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Real-time monitoring of respiratory virus-associated hospitalizations: Trends through October 2025 

by | Nov 13, 2025 | Research, Research Insights

Blue header graphic titled “Monitoring respiratory virus trends” showing multi-colored stacked area peaks representing different respiratory virus hospitalization trends over time. Designed as a hero banner for Truveta’s respiratory virus monitoring report.
  • Respiratory virus–associated hospitalizations declined overall in October 2025 (–31.8%).
  • The rate of RSV-associated hospitalizations in children under five more than doubled for the second consecutive month, signaling early seasonal activity.
  • Rhinovirus remained the leading cause of virus-associated hospitalizations across all ages.

Respiratory viruses, including COVID-19, influenza, and respiratory syncytial virus (RSV), continue to contribute to hospitalizations across the United States. Vulnerable populations, such as infants, children, and older adults, are particularly at risk of severe outcomes. Few sources regularly monitor hospitalizations associated with respiratory viruses. Truveta Research has created a respiratory virus monitoring report to supplement the surveillance data provided by the CDC by describing weekly trends in the rate of hospitalizations overall and for each of the six most common respiratory viruses: COVID-19, influenza, human metapneumovirus (HMPV), parainfluenza virus, RSV, and rhinovirus. This information can inform decisions about public health, clinical care, and public policy.  

Because Truveta Data provides the most complete, timely, and clean de-identified EHR data, including full patient medical records, notes, and images, linked with closed claims for more than 120 million patients across the US, we can show the latest trends in these respiratory virus-associated hospitalizations, including valuable insight into two at-risk populations: infants and children (age 0-4 years old) and older adults (age 65 and over).  

This blog provides a snapshot of the key findings with data through November 2, 2025 in the report specific to the overall population across all respiratory viruses, as well as for two high-risk populations: infants and children (age 0-4 years old) and older adults (age 65 and older). For the full analysis—inclusive of demographics, comorbidities, and overall trends in virus-associated hospitalizations and testing across all age groups for each virus—see the complete report with data through early November 2025 on MedRxiv.  

Key findings: Trends in respiratory virus-associated hospitalizations

Using a subset of Truveta Data, we identified 830,292 hospitalizations of 758,329 unique patients who tested positive for a respiratory virus between October 1, 2020 and November 2, 2025.

Overall hospitalization rates declining

The overall rate of respiratory virus-associated hospitalizations decreased in October. There was a 31.8% decrease in the rate of hospitalizations from the end of September to the end of October, with respiratory virus-associated hospitalizations accounting for 1.3% of all hospitalizations at the end of October.

Line chart showing weekly respiratory virus–associated hospitalization rates per 100 total admissions for the overall population from 2020 through October 2025. COVID-19 dominates early peaks, followed by smaller influenza, RSV, and rhinovirus waves in later years.
Stacked area chart showing cumulative respiratory virus–associated hospitalizations per 100 total admissions across all ages since 2020. Distinct annual peaks correspond to respiratory virus seasons, with COVID-19 leading early waves and RSV, influenza, and rhinovirus contributing later.

Notably, rhinovirus-related hospitalizations were the leading cause of respiratory virus-associated hospitalizations through October. Despite a small decrease in the past month, rhinovirus is associated with 0.7% of all hospitalizations.

COVID-associated hospitalizations decreased substantially across the month (-68.2%), while hospitalizations associated with influenza, HMPV, parainfluenza, and RSV remained low and relatively stable.

Line chart comparing overall weekly respiratory virus–associated hospitalization changes for all ages from September 29 to October 27, 2025. Total hospitalizations declined 31.8%, with COVID-19 decreasing 68.2%, influenza increasing 116.9%, and RSV rising 281.8%.
Pediatric respiratory virus-associated hospitalizations remain stable

Among children aged 0–4 years, respiratory virus-associated hospitalizations remained stable at 2.0% throughout October.

Line chart showing weekly respiratory virus–associated hospitalization rates per 100 admissions among children under five from October 2020 through October 2025. RSV and rhinovirus are the leading contributors, with RSV spikes each fall and winter season.
Stacked area chart showing cumulative weekly respiratory virus–associated hospitalizations per 100 admissions for children under five from 2020 to 2025. Large RSV and rhinovirus peaks occur each fall, with significant spikes in RSV activity during 2023 and 2025.

Rhinovirus accounted for the most virus-associated hospitalizations at 1.4% in this age group. RSV-associated hospitalizations among the pediatric population more than doubled for the second month in a row, now accounting for 0.7% of all hospitalizations in this age group. Test positivity for RSV also rose by 134.6%, indicating early seasonal activity.

Line chart showing percent change in weekly respiratory virus–associated hospitalizations among children under five between September 29 and October 27, 2025. RSV hospitalizations increased 135.3%, influenza rose sharply by 823.2%, and overall rates increased 10%.
Respiratory virus-related hospitalizations continue to decline in adults over the age of 65

Among adults aged 65 and older, hospitalizations related to respiratory viruses declined to 1.2% of all hospitalizations (-41.5%) through October.

Line chart showing weekly respiratory virus–associated hospitalization rates per 100 admissions among adults aged 65 and older from 2020 to 2025. Major peaks appear during winter seasons, led by COVID-19 early in the timeline and influenza and RSV in later years.
Stacked area chart showing cumulative weekly respiratory virus–associated hospitalization rates per 100 hospital admissions among adults 65 and older from October 2020 through October 2025. Peaks correspond to winter seasons, with COVID-19 dominating early years and RSV, influenza, and rhinovirus activity increasing later.

COVID-associated hospitalizations decreased to 0.4% of all hospitalizations among this age group. Rhinovirus now accounts for the most respiratory virus-associated hospitalizations at 0.6%. The rate of test positivity for RSV and influenza also increased among this group (+259.0% and +53.7%, respectively), indicating a rise in virus activity.

Line chart showing percent change in weekly respiratory virus–associated hospitalizations among adults 65 years and older from September 29 to October 27, 2025. Overall hospitalizations declined 41.5%, COVID-19 dropped 67.5%, while influenza rose 63.6% and RSV surged 631.9%.

Discussion

It is important for public health experts and clinical providers to understand the trends in these respiratory infections to inform decisions about public health, clinical care, and public policy. Connecting population-level trends with granular clinical information can be very useful to understand which populations are most impacted and may require additional support.  

We will continue to monitor respiratory virus-associated hospitalization overall and for at-risk populations throughout this 2025-2026 respiratory virus season (October 2025 through September 2026).