Centers for Disease Control and Prevention, Atlanta, Georgia.
Texas Children's Hospital and Department of Pediatrics, Baylor College of Medicine, Houston, Texas.
Pediatrics. 2024 Mar 1;153(3). doi: 10.1542/peds.2023-062574.
Respiratory syncytial virus (RSV) is the leading cause of hospitalization in US infants. Accurate estimates of severe RSV disease inform policy decisions for RSV prevention.
We conducted prospective surveillance for children <5 years old with acute respiratory illness from 2016 to 2020 at 7 pediatric hospitals. We interviewed parents, reviewed medical records, and tested midturbinate nasal ± throat swabs by reverse transcription polymerase chain reaction for RSV and other respiratory viruses. We describe characteristics of children hospitalized with RSV, risk factors for ICU admission, and estimate RSV-associated hospitalization rates.
Among 13 524 acute respiratory illness inpatients <5 years old, 4243 (31.4%) were RSV-positive; 2751 (64.8%) of RSV-positive children had no underlying condition or history of prematurity. The average annual RSV-associated hospitalization rate was 4.0 (95% confidence interval [CI]: 3.8-4.1) per 1000 children <5 years, was highest among children 0 to 2 months old (23.8 [95% CI: 22.5-25.2] per 1000) and decreased with increasing age. Higher RSV-associated hospitalization rates were found in premature versus term children (rate ratio = 1.95 [95% CI: 1.76-2.11]). Risk factors for ICU admission among RSV-positive inpatients included: age 0 to 2 and 3 to 5 months (adjusted odds ratio [aOR] = 1.97 [95% CI: 1.54-2.52] and aOR = 1.56 [95% CI: 1.18-2.06], respectively, compared with 24-59 months), prematurity (aOR = 1.32 [95% CI: 1.08-1.60]) and comorbid conditions (aOR = 1.35 [95% CI: 1.10-1.66]).
Younger infants and premature children experienced the highest rates of RSV-associated hospitalization and had increased risk of ICU admission. RSV prevention products are needed to reduce RSV-associated morbidity in young infants.
呼吸道合胞病毒（RSV）是导致美国婴儿住院的主要原因。准确估计严重 RSV 疾病可用于制定 RSV 预防政策。
我们对 2016 年至 2020 年期间 7 家儿科医院的 5 岁以下急性呼吸道疾病患儿进行了前瞻性监测。我们对患儿父母进行了访谈，查阅了病历，并通过逆转录聚合酶链反应对中鼻甲鼻拭子和鼻咽拭子进行了 RSV 和其他呼吸道病毒检测。我们描述了因 RSV 住院患儿的特征、入住 ICU 的危险因素，并估计了 RSV 相关的住院率。
在 13524 名 5 岁以下急性呼吸道疾病住院患儿中，4243 例（31.4%）RSV 阳性；2751 例（64.8%）RSV 阳性患儿无基础疾病或早产史。每年 RSV 相关住院率为 4.0（95%置信区间[CI]：3.8-4.1）/1000 名<5 岁儿童，0-2 个月龄儿童最高（23.8 [95% CI：22.5-25.2]/1000），随年龄增长而降低。早产儿 RSV 相关住院率高于足月儿（比率比=1.95 [95% CI：1.76-2.11]）。RSV 阳性住院患儿入住 ICU 的危险因素包括：0-2 个月和 3-5 个月龄（校正比值比[aOR]：1.97 [95% CI：1.54-2.52]和 aOR=1.56 [95% CI：1.18-2.06]，与 24-59 个月龄相比）、早产（aOR=1.32 [95% CI：1.08-1.60]）和合并症（aOR=1.35 [95% CI：1.10-1.66]）。
年龄较小的婴儿和早产儿的 RSV 相关住院率最高，且 ICU 入住风险增加。需要 RSV 预防产品来降低幼儿的 RSV 发病率。
