Pediatric Emergency Department, Hospital Infantil Universitario Niño Jesús, Madrid, Spain.
Instituto de Investigación Sanitaria Hospital Universitario La Princesa, Madrid, Spain.
Pediatrics. 2024 Oct 1;154(4). doi: 10.1542/peds.2024-066584.
In the 2023-2024 respiratory syncytial virus (RSV) season, Spain became one of the first countries to introduce universal RSV prophylaxis, during which all infants born at this time were eligible to receive nirsevimab. Locally, most Spanish regions also immunized infants younger than age 6 months at the start of the season (extended catch-up). The aim of this study was to assess how RSV prophylaxis affected the number of infants presenting to pediatric emergency departments with acute respiratory infections.
A retrospective study was conducted in 15 Spanish pediatric emergency departments from 9 different regions between the 2018 and 2024 epidemic seasons (November-January). We compared the seasons occurring in 2018-2023 and the 2023-2024 season regarding the number of episodes of lower respiratory tract infection and acute bronchiolitis, acute bronchiolitis-related hospital admissions, and PICU admissions.
A comparison with the average rates for the previous epidemic seasons revealed a 57.7% decrease in episodes of lower respiratory tract infection in 2023-2024 (95% CI, 56.5-58.8; P < .001; range among hospitals, 4.8-82.8), a 59.2% decrease in episodes of acute bronchiolitis (95% CI, 57.9-60.4; P < .001; range, 6.9-84.1), a 63.1% reduction in acute bronchiolitis-related hospital admissions (95% CI, 60.9-65.2; P < .001; range, 31.4-86.8), and a 63.1% reduction in PICU admissions (95% CI, 58.1-67.9; P < .001; range, 18.2-81.8). Hospitals in regions applying extended catch-up showed better results.
Nirsevimab can protect a broad infant population against RSV infection with high effectiveness. Approaches including extended catch-up are the most effective, although cost- effectiveness must be considered.
在 2023-2024 年呼吸道合胞病毒（RSV）流行季，西班牙成为首批实施普遍 RSV 预防措施的国家之一，在此期间，所有此时出生的婴儿均有资格接受奈瑟维单抗治疗。在当地，大多数西班牙地区也在流行季开始时为 6 月龄以下婴儿进行免疫接种（扩展补种）。本研究旨在评估 RSV 预防措施对因急性呼吸道感染而到儿科急诊就诊的婴儿数量的影响。
2018-2024 年流行季（11 月至 1 月）期间，在西班牙 9 个不同地区的 15 家儿科急诊中心进行了一项回顾性研究。我们比较了 2018-2023 年流行季和 2023-2024 年流行季的下呼吸道感染和急性细支气管炎发作次数、与急性细支气管炎相关的住院率和 PICU 住院率。
与前一流行季的平均水平相比，2023-2024 年下呼吸道感染发作次数减少了 57.7%（95%CI，56.5-58.8；P<0.001；医院间范围，4.8-82.8），急性细支气管炎发作次数减少了 59.2%（95%CI，57.9-60.4；P<0.001；范围，6.9-84.1），与急性细支气管炎相关的住院率减少了 63.1%（95%CI，60.9-65.2；P<0.001；范围，31.4-86.8），PICU 住院率减少了 63.1%（95%CI，58.1-67.9；P<0.001；范围，18.2-81.8）。实施扩展补种的地区的医院取得了更好的效果。
奈瑟维单抗可使广泛的婴儿人群免受 RSV 感染，具有高有效性。虽然需要考虑成本效益，但包括扩展补种在内的方法是最有效的。
