Younger children are more likely to require hospitalization for RSV

1. In this study of children admitted with acute respiratory illness, about one-third were respiratory syncytial virus (RSV)-positive and higher rates of hospitalization were noted among younger children.

2. Among hospitalized, RSV-positive patients, age outside of 12 – 23 months, comorbid conditions, and premature birth was associated with higher likelihood of requiring intensive care unit (ICU) admission.

Evidence Rating Level: 3 (Average)

Study Rundown: RSV is a common cause of childhood respiratory illnesses and results in a substantial number of hospitalizations. While previous work has evaluated the rates of hospitalizations among RSV-positive patients, current data is lacking. Through prospective surveillance of patients hospitalized with respiratory symptoms, researchers in the current study aimed to elucidate the current burden and clinical outcomes of hospitalized RSV patients. Patients <6 months of age who were RSV positive were more likely to require hospitalization. The majority of admitted patients did not have any underlying conditions. In addition, those with RSV were more likely to need oxygen supplementation and ICU admission than those who tested negative. Furthermore, among RSV-positive patients, those who were outside of the 12 – 23 month age range, had comorbid conditions, and who were born prematurely had higher rates of ICU admission. While this study was strengthened by multi-center recruitment, results may not be generalizable as it was only conducted at large academic institutions in urban areas. Results suggest that preventative and treatment-related efforts should be targeted to younger patients.

Click to read the study, published today in Pediatrics

Click to read the accompanying commentary in Pediatrics

Relevant Reading: The Burden of Respiratory Syncytial Virus Infection in Young Children

In-Depth [cross-sectional study study]: From November 1, 2015 to June 30, 2016, researchers at 7 academic hospitals across the United States recruited patients less than 5 years of age who were admitted with acute respiratory illnesses. Family interviews and chart review were used to gather demographics and historical information. Patients underwent nasal swabbing, throat swabbing, or a tracheal aspirate was sent to assess for viral illnesses. A total of 2696 patients had conclusive viral study results, with 1043 (35%) resulting RSV-positive. The highest rates of RSV-associated hospitalizations were noted among the youngest children with a rate of 2.9 per 1000 children <5 years of age, a rate of 14.7 per 1000 <6 months of age, and a rate of 18.9 per 1000 children < 2 months old. The study found that among RSV-positive children, those who were not between 12 and 23 months of age had higher odds of ICU admission rates when compared to those between 12 and 23 months old (0–2 months: adjusted odds ratio [aOR] = 2.4, 95%CI 1.4–4.1; 3 to 5 months: aOR = 2.2, 95%CI 1.2–4.1; 6 to 11 months: aOR = 2.1, 95%CI 1.1–3.8; 24 to 59 months: aOR = 2.6 with 95%CI 1.4–4.9). RSV-positive patients with comorbid conditions or who were born premature also had higher odds of ICU admission (aOR = 1.5, 95%CI 1.1–2.2).

Image: PD

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