United States: Respiratory syncytial virus (RSV) precipitates approximately 2.1 million outpatient consultations, 58,000 to 80,000 hospital admissions, and 100 to 300 fatalities annually in American children under five years of age. According to the CDC, RSV is a pervasive respiratory pathogen typically engendering mild, cold-like manifestations that abate within a fortnight. Nonetheless, it can incite grave illness in susceptible populations, including infants and young children.
A seminal investigation conducted by St. Jude’s faculty member M. Asunción Mejías, M.D., Ph.D., and her associates accentuates that RSV’s peril transcends infancy. The research underscores age-specific determinants correlated with severe afflictions, according to managedhealthcareexecutive.com.
Published in Pediatric Allergy and Immunology on February 16th, this study delineates significant morbidity linked to RSV in hospitalized infants and children, with notable variances in clinical presentation contingent upon the child’s age.
“RSV constitutes the paramount cause of hospitalization in infants and young children globally,” elucidated Dr. Mejías, a pediatric infectious disease connoisseur and principal author of the study, in an MHE interview. With 22 years of RSV research under her belt, including probing into elements associated with more virulent diseases in children, Mejías offers deep insights.
“We now possess preventive measures for the infant demographic under six months old, either via maternal immunization or direct monoclonal antibody administration,” Mejías remarked. While these preventive measures will markedly influence the youngest infants, she stressed the imperative to devise further preventive strategies for older infants, toddlers, and children. The core objective of this study was to meticulously scrutinize and elucidate the clinical manifestation of older infants and children hospitalized with RSV.
This retrospective, single-center study scrutinized electronic health records of over 5,000 children under five years old hospitalized with RSV during the respiratory seasons from 2012 to 2018 at Nationwide Children’s Hospital in Columbus, OH. The children were categorized by age: under six months, six to 24 months, and 24 to 59 months (two to five years), as highlighted by managedhealthcareexecutive.com.
The study unveiled that nearly half of the hospitalized children were older than six months. Underlying comorbidities were prevalent in 37% of the cases. Supplemental oxygen was administered to almost 70% of patients, averaging four days. Interestingly, a higher number of children aged 24 to 59 months required oxygen compared to those under six months, although the duration of oxygen therapy was protracted in the youngest cohort.
The proportion of patients necessitating care in the pediatric intensive care unit (PICU) was analogous across all age groups. However, infants under six months experienced extended PICU stays and more frequent mechanical ventilation usage. The total hospitalization duration was comparable among age groups.
The research discerned that the incidence of underlying comorbidities, such as asthma, escalated with age and was persistently associated with aggravated disease severity in older children. Concurrent viral infections exerted a more pronounced impact during the first two years of life.
“We discovered that co-infection with RSV and other viral pathogens was a significant risk factor for severe disease,” Mejías noted, acknowledging that their data collection period predated the pandemic and advocating for further research to replicate and comprehend the risk factors of specific viral co-infections, according to managedhealthcareexecutive.com.
While novel therapies will predominantly benefit younger infants, this study underscores the critical need to establish efficacious prevention and management strategies for children up to five years old.