Clinical Scorecard: Are Respiratory Deaths Underreported?

At a Glance

Key Highlights

• 36% of postmortem samples tested positive for respiratory viruses, mainly rhinovirus and influenza.
• Only 1.4% of deaths had influenza listed as cause despite 11% testing positive postmortem.
• Low pre-death respiratory virus testing (11%) suggests many infections go unrecognized.

Guideline-Based Recommendations

Diagnosis

• Utilize molecular diagnostic tools such as multiplex PCR to detect multiple respiratory viruses.
• Increase respiratory virus testing in vulnerable patients, especially during peak winter periods.

Management

• Consider respiratory viral infections in clinical assessments of vulnerable and older patients.
• Broaden use of molecular diagnostics to improve detection and management.

Monitoring & Follow-up

• Enhance surveillance systems to better capture respiratory virus-related mortality.
• Implement more consistent testing protocols in community and long-term care settings.

Risks

• Underdiagnosis of respiratory viral infections may lead to underestimation of their role in mortality.
• Co-infections with multiple viruses can occur, particularly in older or vulnerable populations.

Patient & Prescribing Data

Deceased individuals during winter months, including older and vulnerable groups

Limited pre-death testing indicates potential missed opportunities for antiviral or supportive therapies.

Clinical Best Practices

• Incorporate multiplex PCR testing for respiratory viruses in patients with suspected infections.
• Maintain high clinical suspicion for respiratory viral infections in vulnerable populations during winter.
• Improve diagnostic and surveillance strategies to better understand respiratory virus mortality impact.

References

• Population-based study on respiratory viral infections in deceased individuals (Spain, 2016–2020)