Epidemiological patterns of acute respiratory illnesses in a tertiary center in Riyadh, Saudi Arabia

BACKGROUND:
Acute respiratory illnesses (ARIs) are a major public health concern and are ranked by the World Health Organization among the leading causes of death worldwide.


OBJECTIVES:

To determine the positivity proportion, clinical presentation, and risk factors associated with major respiratory viruses, including Influenza A, Influenza B, respiratory syncytial virus
(
RSV
)
, and SARS-CoV-2.



DESIGN:
Retrospective study conducted between October 2022 and March 2023


SETTINGS:
Single center tertiary hospital in Riyadh, Saudi Arabia


PATIENTS AND METHODS:

Nasopharyngeal swabs (NPS) were collected from patients with ARI and tested for Influenza A
/B
, RSV, and SARS-CoV-2 using a multiplex polymerase chain reaction (PCR) panel, a molecular technique used to amplify DNA for detection and analysis. Patients were categorized into three groups based on the type of viral infection, and comparisons between groups were performed using chi-square or Fisher's exact tests for categorical variables to assess associations among viral infections.



MAIN OUTCOME MEASURES:
Epidemiological and clinical characteristics of patients with positive PCR results.


SAMPLE SIZE:
4526 patients with ARI underwent NPS for viral PCR screening


RESULTS:

Among study population, 537 (11.9%) patients tested positive for at least one of the targeted respiratory viruses. RSV was the predominant pathogen among pediatric patients (n=195, 62.2%), particularly in infants younger than six months. In adults, SARS-CoV-2 was most common (n=98, 44.1%), followed by Influenza A and B. RSV infection was significantly associated with lower respiratory tract involvement (
P
<.0001), whereas SARS-CoV-2 and Influenza were more frequently linked to upper respiratory tract symptoms. The overall recovery rate was 98.8% (n=531), with a mortality rate of 1.2% (n=6).



CONCLUSION:
RSV, Influenza, and SARS-CoV-2 remain significant causes of ARIs in Riyadh, Saudi Arabia, showing distinct age and seasonal patterns. The results underscore the importance of targeted vaccination and strengthened surveillance to protect high-risk groups.


LIMITATIONS:
The study was limited by its single-center design and short six-month duration.