Clinical Presentation and Severity of SARS-CoV-2 Infection Compared to Respiratory Syncytial Virus and Other Viral Respiratory Infections in Children Less than Two Years of Age

Abstract

The spread of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and the implementation of restrictive measures led to a dramatic reduction in respiratory syncytial virus (RSV) occurrence together with rare and mild bronchiolitis induced by SARS-CoV-2. We described the respiratory picture of SARS-CoV-2 infection and evaluated the frequency and the severity of SARS-CoV-2 bronchiolitis comparing it with other respiratory viral infections in children less than two years of age. The severity of respiratory involvement was evaluated based on the need for oxygen therapy, intravenous hydration, and the length of hospital stay. A total of 138 children hospitalized for respiratory symptoms were enrolled: 60 with SARS-CoV-2 and 78 with RSV. In the group of SARS-CoV-2-infected children, 13/60 (21%) received a diagnosis of co-infection. Among the enrolled children, 87/138 (63%) received a diagnosis of bronchiolitis. The comparative evaluation showed a higher risk of the need for oxygen therapy and intravenous hydration in children with RSV infection and co-infection compared to children with SARS-CoV-2 infection. In the children with a diagnosis of bronchiolitis, no differences in the main outcomes among the groups were observed. Although children with SARS-CoV-2 infection have less severe respiratory effects than adults, the pediatrician should pay attention to bronchiolitis due to SARS-CoV-2, which could have a severe clinical course in younger children.

Epidemiology and clinical features of respiratory syncytial virus (RSV) infection in hospitalized children during the COVID‐19 pandemic in Gorgan, Iran

“…In this study, more RSV‐disease was seen in hospitalized children compared with SARS‐CoV‐2 and influenza. In contrast, several other studies reported that the prevalence of RSV disease decreased dramatically after the emergence of SARS‐CoV‐2 20–22 . A study in the United States found that RSV circulation was historically low during 2020–2021, began earlier and continued longer during 2021–2022 compared with prepandemic years and seasons 23 .…”

“…In contrast, several other studies reported that the prevalence of RSV disease decreased dramatically after the emergence of SARS‐CoV‐2. 20 , 21 , 22 A study in the United States found that RSV circulation was historically low during 2020–2021, began earlier and continued longer during 2021–2022 compared with prepandemic years and seasons. 23 In China RSV disease showed atypical seasonality during the pandemic, with a peak incidence in May 2020 and a second peak in November 2020, which was different from the typical winter peak observed in previous years.…”

Epidemiological and Genetic Characteristics of Respiratory Viral Coinfections with Different Variants of Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2)

“…Seven types of seasonal respiratory viruses were identified in mixed infections with SARS-CoV-2, among which RSV was the most common co-pathogen. A study conducted in Italy between 2021 and 2022 also reported a high prevalence of RSV coinfection with SARS-CoV-2 in children [ 38 ]. Similarly, a 2020–2021 study in Ecuador found RSV to be the second most common co-pathogen after influenza A [ 35 ].…”

Longitudinal Cardiac Evaluation of Children with Multisystem Inflammatory Syndrome (MIS-C) Following COVID-19 by Conventional and Speckle-Tracking Echocardiography

“…Despite the milder clinical course of SARS-CoV-2 infection observed in children in comparison to adults, cases of a delayed hyperinflammatory condition, known as Multisystem Inflammatory Syndrome in children (MIS-C), occurring 2-6 weeks after acute SARS-CoV-2 infection, have been described [1][2][3][4][5]. This syndrome is characterized by persisted fever and multiorgan dysfunction, which are accompanied by laboratory evidence of inflammation [4,[6][7][8].…”