Lodi Lorenzo, Catamerò Francesco, Voarino Marta, Barbati Federica, Moriondo Maria, Nieddu Francesco, Sarli Walter Maria, Citera Francesco, Astorino Valeria, Pelosi Caterina, Quaranta Francesca, Stocco Silvia, Canessa Clementina, Lastrucci Vieri, Ricci Silvia, Indolfi Giuseppe, Azzari Chiara
Department of Health Sciences, University of Florence, Florence, Italy.
Immunology Unit, Department of Pediatrics, Meyer Children's Hospital IRCCS, Florence, Italy.
Front Pharmacol. 2024 May 22;15:1381107. doi: 10.3389/fphar.2024.1381107. eCollection 2024.
Respiratory Syncytial Virus (RSV) is the primary cause of respiratory infections and hospitalizations in young children globally, leading to substantial disease burden and mortality. The aim of the present study was to review and provide updates on how the SARS-CoV-2 pandemic have significantly influenced RSV epidemiology on hospitalized children due to RSV infection. A potential impact of the available preventive strategies on the same population were provided. All children aged 0-6 years hospitalized at Meyer Children's Hospital IRCCS for RSV infection from September 2014 to March 2023 were retrospectively recorded. Seasonal trends before and after SARS-CoV-2 pandemic, age distribution, ICU admission and co-infections, comorbidities and prematurity were retrieved. Predictions on the number of hospitalizations avoided by the deployment of different preventive strategies were provided. A total of 1,262 children with RSV infection were included in the study. The 70% of them had less than 1 year-of-age at the moment of hospitalization and almost 50% less than 3 months. In the post-pandemic seasons, a 317% increase in the number of hospitalizations was recorded with a significant increase in older children compared to the pre-pandemic seasons. ICU support was required for 22% of children, the majority of whom were under 3 months of age. Almost 16% of hospitalized children were born preterm and only 27% of hospitalized children had prior comorbidities. The rate of comorbidities among RSV hospitalized children increased with age. Nirsevimab prophylaxis could have prevented more than 46% of hospitalizations in this cohort. A preventive strategy addressing also children aged 7 months to 6 years of age with co-existing comorbidities would increase that rate above 57%. The identification of RSV hospitalization-related features is informing the decision-maker for the deployment of the wisest preventive approach on a population scale.
呼吸道合胞病毒（RSV）是全球幼儿呼吸道感染和住院的主要原因，导致了巨大的疾病负担和死亡率。本研究的目的是回顾并提供最新信息，说明严重急性呼吸综合征冠状病毒2（SARS-CoV-2）大流行如何显著影响因RSV感染住院儿童的RSV流行病学情况。还提供了现有预防策略对同一人群的潜在影响。回顾性记录了2014年9月至2023年3月在迈耶儿童医院IRCCS因RSV感染住院的所有0至6岁儿童。检索了SARS-CoV-2大流行前后的季节性趋势、年龄分布、重症监护病房（ICU）收治情况和合并感染、合并症和早产情况。提供了关于不同预防策略避免住院人数的预测。本研究共纳入1262例RSV感染儿童。其中70%在住院时年龄小于1岁，近50%小于3个月。在大流行后的季节，与大流行前的季节相比，住院人数增加了317%，年龄较大的儿童显著增加。22%的儿童需要ICU支持，其中大多数年龄在3个月以下。近16%的住院儿童为早产儿，只有27%的住院儿童有既往合并症。RSV住院儿童的合并症发生率随年龄增长而增加。在该队列中，尼塞韦单抗预防可预防超过46%的住院病例。针对同时患有合并症的7个月至6岁儿童的预防策略将使这一比例提高到57%以上。确定与RSV住院相关的特征可为决策者在人群层面部署最明智的预防方法提供参考。
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