Inpatient burden of respiratory syncytial virus in children ≤2 years of age in Germany: A retrospective analysis of nationwide hospitalization data, 2019–2022

Abstract

BackgroundRespiratory syncytial virus (RSV) causes respiratory tract disease in seasonal waves, primarily in infants and young children. This study aims to quantify the number of RSV‐related hospitalizations in children ≤2 years of age and to determine corresponding resource use and costs in Germany.MethodsWe retrospectively analyzed population‐wide hospital data from the Institute for the Hospital Remuneration System (InEK) from 2019 to 2022. RSV cases were identified using the RSV‐specific 10th revision of the International Classification of Diseases (ICD‐10) codes J12.1, J20.5, and J21.0. The RSV‐associated proportion of all hospitalizations caused by severe acute respiratory infections (SARIs), clinical manifestations, length of stay (LOS), intensive care unit (ICU) admissions, ventilation rates, and hospitalization costs were retrieved.ResultsWe identified 98,220 hospitalizations (26,052, 15,407, 31,362, and 25,399 in 2019, 2020, 2021, and 2022, respectively) with a principal RSV diagnosis in children aged ≤2 years in Germany. The majority of RSV hospitalizations (73,178) occurred in infants (<1 year), with annual incidence rates ranging from 14.9 to 28.6 per 1000 population. Fifty‐eight percent of all SARI hospitalizations in this age group were attributable to RSV. In children aged ≤2 years, mean LOS was 4.5 days, 6.1% of cases were admitted to ICU, and 5.3% of cases were ventilated. Mean hospitalization costs per case ranged from €3001 to €3961 over the study period.ConclusionsRSV causes substantial disease burden and is a leading cause of SARI‐related hospital admissions of children ≤2 years of age in Germany. Our results confirm the need to explore and evaluate strategies to prevent RSV in infants and young children.

COVID-19, Influenza, and RSV in Children and Adults: A Clinical Comparative Study of 12,000 Cases

“…RSV is a leading cause of hospital admissions among infants under 2 years old in the U.S. and Germany [ 8 , 16 , 17 ]. During the three years following the 2020 COVID-19 pandemic’s onset, hospitalizations due to RSV in infants under 1 year in Germany exceeded half of all cases, with higher rates in 1–2-year-olds post-pandemic than pre-pandemic [ 8 ]. This indicates RSV’s significant impact on pediatric respiratory illnesses, independent of COVID-19.…”

“…Conversely, during this period, social measures such as social distancing and wearing masks contributed to a decrease in emergency department (ED) visits [ 5 ]. Additionally, the incidence of infections from respiratory viruses other than COVID-19 displayed varying trends, with noticeable decreases [ 6 , 7 ] or increases [ 8 ] in different countries.…”

“…Investigations into the severity of infections caused by COVID-19, FLU, and RSV have predominantly concentrated on pediatric and adult populations independently, often scrutinizing the effects of either individual viruses or their combined impact [ 2 , 4 , 6 , 7 , 8 , 10 , 11 , 13 , 16 , 17 , 18 , 19 ]. Notwithstanding, comparative analyses delineating the clinical manifestations of these pathogens among individuals younger than 18 versus those of adults remain markedly limited.…”

Anstieg invasiver Erkrankungen durch Streptokokken und komplizierte Pneumonien zum Ende der COVID-19-Pandemie

“…In zeitlicher Koinzidenz mit der Lockerung und/oder Ende der NPI im Laufe des Jahres 2021 kam es weltweit und auch in Deutschland zu einem teils massiven Wiederanstieg der Inzidenz von ARI und anderen Erkrankungen durch über die Atemwege übertragene Viren 5 . In Deutschland kam es nach dem völligen Ausbleiben der RSV-Saison 2020/2021 zu zwei früh beginnenden RSV-Saisonen 2021/22 und 2022/23 17 , 18 . Das IRIS-Netzwerk beobachtete seit Ende 2021 in zeitlicher Koinzidenz einen ansteigenden Nachweis von S. pneumoniae, H. influenzae und N. meningitidis 6 .…”