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Viruses
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Respiratory Syncytial Virus: Pathogenesis, Prevention and Treatment
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Respiratory Syncytial Virus: Pathogenesis, Prevention and Treatment

A special issue of Viruses (ISSN 1999-4915). This special issue belongs to the section "Human Virology and Viral Diseases".

Deadline for manuscript submissions: closed (30 April 2026) | Viewed by 1956

Special Issue Editor

Dr. Javier de Miguel-Díez

E-Mail Website
Guest Editor
1. Respiratory Department, Hospital General Universitario Gregorio Marañón, 28007 Madrid, Spain
2. Facultad de Medicina, Universidad Complutense de Madrid, Instituto de Investigación Sanitaria Gregorio Marañón, 28040 Madrid, Spain
Interests: pulmonology; COVID-19 pneumonia; lung diseases
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

Respiratory syncytial virus (RSV) remains a principal cause of severe respiratory illness worldwide, particularly affecting infants, the elderly, and immunocompromised patients. Clinically, RSV infection can lead to bronchiolitis, pneumonia, hospitalizations, and, in severe cases, death. Despite its global burden, effective clinical management and prevention strategies continue to evolve as new evidence emerges.

This Special Issue, entitled “Respiratory Syncytial Virus: Pathogenesis, Prevention and Treatment”, seeks to highlight recent clinical research and advances in understanding the pathogenesis, diagnosis, treatment, and prevention of RSV-related disease. We invite submissions focusing on the following topics:

  • Clinical manifestations and disease severity in different patient populations;
  • Diagnostic approaches, including novel biomarkers and imaging techniques;
  • Therapeutic strategies, including antiviral treatments and supportive care;
  • Vaccine development and clinical trials aimed at reducing disease burden;
  • Management of RSV coinfections and complications in at-risk groups;
  • Epidemiology and healthcare impact of RSV infections.

We welcome the submission of original clinical studies, case reports, reviews, and short communications that provide insights into improving patient outcomes and public health interventions against RSV.

We look forward to receiving your valuable contributions to this clinically oriented Special Issue.

Best regards,

Dr. Javier de Miguel-Díez
Guest Editor

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 250 words) can be sent to the Editorial Office for assessment.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Viruses is an international peer-reviewed open access monthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2600 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • respiratory syncytial virus (RSV)
  • RSV infection
  • pathogenesis
  • RSV prevention
  • RSV treatment
  • vaccines

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Further information on MDPI's Special Issue policies can be found here.

Published Papers (2 papers)

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Research

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27 pages, 4063 KB  
Article
Did Nirsevimab Shift Pediatric Hospitalizations Due to Lower Respiratory Tract Infections? A Nationwide Italian Study (2024–2025)
by Paolo Manzoni, Matteo Riccò, Chryssoula Tzialla, Graziano Barera, Paolo Del Barba, Simona De Franco, Guido Pellegrini, Enrico Crapanzano, Giangiacomo Nicolini, Andrea Alba, Stefano Fiocchi, Mauro Vivalda, Giulia Natta, Alessandra Casati, Mariano Manzionna, Simone Rugolotto, Laura Saggioro, Simona Pesce, Maria Scavone, Antonietta Distilo, Vincenza Roseto, Antonino Di Toro, Luca Pierri, Gianfranco Scarpelli, Elvira Bonanno, Lidia Decembrino, Enrico Felici, Camilla Selvatico, Valentina Saracco, Francesco Morrone, Claudio Costantino, Cecilia Nobili and Mario Giuffrèadd Show full author list remove Hide full author list
Viruses 2026, 18(3), 274; https://doi.org/10.3390/v18030274 - 24 Feb 2026
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Abstract
Nirsevimab is a long-acting monoclonal antibody designed to prevent infections due to respiratory syncytial virus (RSV). Here we report on a retrospective, multicenter study encompassing a total of 19 Italian neonatal and pediatric centers evaluating the epidemiology of lower respiratory tract infection (LRTI)-related [...] Read more.
Nirsevimab is a long-acting monoclonal antibody designed to prevent infections due to respiratory syncytial virus (RSV). Here we report on a retrospective, multicenter study encompassing a total of 19 Italian neonatal and pediatric centers evaluating the epidemiology of lower respiratory tract infection (LRTI)-related hospitalizations in infants younger than 2 years during the first RSV season following the introduction of nirsevimab prophylaxis. A total of 401 hospitalizations were reported, with 40.4% being in children with previous prophylaxis with nirsevimab. Respiratory syncytial virus was the most frequently identified pathogen (47.5%), followed by rhinovirus/enterovirus (20.2%) and human metapneumovirus (hMPV; 6.9%). In multivariable analyses adjusted for age, sex, and month of diagnosis, prior nirsevimab immunization was associated with a significantly reduced likelihood of RSV-related hospitalization (adjusted odds ratio [aOR], 0.259; 95% CI, 0.157–0.427), corresponding to an estimated effectiveness of 74.1% (95% CI, 57.3–84.3). Conversely, nirsevimab-immunized infants showed increased odds of hospitalization due to hMPV (aOR, 2.490; 95% CI, 1.019–6.085) and rhinovirus/enterovirus (aOR, 2.573; 95% CI, 1.424–4.650). Lower respiratory tract infections associated with hMPV predominantly occurred outside the typical RSV season, being associated with moderate-to-severe clinical presentations. These findings confirm the real-world effectiveness of nirsevimab against RSV hospitalizations, also highlighting the need for the continued surveillance of non-RSV respiratory pathogens in the context of universal RSV immunoprophylaxis. Full article
(This article belongs to the Special Issue Respiratory Syncytial Virus: Pathogenesis, Prevention and Treatment)
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Review

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17 pages, 3109 KB  
Review
Roles of the Chemokine Receptor CX3CR1 in the Pathogenesis of RSV Infections
by Robert Meineke, Martin Ludlow, Albert D. M. E. Osterhaus and Guus F. Rimmelzwaan
Viruses 2026, 18(4), 463; https://doi.org/10.3390/v18040463 - 13 Apr 2026
Viewed by 357
Abstract
CX3CR1 is a chemokine receptor expressed on respiratory epithelial and immune cells and has been identified as a host factor important for infections with respiratory syncytial virus (RSV). In this review, we discuss the roles CX3CR1 plays in the pathogenesis of RSV infections [...] Read more.
CX3CR1 is a chemokine receptor expressed on respiratory epithelial and immune cells and has been identified as a host factor important for infections with respiratory syncytial virus (RSV). In this review, we discuss the roles CX3CR1 plays in the pathogenesis of RSV infections as a viral entry receptor and regulator of immune cell trafficking. The conserved CX3C motif of the RSV G glycoprotein binds to CX3CR1 to mediate viral attachment and entry into respiratory epithelial cells. Furthermore, soluble G protein (sG) can bind to CX3CR1 and competitively interfere with cell signaling induced by the chemokine CX3CL1, resulting in inhibition of immune cell recruitment to the site of infection. In addition, sG engages TLR2 on epithelial cells, activating MyD88-NF-κB signaling and priming the NLRP3 inflammasome, which enhances viral dissemination through pyroptotic cell death. CX3CR1 signaling should be viewed as one of several overlapping host factors that—along with developmental changes in interferon and STAT3 signaling, airway anatomy, inflammasome activity, and tissue-resident memory responses—contribute to differential disease outcomes of RSV infection. A more complete molecular understanding of RSV-CX3CR1 interactions and downstream host responses may enable the development of improved prevention and treatment strategies. Full article
(This article belongs to the Special Issue Respiratory Syncytial Virus: Pathogenesis, Prevention and Treatment)
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