Respiratory Syncytial Virus-Associated Hospitalizations in Children <5 Years: 2016-2022

Area of Science:

• Pediatric Infectious Diseases
• Epidemiology
• Public Health

Background:

• The COVID-19 pandemic significantly disrupted typical respiratory syncytial virus (RSV) seasonality.
• This disruption led to early and atypical RSV seasons in 2021 and 2022.
• The 2022 RSV peak severely impacted pediatric healthcare facilities.

Purpose of the Study:

• To analyze the impact of pandemic-disrupted seasons on RSV epidemiology.
• To compare RSV-associated hospitalization rates and patient characteristics between prepandemic and pandemic seasons.
• To assess changes in disease severity during atypical RSV seasons.

Main Methods:

• Prospective surveillance for acute respiratory illness was conducted from 2016-2022 across 7 pediatric hospitals.
• Data collection involved parent interviews, medical record reviews, and respiratory specimen testing for viruses.
• RSV-associated hospitalization rates in children under 5 years were estimated and compared across seasons.

Main Results:

• RSV hospitalization rates increased in 2021 and 2022 compared to prepandemic averages.
• Children aged 24-59 months showed significantly higher hospitalization rates in 2022.
• While supplemental oxygen use and viral co-detections increased in 2022, key severity indicators like mechanical ventilation and ICU admission remained unchanged.

Conclusions:

• The 2021 and 2022 RSV seasons were characterized by atypical patterns and elevated hospitalization rates.
• Disease severity for hospitalized children during these atypical seasons was comparable to prepandemic periods.
• These findings highlight the ongoing impact of pandemic-related disruptions on pediatric respiratory virus epidemiology.