Risk Factors for Severe Respiratory Syncytial Virus Infection in Hospitalized Children

Abstract

Background: RSV often leads to hospitalization, and accurate knowledge of risk factors is crucial. Methods: We retrospectively analyzed laboratory-confirmed RSV hospitalizations regarding pregnancy factors, birth status, cigarette smoke exposure, nutrition, social conditions, clinical presentation, and severe disease defined as a need for passive oxygen therapy (pO2Tx), the presence of pneumonia, respiratory failure, intensive care unit (ICU) transfer, and prolonged hospitalization. Results: A univariate analysis included 594 children (median age 4 months) and revealed a pO2Tx relationship with age ≤ 3 months (OR = 1.56), prematurity (OR = 1.71), being born during RSV season (OR = 1.72), smoke exposure during pregnancy (both parents (OR = 2.41, father (OR = 1.8)), dyspnea (OR = 5.09), and presence of apnea (OR = 5.81). Pneumonia was associated with maternal smoke exposure (OR = 5.01), fever (OR = 3.92), dyspnea (OR = 1.62), history of aspiration (OR = 4.63), and inversely with age ≤ 3 months (OR = 0.45). Respiratory failure was associated with prematurity (OR = 3.13) and apnea (OR = 18.78), while the lower odds were associated with older age (OR = 0.57 per month) and presence of fever (OR = 0.11). ICU transfer was associated with apnea (OR = 17.18), but an inverse association was observed with age (OR = 0.54) and fever (OR = 0.11). A prolonged hospital stay was associated with prematurity (OR = 1.76), low birth weight (OR = 2.89), aspiration (OR = 4.93), and presence of fever (OR = 1.51). Conclusions: Age (up to 3 months), prematurity, and presence of apnea are risk factors for a severe RSV course.

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

“…Our results showed a clear seasonality pattern of RSV-associated hospitalization rates in young children before the COVID-19 pandemic, with the highest hospitalization rates between December and April, peaking in February. This finding is in line with other publications suggesting that the peak of RSV infections worldwide occurs in the winter months [8,[20][21][22][23][24][25][26].…”

“…RSV is a prominent global health concern, particularly due to its substantial impact on respiratory morbidity in vulnerable populations such as young children and older adults [5]. Young children, particularly infants and toddlers, are at increased risk of RSV infection due to factors such as an immature immune system, limited prior exposure to the virus, and close contact within daycare settings [6][7][8]. The clinical manifestations of RSV infections in this age group often include symptoms such as nasal congestion, cough, and fever; however, severe infections can lead to bronchiolitis and pneumonia.…”