Young Infants, Children Born Prematurely Face Highest Risk for RSV Hospitalization: Daily Dose

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Last week, we reported on findings from a study published in Pediatrics that provided updated population-based estimates of respiratory syncytial virus (RSV)-associated hospitalization in the US and described the epidemiology of severe RSV among children.

The study

Researchers conducted prospective surveillance for children aged <5 years with acute respiratory illness (ARI) from 2016 to 2020 at 7 pediatric hospitals. Investigators interviewed parents, reviewed medical records, and tested nasal and throat swabs by reverse transcription polymerase chain reaction for RSV and other respiratory viruses, according to the study.

The findings

Out of 13 524 patients with ARI, 4243 (31.4%) were RSV-positive and 2751 (64.8%) of those children had no underlying condition or history of prematurity.

The average annual RSV-associated hospitalization rate was 4 per 1000 children (95% CI 3.8-4.1), and the rate was highest among children aged 0 to 2 months old (23.8 per 1000 children; 95% CI 22.5-25.2) and decreased with age.

Researchers observed that children born prematurely were nearly twice as likely to be hospitalized compared to term children (rate ratio=1.95; 95% CI 1.76-2.11).

According to the results, risk factors for ICU admission among RSV-positive inpatients included being aged 0-2 and 3-5 months (adjusted odds ratio [aOR] =1.97, 95% CI 1.54-2.52 and aOR=1.56, 95% CI 1.18-2.06, respectively, compared with those aged 24-59 months), prematurity (aOR=1.32, 95% CI 1.08-1.60), and comorbid conditions (aOR=1.35, 95% CI 1.10-1.66).

Authors' comment

“Until recently, palivizumab, a monoclonal antibody product, was the only available product to protect infants at high risk for RSV-associated severe disease. Nirsevimab is now recommended for US infants < 8 months old during or entering their first RSV season and for children 8 to 19 months old at increased risk for severe RSV entering their second RSV season. Additional prevention products in late clinical development may be recommended for infants or pregnant women in the near future."

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