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Published on: December 10, 2013
The Impact of COVID-19 Pandemic on Respiratory Syncytial Virus Infection in Children
Jose Boris Trigueros Montes1, Diego Montes2, Andrew Miele3
1Department of Pediatrics, Flushing Hospital Medical Center, Flushing, New York 11355, USA.
Insights
The COVID-19 pandemic reduced respiratory syncytial virus (RSV) incidence and hospitalizations in children. The 2021-2022 RSV season saw older children with milder illness, impacting prevention strategies.
Area of Science:
- Pediatric Infectious Diseases
- Epidemiology
- Public Health
Background:
- Respiratory syncytial virus (RSV) is a primary cause of severe lower respiratory tract infections like bronchiolitis in young children.
- Bronchiolitis can lead to serious complications including pneumonia, respiratory failure, and mortality.
- The impact of the coronavirus disease 2019 (COVID-19) pandemic on RSV epidemiology in pediatric populations requires investigation.
Purpose of the Study:
- To compare the incidence and severity of RSV infections in children aged 0-60 months before and during the COVID-19 pandemic.
- To analyze changes in RSV seasonality and patient demographics during the pandemic period.
Main Methods:
- A retrospective chart review of pediatric patients (0-60 months) testing positive for RSV from May 2018 to May 2022.
- Comparison of RSV seasons: 2018-2019 and 2019-2020 (pre-pandemic) versus 2020-2021 and 2021-2022 (during pandemic).
- Assessment of illness severity using the Bronchiolitis Severity Score (BSS); statistical analysis using R software.
Main Results:
- RSV incidence typically peaked from October to February pre-pandemic, but the 2020-2021 season showed a truncated, low-incidence period.
- The 2021-2022 season began earlier (September-January) with a higher peak incidence (37%) but lower overall frequency.
- Patients in the 2021-2022 season were older and presented with milder illness compared to pre-pandemic cohorts.
Conclusions:
- The COVID-19 pandemic was associated with a decreased incidence and hospitalization rate for RSV in children.
- RSV seasonality shifted during the pandemic, with an earlier and longer-lasting season in 2021-2022 affecting older children more.
- Pandemic-induced changes in RSV epidemiology necessitate re-evaluation of prevention and control strategies.
Abstract:
Background/Objective: Respiratory syncytial virus (RSV) is a major cause of bronchiolitis in infants and young children. Bronchiolitis, an acute inflammation of the lower respiratory tract, can lead to pneumonia, respiratory failure, and death. We aimed to compare the incidence and severity of RSV infection in children aged 0-60 months before and during the coronavirus disease 2019 (COVID-19) pandemic. Methods: A retrospective chart review was conducted on patients aged 0-60 months who tested positive for RSV between May 1, 2018, and May 31, 2022, in a community hospital in Queens County, New York City, United States. Comparisons were made between seasons 2018-2019 and 2019-2020 as before, and seasons 2020-2021 and 2021-2022 as during the COVID-19 pandemic. Severity of RSV infection was assessed using the Bronchiolitis Severity Score (BSS). Data were analyzed using R software, a p value of < 0.05 was considered statistically significant. Results: The incidence of RSV infection in seasons 2018-2019 and 2019-2020 peaked from mid-October to February, whereas the first season during the COVID-19 pandemic (2020-2021) was truncated with a very low incidence of RSV infection, and season 2021-2022 peaked from September to January, with the highest incidence (37%) and lower frequency of RSV infection at any given point. Patients during the season 2021-2022 were older (H [2, 196.6] = 12.5, p < 0.001, 95% CI = [5.4, 25.6]) and had milder illness (H [2, 187.5] = 7.5, p < 0.01, 95% CI = [2.1, 19.2]). Conclusions: We observed a lower incidence of RSV infection and a lower rate of hospitalization for RSV during the COVID-19 pandemic. The second RSV season during the COVID-19 pandemic began earlier, lasted longer, and had a lower frequency. Older children with milder illnesses were affected most during this season. RSV epidemiology and disease burden were impacted by the COVID-19 pandemic and could have significant ramifications for its prevention and control strategies.
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