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Rhinovirus in Adults With Severe Lower Respiratory Tract Infection: Incidental Carriage or Primary Pathogen? A
Ana Helena Perosa1, Klinger S Faico-Filho1, Karen Pendeloski1
1Laboratório de Virologia Clínica-Disciplina de Infectologia-Departamento de Medicina, Universidade Federal de Sao Paulo (UNIFESP/EPM), Sao Paulo, Sao Paulo, Brazil.
Tropical Medicine & International Health : TM & IH
|August 6, 2026
Summary
Rhinovirus (RV) in hospitalized adults with severe lower respiratory tract infections (LRTI) may be incidental carriage, not a primary cause. However, RV is a significant pathogen in adult acute respiratory infections and pediatric LRTI.
Area of Science:
- Respiratory viral infections
- Clinical microbiology
- Epidemiology of infectious diseases
Background:
- Rhinovirus (RV) is a common respiratory pathogen.
- Its role in severe adult lower respiratory tract infections (LRTI) is debated.
- This study investigated RV prevalence across different clinical statuses in Brazil.
Purpose of the Study:
- To determine the role of Rhinovirus (RV) in severe lower respiratory tract infections (LRTI) in hospitalized adults.
- To compare RV detection rates in adults with varying clinical conditions (asymptomatic, outpatient ARI, hospitalized LRTI).
- To assess RV as a pathogen in pediatric LRTI.
Main Methods:
- Cross-sectional study conducted from January 2023 to August 2025.
- Enrolled 2688 participants across four groups: asymptomatic adults, adult outpatients with acute respiratory infection (ARI), hospitalized adults with severe LRTI, and hospitalized children with LRTI.
- Rhinovirus (RV) detection performed using reverse transcription quantitative polymerase chain reaction (RT-qPCR).
Main Results:
- RV detection rates varied: 4.7% (asymptomatic adults), 7.8% (hospitalized adults), 15.6% (adult outpatients), and 20.9% (hospitalized children).
- Hospitalized adults showed similar RV rates to asymptomatic individuals (p=0.135), but lower than outpatients (p<0.001) and children (p<0.001).
- Among RV-positive hospitalized adults, 90.5% had comorbidities, and 65.1% were immunosuppressed.
Conclusions:
- RV detection in hospitalized adults with LRTI is comparable to asymptomatic individuals, suggesting incidental carriage.
- RV appears to be a major pathogen in non-severe adult acute respiratory infections.
- RV is a clearly pathogenic agent in severe pediatric LRTI.
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