Respiratory Syncytial Virus–Associated Hospitalizations Among Young Children: 2015–2016

Abstract

BACKGROUND: Respiratory syncytial virus (RSV) is a major cause of hospitalized acute respiratory illness (ARI) among young children. With RSV vaccines and immunoprophylaxis agents in clinical development, we sought to update estimates of US pediatric RSV hospitalization burden.METHODS: Children ,5 years old hospitalized for ARI were enrolled through active, prospective, population-based surveillance from November 1, 2015, to June 30, 2016, at 7 US pediatric hospital sites. Clinical information was obtained from parent interviews and medical records. Midturbinate nasal and throat flocked swabs were collected and tested for RSV by using molecular diagnostic assays at each site. We conducted descriptive analyses and calculated population-based rates of RSV-associated hospitalizations.RESULTS: Among 2969 hospitalized children included in analyses, 1043 (35%) tested RSVpositive; 903 (87%) children who were RSV-positive were ,2 years old, and 526 (50%) were ,6 months old. RSV-associated hospitalization rates were 2.9 per 1000 children ,5 years old and 14.7 per 1000 children ,6 months old; the highest age-specific rate was observed in 1-month-old infants (25.1 per 1000). Most children who were infected with RSV (67%) had no underlying comorbid conditions and no history of preterm birth.CONCLUSIONS: During the 2015-2016 season, RSV infection was associated with one-third of ARI hospitalizations in our study population of young children. Hospitalization rates were highest in infants ,6 months. Most children who were RSV-positive had no history of prematurity or underlying medical conditions, suggesting that all young children could benefit from targeted interventions against RSV.WHAT'S KNOWN ON THIS SUBJECT: Respiratory syncytial virus (RSV) infection is a major cause of hospitalization among young children. The US pediatric burden of hospitalized RSV is substantial, with the most recent prospective populationbased estimates of burden coming from 3 counties in 2000-2005.WHAT THIS STUDY ADDS: During 2015-2016, prospective population-based surveillance over a broader geographic area detected RSV in one-third of acute respiratory illness hospitalizations in our study population of young US children and yielded updated burden estimates that should help inform RSV-specific intervention strategies.

Acute Respiratory Illnesses in Children in the SARS-CoV-2 Pandemic: Prospective Multicenter Study

“…Further, local healthcare providers and researchers altered their practices and priorities during the early part of the COVID-19 pandemic, which posed limitations in our enrollment. 19 Nonetheless, all sites recorded the number of eligible subjects even when enrollment was not possible due to institution-specific mandates in research curtailment. These data showed a significant decrease in the number of eligible subjects in 2020, as well as in the proportions positive for RSV and influenza.…”

“…Provisional data were obtained from the New Vaccine Surveillance Network (NVSN), a prospective, population-based ARI surveillance platform funded by the Centers for Disease Control and Prevention (CDC). 18,19…”

“…18 All sites conducted CDC-sponsored proficiency testing to ensure the validity and consistency of respiratory viral detections at each site. 18,19…”

“…Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), the cause of coronavirus disease 2019 (COVID- 19), is a highly contagious respiratory virus, primarily transmitted between humans through exposure to respiratory droplets and aerosols from infected individuals. 1 Early in the pandemic, national and global efforts have focused on community mitigation strategies to prevent the spread of SARS-CoV-2 throughout the pandemic in the absence of available vaccines and medical interventions.…”

Deep Immune Profiling of MIS-C demonstrates marked but transient immune activation compared to adult and pediatric COVID-19

“…In contrast, COVID-19 hospitalization rates are low in children, with fewer than 0.1% of the total deaths occurring in those under 21 years of age [7][8][9][10] . The underlying reasons for differences in pediatric versus adult SARS-CoV-2 infection remain unclear given that other respiratory viruses, including influenza and respiratory syncytial virus, can cause substantial morbidity and mortality in young children as well as in older adults [11][12][13][14][15][16] .…”