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Increased RSV-A Bronchiolitis Severity in RSV-Infected Children Admitted to a Reference Center in Catalonia (Spain)

Jorgina Vila^1,2,3, Esther Lera^2,4, Paula Peremiquel-Trillas^5,6

¹Pediatric Hospital Medicine, Department of Pediatrics, Hospital Infantil Vall d'Hebron, Vall d'Hebron Barcelona Hospital Campus, Barcelona, Spain.

Journal of the Pediatric Infectious Diseases Society

|February 6, 2023

Insights

Respiratory syncytial virus (RSV) subtype A infections are linked to more severe bronchiolitis cases than RSV-B. Identifying RSV subtypes can improve clinical care and healthcare planning for seasonal respiratory illnesses.

Area of Science:

Pediatrics
Infectious Diseases
Virology

Background:

Bronchiolitis is a common respiratory infection in infants.
Respiratory Syncytial Virus (RSV) is a primary cause of bronchiolitis.
RSV has two main subtypes, RSV-A and RSV-B, with potential differences in severity.

Purpose of the Study:

To compare the clinical severity of bronchiolitis caused by RSV-A versus RSV-B.
To evaluate the need for intensive care and respiratory support based on RSV subtype.
To inform clinical evaluation and healthcare resource planning for RSV seasons.

Main Methods:

Retrospective analysis of 687 bronchiolitis cases in Catalonia, Spain (2014-2018).
Evaluation of clinical severity, including intensive care unit (ICU) admission and respiratory support.
Statistical comparison of outcomes between RSV-A and RSV-B infections using adjusted relative risk (aRR).

Main Results:

RSV-A cases showed a significantly higher likelihood of requiring intensive care (aRR = 1.44, p < 0.01).
RSV-A infections were associated with increased need for respiratory support (aRR = 1.07, p < 0.01).
Hospital stays were, on average, one day longer for RSV-A cases (p < 0.01).

Conclusions:

RSV-A is associated with more severe bronchiolitis compared to RSV-B.
Subtyping of RSV can provide valuable information for clinical management.
Understanding subtype-specific severity aids in seasonal healthcare planning and resource allocation.

Read full analysis

Abstract:

Between 2014 and 2018, we evaluated the severity of 687 cases of bronchiolitis caused by respiratory syncytial virus (RSV) in Catalonia, Spain. Compared to RSV-B, RSV-A cases required intensive care (adjusted relative risk (aRR) = 1.44, p < 0.01) and respiratory support (aRR = 1.07, p < 0.01) more often; hospital stay was one day longer (p < 0.01). Subgroup identification may aid clinical evaluation and seasonal healthcare planning.

Keywords:

RSV-A bronchiolitis bronchiolitis severity respiratory infections respiratory syncytial virus

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