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Epidemiological Impact of Nirsevimab on Admissions for Bronchiolitis in a Pediatric Emergency Department: A

Emanuele Castagno1, Carola Aschieri2, Irene Ferri2

  • 1Department of Pediatric Emergency, Regina Margherita Children's Hospital, 10126 Turin, Italy.

Viruses
|April 27, 2026
PubMed

Insights

Nirsevimab immunization significantly reduced respiratory syncytial virus (RSV) cases in infants, decreasing RSV-positive swabs and hospital admissions. This supports nirsevimab

Area of Science:

  • Pediatrics
  • Infectious Diseases
  • Immunology

Background:

  • Respiratory syncytial virus (RSV) is a primary cause of bronchiolitis in young children, leading to significant healthcare utilization.
  • Nirsevimab, a monoclonal antibody, is recommended for infant protection against RSV.

Purpose of the Study:

  • To evaluate the impact of nirsevimab introduction on bronchiolitis epidemiology in a pediatric emergency department.
  • To assess changes in RSV positivity and hospitalization rates following nirsevimab implementation.

Main Methods:

  • A retrospective cohort study analyzed children under 24 months with bronchiolitis over two RSV seasons.
  • Data included RSV testing, immunization status, and clinical outcomes (ED visits, hospitalizations).
  • Descriptive and multivariate analyses were performed to compare the two seasons.

Main Results:

  • RSV positivity decreased significantly in the second season (32.4% vs. 47.9%, p=0.003) after nirsevimab introduction.
  • Immunized children showed substantially lower RSV positivity rates (16.2% vs. 51.5%, p<0.001).
  • Nirsevimab immunization was associated with a reduced risk of RSV-positive swabs (OR=0.159). Hospital admissions were halved, though overall hospitalization rates remained stable.

Conclusions:

  • Nirsevimab immunization effectively reduced the burden of RSV in infants.
  • Findings support nirsevimab's role in universal prevention programs for RSV.
  • Further multicenter studies are needed to evaluate long-term outcomes.

Keywords:
Respiratory syncytial virusbronchiolitisemergency departmentinfantsnirsevimab

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