Related Experiment Video
Updated: Jul 31, 2025
An In vitro Model to Study Immune Responses of Human Peripheral Blood Mononuclear Cells to Human Respiratory Syncytial Virus Infection
Published on: December 10, 2013
Healthcare-Associated Respiratory Syncytial Virus in Children's Hospitals
Lisa Saiman1, Susan E Coffin2, Larry K Kociolek3
1Department of Pediatrics, NewYork-Presbyterian Morgan Stanley Children's Hospital, Columbia University Irving Medical Center, New York, New York, USA.
Insights
Sporadic healthcare-associated respiratory syncytial virus (HA-RSV) infections in children lead to significant respiratory support escalation and PICU transfers. These preventable HA-RSV infections increase healthcare utilization and highlight the need for mitigation strategies.
Area of Science:
- Pediatric Infectious Diseases
- Hospital Epidemiology
- Healthcare-Associated Infections
Background:
- Healthcare-associated respiratory syncytial virus (HA-RSV) outbreaks in children are documented, yet sporadic cases are less understood.
- This study investigates the epidemiology and clinical outcomes of sporadic HA-RSV infections in hospitalized children.
Purpose of the Study:
- To assess the incidence and characteristics of sporadic HA-RSV infections in children.
- To determine the clinical outcomes, including respiratory support needs and mortality, associated with sporadic HA-RSV infections.
Main Methods:
- Retrospective and prospective cohort study of hospitalized children (≤18 years) with HA-RSV infections across six US children's hospitals.
- Data collected over multiple respiratory viral seasons (2016-2019) and a prospective period (2020-2021).
- Outcomes evaluated included respiratory support escalation, PICU transfer, and in-hospital mortality; comorbidities were assessed for association with respiratory support escalation.
Main Results:
- 122 children with HA-RSV were identified, with a median age of 16 months and median hospital day of 14 for infection onset.
- Over 63% of children had two or more comorbidities, most commonly cardiovascular, gastrointestinal, neurologic, respiratory, and neonatal.
- 45.1% required escalated respiratory support, 14.8% were transferred to the PICU, and 4.1% died; respiratory comorbidities significantly increased the odds of respiratory support escalation.
Conclusions:
- Sporadic HA-RSV infections contribute to significant, preventable morbidity in hospitalized children.
- These infections increase healthcare resource utilization, underscoring the need for effective prevention strategies.
- The impact of COVID-19 on seasonal viral infections further emphasizes the priority for studying HA-RSV mitigation.
Background:
Outbreaks of healthcare-associated respiratory syncytial virus (HA-RSV) infections in children are well described, but less is known about sporadic HA-RSV infections. We assessed the epidemiology and clinical outcomes associated with sporadic HA-RSV infections.
Methods:
We retrospectively identified hospitalized children ≤18 years old with HA-RSV infections in six children's hospitals in the United States during the respiratory viral seasons October-April in 2016-2017, 2017-2018, and 2018-2019 and prospectively from October 2020 through November 2021. We evaluated outcomes temporally associated with HA-RSV infections including escalation of respiratory support, transfer to the pediatric intensive care unit (PICU), and in-hospital mortality. We assessed demographic characteristics and comorbid conditions associated with escalation of respiratory support.
Results:
We identified 122 children (median age 16.0 months [IQR 6, 60 months]) with HA-RSV. The median onset of HA-RSV infections was hospital day 14 (IQR 7, 34 days). Overall, 78 (63.9%) children had two or more comorbid conditions; cardiovascular, gastrointestinal, neurologic/neuromuscular, respiratory, and premature/ neonatal comorbidities were most common. Fifty-five (45.1%) children required escalation of respiratory support and 18 (14.8%) were transferred to the PICU. Five (4.1%) died during hospitalization. In the multivariable analysis, respiratory comorbidities (aOR: 3.36 [CI95 1.41, 8.01]) were associated with increased odds of escalation of respiratory support.
Conclusions:
HA-RSV infections cause preventable morbidity and increase healthcare resource utilization. Further study of effective mitigation strategies for HA-respiratory viral infections should be prioritized; this priority is further supported by the impact of the COVID-19 pandemic on seasonal viral infections.
Related Concept Videos
01:31Common Respiratory Disorders
Upper respiratory disorders impact the airways above the vocal cords, encompassing areas like the nose, sinuses, and throat. Various conditions fall under this category, including the common cold and allergic rhinitis. These disorders can stem from several causes,...
01:21Acute Respiratory Failure-II
The underlying physiological abnormalities that contribute to hypoxemic respiratory failure include:
01:29Acute Respiratory Failure-V
Ensure that patients are monitored continuously for their response to therapy, including changes in...
01:21Acute Respiratory Failure-I
Definition: It is defined by specific criteria based on blood gas measurements. Hypoxemia happens when the partial pressure of oxygen (PaO2) falls below 60 mmHg. At the same time,...
01:30Acute Respiratory Failure-III
01:25Transmission-based Precautions II: Airborne and Protective Environment
Airborne precautions:
Use airborne precautions when treating patients known or suspected to have diseases that spread through the air—for example, tuberculosis or measles. These organisms are present in smaller droplets expelled by an infected person and...