Impact of immune status on respiratory virus prevalence and co-detection patterns: a retrospective analysis (2019-2024)

BMC Pulm Med. 2026 Apr 22;26(1):263. doi: 10.1186/s12890-026-04310-2.

Abstract

BACKGROUND: This study aimed to describe yearly laboratory-based detection patterns of respiratory viruses, excluding SARS-CoV-2, among PCR-confirmed positive cases identified through multiplex respiratory polymerase chain reaction (PCR) testing over a six-year period.It focused on the distribution of viruses across different age groups and also differences between immunocompromised and immunocompetent patients. METHODS: This retrospective study included 5,282 PCR-confirmed positive patients identified through respiratory multiplex PCR testing between January 2019 and December 2024. Patient ages ranged from pediatric to adult, with a mean age of 29.4 years; 46.1% were female and 53.9% were male. Nasopharyngeal swab samples were analyzed using real-time multiplex PCR targeting multiple respiratory viruses, including Influenza A/B, human adenovirus, human bocavirus, seasonal coronaviruses, enterovirus, human parechovirus, human rhinovirus, RSV, and human parainfluenza virus types 1–4. Single and multiple viral pathogens were identified within PCR-positive samples. RESULTS: Among PCR-confirmed positive patients, 74.6% were immunocompetent whereas 25.4% were immunocompromised. Notably, immunocompromised individuals were significantly older with a higher proportion of males (p < 0.05). A total of 6136 respiratory pathogens were detected. Co-detections occurred in 13.0% of the samples. Human rhinovirus was the most frequently identified pathogen (32.5%), followed by influenza A (13.6%) and RSV (12.5%). Over the study period, variations in laboratory detection numbers were observed. Co-detections were most commonly seen with human rhinovirus, RSV, and human adenovirus. While human rhinovirus and RSV were frequently detected across all age groups, influenza A was more common in adults, whereas human adenovirus and human bocavirus were more frequent in children. CONCLUSIONS: Among PCR-confirmed positive patients, the distribution of respiratory viral pathogens showed significant variations across different age groups and immune status categories. These findings represent laboratory-based detection trends within a healthcare setting rather than population-level incidence.

Keywords: Co-detection; Immunocompetent; Immunocompromised; Respiratory viruses.

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Child
  • Child, Preschool
  • Coinfection* / epidemiology
  • Coinfection* / virology
  • Female
  • Humans
  • Immunocompetence
  • Immunocompromised Host*
  • Infant
  • Male
  • Middle Aged
  • Multiplex Polymerase Chain Reaction
  • Prevalence
  • Respiratory Tract Infections* / diagnosis
  • Respiratory Tract Infections* / epidemiology
  • Respiratory Tract Infections* / immunology
  • Respiratory Tract Infections* / virology
  • Retrospective Studies
  • Young Adult