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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
Pediatric respiratory syncytial virus rehospitalization rate - a retrospective observational study from Switzerland
Naomi Rupp1, Nina Schöbi1, Andrea Duppenthaler1
1Division of Pediatric Infectious Disease, Department of Pediatrics, Bern University Hospital, Inselspital, University of Bern, Bern, CH-3010, Switzerland.
Insights
Same-season rehospitalizations for Respiratory Syncytial Virus (RSV) are very rare in children. Current recommendations likely cover most children needing secondary RSV prevention, making additional antibody doses unnecessary for same-season protection.
Area of Science:
- Pediatrics
- Infectious Diseases
- Immunology
Background:
- New long-acting monoclonal antibodies for Respiratory Syncytial Virus (RSV) are available for preventing severe disease in young children.
- Understanding the risk of rehospitalization after a severe RSV episode is crucial for determining the need for secondary prevention.
- This study focuses on the risk of RSV rehospitalization, particularly within the same season.
Purpose of the Study:
- To evaluate the risk of rehospitalization due to Respiratory Syncytial Virus (RSV) in a large pediatric cohort.
- To specifically assess the incidence of same-season RSV rehospitalizations.
- To inform decisions regarding the necessity of additional monoclonal antibody doses for secondary RSV prevention.
Main Methods:
- A retrospective single-center study analyzed RSV rehospitalizations over 13 seasons (2009-2023).
- Data were collected through an ongoing RSV surveillance program.
- Rates of overall and same-season rehospitalizations were calculated for all ages and specifically for children up to 5 years old.
Main Results:
- Out of 3,143 primary RSV hospitalizations, 69 resulted in rehospitalization (2.2% overall risk).
- Same-season RSV rehospitalizations were rare, occurring in only 2 cases (0.06% risk).
- Rehospitalized children were more likely to have pre-existing conditions (68%) or be born prematurely (40%), and their hospital stays were shorter than first admissions.
Conclusions:
- Same-season RSV rehospitalizations are exceptionally uncommon.
- Routine administration of an additional monoclonal antibody dose solely for same-season protection is not generally recommended.
- Most children requiring readmission in a subsequent season are likely already covered by existing prophylaxis recommendations for those with pre-existing conditions.
Background:
Long-acting monoclonal antibodies against Respiratory Syncytial Virus (RSV) have recently become available for prevention of severe disease including RSV hospitalization in children below two years of age. Data on the risk of rehospitalization among children, who had suffered from severe first RSV episode, remain important to inform the need for secondary prevention using a (additonal) dose of such an antibody. We studied the risk of RSV rehospitalization in a large cohort of patients with a particular focus on same-season rehospitalizations.
Methods:
Retrospective single-center study of all RSV rehospitalizations occurring in 13 RSV seasons between 2009 and 2023 based on an ongoing RSV surveillance program. We calculated the overall and same-season rates of rehospitalizations for patients of any age and for the first 5 years of life, respectively, and provide a clinical description of of rehospitalization cases.
Results:
In a cohort of 3'143 patients having had a primary RSV hospitalization, the overall risk of rehospitalization (69 cases) and same-season risk of rehospitalization (2 cases) for a second RSV infection were 2.2% (95% confidence interval (CI), 1.73-2.79) and 0.06% (95% CI 0.02-0.23), respectively. The figures for the RSV rehospitalization rates from birth until age 5 years of age were 2.3% (95% CI 1.76-3.07) for all rehospitalizations and 0.04% (95% CI 0.01-0.25) for same-season rehospitalizations. The median length of stay (LoS) of rehospitalizations (4.0 days, interquartile range (IQR) 3.0-6.0) was significantly shorter than the LoS of first hospitalizations (6.0 days, IQR 4.0-9.0, p < 0.0001). Children with a pre-existing condition (68%) and those born prematurely (40%) predominated among rehospitalized patients.
Conclusion:
Same-season RSV rehospitalizations were exquisitely rare. Routine administration of a dose of a monoclonal antibody for protection against a same-season rehospitalization does not appear to be generally warranted. The majority of patients with subsequent season readmission would be covered by the current recommendations in Switzerland as they had pre-existing conditions making them eligible for second-season RSV prophylaxis.
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