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Lung CT Segmentation to Identify Consolidations and Ground Glass Areas for Quantitative Assesment of SARS-CoV Pneumonia

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Respiratory Syncytial Virus and COVID-19 in Hospitalized Adults in Spain: Clinical, Radiological Features and

Jose-Reynaldo Homen Fernandez^1,2, Inés Armenteros³, Adrián Valls Carbó^1,2

¹Servicio de Enfermedades Infecciosas, Instituto de Investigación Sanitaria del Hospital Clínico San Carlos (IdISSC), Hospital Clínico San Carlos, Madrid, Spain.

Immunity, Inflammation and Disease

|November 25, 2025

Abstract

Background:

Lower respiratory tract infections (LRTIs) impose a significant global burden, with over 400 million cases annually. This study compares the clinical features of adults hospitalized with respiratory syncytial virus (RSV) and COVID-19, two viral pathogens with similar presentations but differing epidemiology.

Methods:

This cross-sectional study analyzed 100 adult cases with PCR-confirmed RSV or COVID-19, admitted to the hospital from January 2022 to March 2023. Data on clinical, sociodemographic, radiological, treatment, and laboratory variables were extracted from records.

Results:

Both cohorts consisted of elderly patients (> 70 years) with multiple comorbidities. Notably, the RSV group had a higher prevalence of CHF (24% vs. 10%, p = 0.014) and COPD (29% vs. 9%, p = 0.001). Radiologically, 51% of RSV patients had normal findings, whereas 48% of COVID-19 patients exhibited bilateral pneumonia (p = 0.001). Antimicrobial treatment was administered to 75% of RSV patients compared to 41% of COVID-19 patients (p < 0.001). RSV patients had marginally higher leukocyte and neutrophil counts, while COVID-19 patients showed significantly elevated CRP, ferritin, LDH, ALT, and potassium levels.

Conclusions:

Distinct profiles were identified between hospitalized RSV and COVID-19 patients. RSV patients, mostly older with CHF and COPD, were more likely to receive antibiotics, possibly reflecting the lack of targeted therapies. In contrast, COVID-19 patients exhibited higher inflammation and lung involvement. These findings highlight the need to refine treatment protocols, enhance antimicrobial stewardship, and develop specific RSV therapies alongside preventive strategies for high-risk groups.

Keywords:

COVID‐19 SARS‐CoV2 Spain antimicrobial stewardship comorbidity epidemiology hospitalization inflammatory markers radiography respiratory syncytial virus infections

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