Respiratory Syncytial Virus Disease Severity in Young Children

Abstract

Background Respiratory syncytial virus (RSV) is the leading cause of acute respiratory infections (ARI) in hospitalized children. Although prematurity and underlying medical conditions are known risk factors, most of these children are healthy, and factors including RSV load and subgroups may contribute to RSV-ARI severity. Therefore, we aimed to evaluate the role of RSV in ARI disease severity and determine factors associated with increased RSV-ARI severity in young children. Method Children less than five years with fever and/or ARI symptoms were recruited from the emergency department (ED) or inpatient settings at Vanderbilt Children's Hospital. Nasal and/or throat swabs were tested by qRT-PCR for common respiratory viruses, including RSV. A severity score was calculated for RSV-positive children. Results From 11/2015 through 07/2016, 898 participants were enrolled, and 681 (76%) had at least one virus detected, with 191 (28%) testing positive for RSV. RSV-positive children were more likely to be hospitalized, require intensive care unit (ICU) admission, and receive oxygen compared to other-virus-positive children. Higher viral load, White race, younger age, and higher severity score were independently associated with hospitalization in RSV-positive children. No differences in disease severity were noted among children infected with RSV A and B. Conclusion RSV was associated with increased ARI severity in young children enrolled from ED and inpatient settings, but no differences in disease severity were noted between RSV A and B. . These findings emphasize the need for effective antiviral therapy and/or preventive measures such as vaccines against RSV in young children.

Prevalence of GII.4 Sydney Norovirus Strains and Associated Factors of Acute Gastroenteritis in Children: 2019/2020 Season in Guangzhou, China

“…Compared with non-GII.4, the clinical feature of GII.4-associated AGE is more severe, especially in diarrhoea and abdominal pain (Desai et al, 2012 ; Leshem et al, 2013 ). Our data indicated that “GII.4” group had a longer diarrhoea duration and a greater maximum number of diarrhoeal stools per day than those with “Others” group (both p < 0.05), which was consistent with previous studies (Haddadin et al, 2020 ; Wang et al 2019a ). The MVS has been used in several studies of norovirus infections to evaluate the severity of AGE (Bhavanam et al, 2020 ; Wang et al 2016a ).…”

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

“…It might be expected, if confounding by limitations of enrollment to only the most ill children was influential, that the proportions of enrolled children with RSV and influenza detection might have increased, not decreased, especially since RSV and influenza are important causes of severe ARI in children. [16][17][18][28][29][30][31] Both RSV and influenza activity show natural fluctuations from season to season such that the decrease in RSV and influenza detections in our study might be partially explained by seasonal variation or even differences in virulence of circulating viral strains. 14,15,17 The use of four seasons of data from the same study sites using similar enrollment criteria across wide geographic settings makes secular seasonal and virulence trends less likely to explain our findings of abrupt curtailment of RSV and influenza circulation among children in the study sites.…”

“…RSV is a major cause of ARI hospitalizations in young children during the fall and winter months and associated with significant morbidity. 16,17 We found a greater than 70% decrease in RSV-positive ARI in the community mitigation period in 2020 compared to the same period in prior surveillance seasons during which similar enrollment protocols were used. Baker et.…”

“…For example, respiratory syncytial virus (RSV) and influenza are among the most common causes of ARI in children, both associated with increased disease severity, and generally peak in winter and early-spring months each year. [14][15][16][17][18] Therefore, this study aimed to (1) assess the frequency of ARI in children, including those due to RSV and influenza, in both the ED and inpatient settings, before and during the pandemic within a US multicenter active surveillance network, and (2) whether the proportions of such ARIs testing positive for RSV and influenza during the COVID-19 mitigation period in 2020 were lower than in prior seasons.…”

Comparison of clinical presentations and burden of respiratory syncytial virus in infants across three distinct healthcare settings in Davidson County, Tennessee

“… 1 , 18 , 19 Given that the vast majority of prior surveillance studies are cross-sectional, they potentially underestimate the full illness spectrum of RSV-associated healthcare utilization across clinical settings in the United States. 1 , 6 , 18 , 20 – 22 For example, in a population-based surveillance study among children under 5 years, 61% of RSV-positive children were hospitalized and 39% were seen in ambulatory care (i.e. EDs, pediatric offices).…”