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Rhinovirus-Associated Lower Respiratory Tract Infection in Hospitalized Adult Patients: A Retrospective Cohort Study.
Rongling Zhang1, Xiao Shang2, Chunlei Wang3
1Institute of Respiratory Medicine, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China.
The Journal of Infectious Diseases
|December 28, 2025
Summary
Human rhinovirus (HRV) can infect lower respiratory tract cells in adults, causing pneumonia. Male sex, fever, and cough are key predictors of HRV-associated pneumonia, even with co-infections.
Area of Science:
- Infectious Diseases
- Pulmonology
- Virology
Background:
- The role of human rhinovirus (HRV) in adult lower respiratory tract infections (LRTIs) is debated due to limited evidence of alveolar tropism.
- Previous studies lacked age-specific clinical characterization for HRV in LRTIs.
Purpose of the Study:
- To investigate the clinical impact of HRV in adult LRTIs.
- To validate HRV's capacity to infect lower respiratory tract cells.
- To identify predictors for HRV-associated pneumonia in adults.
Main Methods:
- Retrospective analysis of hospitalized adults screened for HRV via RT-PCR (January 2020-December 2023).
- Immunofluorescence staining on transbronchial lung biopsy/cryobiopsy specimens to confirm HRV infection in lower respiratory tract cells.
- Multivariable logistic regression to identify predictors of HRV pneumonia.
Main Results:
- HRV was detected in 4.6% of patients, with seasonal peaks.
- Co-infections were common (49.0%), primarily bacterial and viral.
- HRV was confirmed in lung tissue via immunofluorescence, establishing LRT cell tropism.
- Male sex, fever, and cough were independent predictors of HRV pneumonia.
Conclusions:
- This study provides the first histological evidence of HRV infecting lower respiratory tract cells in immunocompetent adults.
- HRV independently contributes to pneumonia development, irrespective of co-infections.
- Identifying predictors like male sex, fever, and cough can aid in diagnosing HRV-associated pneumonia.
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