Imperial College London

Peter Openshaw - Professor of Experimental Medicine

Faculty of MedicineNational Heart & Lung Institute

Senior Consul, Professor of Experimental Medicine



+44 (0)20 7594 3854p.openshaw Website CV




Ms Gale Lewis +44 (0)20 7594 0944




353Norfolk PlaceSt Mary's Campus






BibTex format

author = {Shi, T and Arnott, A and Semogas, I and Falsey, AR and Openshaw, P and Wedzicha, JA and Campbell, H and Nair, H and RESCEU, Investigators},
doi = {infdis/jiy662},
journal = {Journal of Infectious Diseases},
pages = {S563--S569},
title = {The etiological role of common respiratory viruses in acute respiratory infections in older adults: a systematic review and meta-analysis},
url = {},
volume = {222},
year = {2020}

RIS format (EndNote, RefMan)

AB - Acute respiratory tract infections (ARI) constitute a substantial disease burden in adults and elderly individuals. We aimed to identify all case-control studies investigating the potential role of respiratory viruses in the etiology of ARI in older adults aged ≥65 years. We conducted a systematic literature review (across 7 databases) of case-control studies published from 1996 to 2017 that investigated the viral profile of older adults with and those without ARI. We then computed a pooled odds ratio (OR) with a 95% confidence interval and virus-specific attributable fraction among the exposed (AFE) for 8 common viruses: respiratory syncytial virus (RSV), influenza virus (Flu), parainfluenza virus (PIV), human metapneumovirus (HMPV), adenovirus (AdV), rhinovirus (RV), bocavirus (BoV), and coronavirus (CoV). From the 16 studies included, there was strong evidence of possible causal attribution for RSV (OR, 8.5 [95% CI, 3.9-18.5]; AFE, 88%), Flu (OR, 8.3 [95% CI, 4.4-15.9]; AFE, 88%), PIV (OR, not available; AFE, approximately 100%), HMPV (OR, 9.8 [95% CI, 2.3-41.0]; AFE, 90%), AdV (OR, not available; AFE, approximately 100%), RV (OR, 7.1 [95% CI, 3.7-13.6]; AFE, 86%) and CoV (OR, 2.8 [95% CI, 2.0-4.1]; AFE, 65%) in older adults presenting with ARI, compared with those without respiratory symptoms (ie, asymptomatic individuals) or healthy older adults. However, there was no significant difference in the detection of BoV in cases and controls. This review supports RSV, Flu, PIV, HMPV, AdV, RV, and CoV as important causes of ARI in older adults and provides quantitative estimates of the absolute proportion of virus-associated ARI cases to which a viral cause can be attributed. Disease burden estimates should take into account the appropriate AFE estimates (for older adults) that we report.
AU - Shi,T
AU - Arnott,A
AU - Semogas,I
AU - Falsey,AR
AU - Openshaw,P
AU - Wedzicha,JA
AU - Campbell,H
AU - Nair,H
AU - RESCEU,Investigators
DO - infdis/jiy662
EP - 569
PY - 2020///
SN - 0022-1899
SP - 563
TI - The etiological role of common respiratory viruses in acute respiratory infections in older adults: a systematic review and meta-analysis
T2 - Journal of Infectious Diseases
UR -
UR -
UR -
VL - 222
ER -