.nlm.nih.gov/mesh?term=Aged%2C+80+and+over) * [ Add to Search ](https://pubmed.ncbi.nlm.nih.gov/42758792/) * Brazil / epidemiology Actions * [ Search in PubMed ](https://pubmed.ncbi.nlm.nih.gov/?term=%22Brazil%2Fepidemiology%22%5BMeSH%5D&sort=date&sort_order=desc) * [ Search in MeSH ](https://www.ncbi.nlm.nih.gov/mesh?term=Brazil) * [ Add to Search ](https://pubmed.ncbi.nlm.nih.gov/42758792/) * Databases, Factual Actions * [ Search in PubMed ](https://pubmed.ncbi.nlm.nih.gov/?term=%22Databases%2C+Factual%22%5BMeSH%5D&sort=date&sort_order=desc) * [ Search in MeSH ](https://www.ncbi.nlm.nih.gov/mesh?term=Databases%2C+Factual) * [ Add to Search ](https://pubmed.ncbi.nlm.nih.gov/42758792/) * Female Actions * [ Search in PubMed ](https://pubmed.ncbi.nlm.nih.gov/?term=%22Female%22%5BMeSH%5D&sort=date&sort_order=desc) * [ Search in MeSH ](https://www.ncbi.nlm.nih.gov/mesh?term=Female) * [ Add to Search ](https://pubmed.ncbi.nlm.nih.gov/42758792/) * Hospital Mortality Actions * [ Search in PubMed ](https://pubmed.ncbi.nlm.nih.gov/?term=%22Hospital+Mortality%22%5BMeSH%5D&sort=date&sort_order=desc) * [ Search in MeSH ](https://www.ncbi.nlm.nih.gov/mesh?term=Hospital+Mortality) * [ Add to Search ](https://pubmed.ncbi.nlm.nih.gov/42758792/) * Hospitalization* / statistics & numerical data Actions * [ Search in PubMed ](https://pubmed.ncbi.nlm.nih.gov/?term=%22Hospitalization%2Fstatistics+and+numerical+data%22%5BMAJR%5D&sort=date&sort_order=desc) * [ Search in MeSH ](https://www.ncbi.nlm.nih.gov/mesh?term=Hospitalization) * [ Add to Search ](https://pubmed.ncbi.nlm.nih.gov/42758792/) * Humans Actions * [ Search in PubMed ](https://pubmed.ncbi.nlm.nih.gov/?term=%22Humans%22%5BMeSH%5D&sort=date&sort_order=desc) * [ Search in MeSH ](https://www.ncbi.nlm.nih.gov/mesh?term=Humans) * [ Add to Search ](https://pubmed.ncbi.nlm.nih.gov/42758792/) * Male Actions * [ Search in PubMed ](https://pubmed.ncbi.nlm.nih.gov/?term=%22Male%22%5BMeSH%5D&sort=date&sort_order=desc) * [ Search in MeSH ](https://www.ncbi.nlm.nih.gov/mesh?term=Male) * [ Add to Search ](https://pubmed.ncbi.nlm.nih.gov/42758792/) * Middle Aged Actions * [ Search in PubMed ](https://pubmed.ncbi.nlm.nih.gov/?term=%22Middle+Aged%22%5BMeSH%5D&sort=date&sort_order=desc) * [ Search in MeSH ](https://www.ncbi.nlm.nih.gov/mesh?term=Middle+Aged) * [ Add to Search ](https://pubmed.ncbi.nlm.nih.gov/42758792/) * Respiratory Syncytial Virus Infections* / epidemiology Actions
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