Respiratory Syncytial Virus Infections in Polish Pediatric Patients from an Expert Perspective

Abstract

Respiratory syncytial virus (RSV) is the most common pathogen causing respiratory tract infections in infants, affecting over 90% of children within the first two years of life. It may cause lower respiratory tract infections, which constitute a significant healthcare burden both in the primary and secondary care settings. Meanwhile, the data regarding RSV disease in Poland is scarce, and published data significantly differs from the numbers reported for other countries with longstanding surveillance and reporting systems. A literature review and an expert panel were conducted to (1) understand the healthcare burden of RSV infections in Poland; (2) collect data on infection seasonality, patient pathway, and management patterns; and (3) evaluate RSV infection surveillance in Poland. According to the literature, RSV is the major agent responsible for non-influenza respiratory diseases in Poland. The reported rates of hospitalization for RSV infections are 267.5/100,000 for children under 5 years of age and 1132.1/100,000 for those under 1 year of age. Comparisons with data from other countries suggest that these values may be underestimated, possibly due to insufficient access to microbiological testing and a low awareness of RSV. Infections occur mainly between December and April, however, this pattern has changed following the implementation of preventive measures for coronavirus disease 2019 in the past few years. According to available reports, bronchodilators, antibiotics, corticosteroids, and X-ray imaging have been frequently used. The surveillance system in Poland has limitations, but these may be overcome due to recent changes in healthcare law as well as the availability and reimbursement of diagnostic tests.

Epidemiology of Respiratory Syncytial Virus Hospitalizations in Poland: An Analysis from 2015 to 2023 Covering the Entire Polish Population of Children Aged under Five Years

“…While the effect of comorbidities such as prematurity, lung disease, or congenital heart disease on the severity of RSV infection is well known, most hospitalizations occur in children with no such risk factors [50]. The low proportion of at-risk children in our population could also be due to the national program of RSV immunoprophylaxis, which has been in operation since 2008, covering most of the above high-risk groups [15]. Over 90% of eligible children received immunoprophylaxis in the 2021/22 season (data not published).…”

“…An estimated 97% of RSV-caused deaths in children aged 0-60 months occurred in lowand middle-income countries [5]. Preventive strategies, such as the use of monoclonal antibodies for high-risk infants and a maternal vaccine to protect babies, are critical in mitigating the impact of RSV infections in young children [4,11,15].…”

“…In Poland, the incidence and disease burden of RSV infections among young children is not well understood and likely to be underestimated due to a previous lack of routine laboratory-based RSV testing and surveillance [15]. Since January 2023, the National Health Fund in Poland (Narodowy Fundusz Zdrowia [NFZ]) has covered rapid RSV tests, and since February 2023, physicians have been obliged to record RSV infections confirmed by laboratory testing [16].…”

Respiratory syncytial virus immunoprophylaxis: Novel opportunities and a call for equity

“…Moreover, recent data show that it can constitute a higher risk of severe disease and death than seasonal influenza or COVID‐19 under the severe acute respiratory syndrome coronavirus 2 (SARS‐Cov‐2) Omicron dominance 11 . Nevertheless, its burden is often not fully recognized, even in some high‐income regions, due to limited surveillance and awareness 12 …”