Younger infants, preemies most at risk for RSV hospitalization, study shows
Click Here to Manage Email Alerts
Key takeaways:
- On average, four of every 1,000 children aged younger than 5 years are hospitalized with RSV.
- Children aged 0 to 2 months had the highest rate of hospitalization.
Infants aged younger than 3 months and children with a history of prematurity experience the highest rates of hospitalization for respiratory syncytial virus, according to study findings published in Pediatrics.
Last year, two new tools became available to combat RSV, the leading cause of infant hospitalization in the United States: a vaccine for pregnant people and a new monoclonal antibody.
The CDC established the New Vaccine Surveillance Network 2 decades ago to monitor the burden of respiratory viruses in children, one of the authors of the new study told Healio.
“This analysis is the result of 4 years of work at seven pediatric hospitals across the country and the enrollment, swabbing, and testing of over 50,000 children with acute respiratory illness for RSV and other respiratory viruses,” Meredith L. McMorrow, MD, MPH, a researcher in the CDC’s Coronavirus and Other Respiratory Viruses Division, told Healio. “These updated estimates help inform Advisory Committee on Immunization Practices’ recommendations for immunizations to prevent severe RSV in infants, including maternal vaccines and long-acting monoclonal antibodies, like nirsevimab.”
McMorrow and colleagues estimated RSV-associated hospitalizations among children aged younger than 5 years at the seven pediatric hospitals from 2016 to 2020.
“We also compared characteristics of hospitalized children who were in the intensive care unit to those who were not to understand what factors increase the risk of severe RSV disease,” McMorrow said.
Out of 13,524 patients with acute respiratory illness, 31.4% had RSV and 64.8% of those children had no underlying condition or history of prematurity.
The average annual RSV-associated hospitalization rate was 4 per 1,000 children (95% CI, 3.8-4.1). The rate was highest among children aged 0 to 2 months old (23.8 per 1,000; 95% CI, 22.5-25.2) and decreased with age. Premature children were almost twice as likely to be hospitalized vs. term children (rate ratio = 1.95; 95% CI, 1.76-2.11).
In addition to those two groups, other risk factors for ICU admission included being aged 3 to 5 months and having a comorbid condition.
“Overall, the results were consistent with what we experience as pediatricians taking care of kids in the hospital — that all young babies are at risk of being hospitalized with RSV, especially the youngest infants 0 to 2 months old during the RSV season,” McMorrow said.
She clarified that although hospitalization rates were higher among premature infants, they represented a small percentage of children hospitalized for RSV.
“Most RSV-associated hospitalizations occurred in healthy, term infants,” McMorrow said. “This is why all babies need protection from either maternal RSV vaccination or nirsevimab during their first RSV season.”
McMorrow’s team hopes to publish a similar analysis, “focused on the two atypical pandemic-era seasons we experienced in 2021 and 2022.”
“With the recent introduction of RSV prevention products, such as nirsevimab, we are excited to evaluate their impact on RSV burden and to share important information about their effectiveness,” McMorrow said.
Collapse
Read more about
Click Here to Manage Email Alerts