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Long Term Sequelae of Mild RSV Infections in Healthy Children Aged 0-3 Years in the Primary Care Setting-A

Paulina Ehlmaier1, Peter Voitl1,2, Angela Riepl1

  • 1First Vienna Pediatric Medical Center, Vienna, Austria.

Journal of Medical Virology
|June 12, 2025
PubMed

Insights

Mild respiratory syncytial virus (RSV) infections in children were linked to a lower risk of developing wheezing compared to other respiratory infections. Rhinovirus infections, however, showed a trend towards increased wheezing risk in children.

Area of Science:

  • Pediatrics
  • Infectious Diseases
  • Pulmonology

Background:

  • Severe early respiratory syncytial virus (RSV) infections are known to increase later wheezing risk in children.
  • The impact of mild RSV infections managed in primary care on subsequent wheezing incidence remains less understood.

Purpose of the Study:

  • To determine if mild RSV infections in children are associated with an increased incidence of wheezing in the two years post-infection.
  • To compare wheezing risk between children with mild RSV and those with other respiratory infections.

Main Methods:

  • A longitudinal study involving 216 RSV-positive and 201 RSV-negative children matched for age, gender, and diagnosis time.
  • Multiplex PCR was used to identify 23 pathogens from nasal swabs of children with acute respiratory infections.
  • Telemedical follow-up for two years recorded wheezing, hospitalizations, and respiratory tract infection frequency.

Main Results:

  • RSV-positive patients had a significantly lower risk (48%) of developing wheezing compared to RSV-negative patients (OR 0.520, p=0.03).
  • Rhinovirus-positive patients exhibited a trend towards an increased risk of wheezing (OR 1.47, p=0.0872).
  • Reduced prescription rates of short-acting beta-agonists were observed in the RSV group, correlating with fewer wheezing episodes.

Conclusions:

  • Mild RSV infections may be associated with fewer wheezing episodes compared to other respiratory infections in children.
  • Rhinovirus infections appear to be linked to an increased risk of wheezing.
  • The findings suggest a potential dose-effect relationship for RSV infections and wheezing risk.

Keywords:
RSVatopychildrenhospitalizationlong term sequelaerhinoviruswheezing

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