Age-Related Infectious Disease Risks: Rhinovirus, Polypharmacy, and COVID-19 Treatment Patterns
Studies reveal age-related infectious disease patterns including higher symptomatic rhinovirus risk in adults over 60, polypharmacy complications in infectious disease patients, and significant underutilization of COVID-19 antivirals among older adults despite proven benefits.
New research highlights distinct infectious disease risks and treatment patterns across older adult populations, with findings on rhinovirus susceptibility, polypharmacy complications, and COVID-19 antiviral prescribing disparities. Studies demonstrate that age significantly influences both infection presentation and clinical management approaches in infectious disease care.
A study published in Influenza and Other Respiratory Viruses examined rhinovirus infections across two periods in Shanghai, China. Analysis of 72,811 asymptomatic adults and 16,760 symptomatic inpatients revealed that individuals younger than 60 years had higher asymptomatic rhinovirus infection rates (0.68%) compared to those older than 60 years (0.55%, P=.022). Conversely, adults over 60 showed significantly increased odds of developing respiratory symptoms from rhinovirus infections (2.81% vs 2.04%, P=.001). The research found nonpharmaceutical interventions implemented during COVID-19 had minimal effect on rhinovirus prevalence, with asymptomatic infection rates remaining stable across both study periods (0.68% in 2021-2022, 0.56% in 2023-2024).
Polypharmacy emerges as a significant concern in infectious disease management, particularly among older adults. A systematic review in Cureus analyzing 36 studies from 2015-2025 found consistent associations between multiple medication regimens and increased drug-related problems, adverse events, and clinically significant interactions. Higher medication counts were linked to reduced viral suppression in some HIV populations and increased hospitalization risk. The review identified that pharmacist-led medication reviews and regimen simplification strategies improved medication safety outcomes, while structured multidisciplinary care and deprescribing approaches may reduce medication-related risks.
COVID-19 antiviral treatment shows significant underutilization among high-risk older adults despite proven benefits. CDC data from June 2023 through September 2025 revealed that only 16-23% of outpatients aged 65 and older received antiviral prescriptions during periods of low COVID-19 incidence, compared to 37-38% during higher incidence periods. Among those prescribed treatment, 99% received it within 7 days of diagnosis, with 80% prescribed nirmatrelvir/ritonavir. Analysis showed higher odds of prescription receipt among adults aged 75-84 (adjusted odds ratio 1.09) and 85 and older (1.11), as well as among those who had received COVID-19 vaccination (1.73). Lower odds were observed among patients with comorbidities and rural residents.
These findings collectively underscore the complexity of managing infectious diseases in aging populations, from age-specific infection risks to treatment optimization challenges. The research suggests targeted preventive strategies and improved clinical approaches may help address these multifaceted public health concerns.