Respiratory Complications in Children Hospitalized with Respiratory Syncytial Virus Infection

The goal of this study was to define the prevalence of respiratory complications, other than bronchiolitis, such as pneumonia, acute otitis media, and conjunctivitis in children treated in a hospital due to respiratory syncytial virus (RSV) infection, with reference to the plausible risk factors. The study included 111 children, aged up to 22 months (median 3 months). Complications were observed in 68 (61%) children, with 32 (29%) children presenting more than one. The most frequent complication was acute otitis media in 53 (48%), pneumonia in 37 (33%), and conjunctivitis in 12 (11%) out of the 111 children. Children with complications were older than those without complications and had fever that lasted for a significantly longer time, both before and during hospitalization, and the fever was stronger. They also presented a significantly lower breathing rate at admission. The age over 3 months was a single risk factor associated with the development of otitis media (OR = 9.8, 95%CI: 3.6-26.7) and pneumonia (OR = 2.8, 95%CI: 1.1-7.3). Other factors such as prematurity, birth weight below 2500 g, exposure to tobacco smoke during pregnancy, and the cessation of breastfeeding below age 6 months were statistically irrelevant to this end. We conclude that complications are very frequent in hospitalized children with RSV infection and their risk increases with the infant age.