Taku Keisuke, Ichikawa Shun, Ogawa Masato, Kokubo Takayuki, Manabe Toshihiko, Takano Kenichi, Murakawa Saori, Takahashi Hikaru, Hirakawa Jun, Sakemi Yoshihiro, Yoshino Miwa, Nakamura Ryoko, Yamamoto Jyunko, Hoshina Takayuki
Department of Pediatrics, School of Medicine, University of Occupational and Environmental Health, Kitakyushu, Japan.
Department of Pediatrics, School of Medicine, University of Occupational and Environmental Health, Kitakyushu, Japan; Department of Pediatrics, Kitakyushu General Hospital, Kitakyushu, Japan.
J Infect Chemother. 2025 Mar;31(3):102585. doi: 10.1016/j.jiac.2024.12.014. Epub 2024 Dec 10.
The coronavirus disease (COVID-19) pandemic has affected the epidemiology of respiratory syncytial virus (RSV) infection. This study assessed whether or not palivizumab prophylaxis was appropriate during the COVID-19 pandemic.
This prospective study included children <24 months old who were hospitalized for RSV infection between April 2019 and March 2023. We compared the clinical characteristics of inpatients with RSV infection, with and without palivizumab prophylaxis.
During the investigation period, 2133 children <24 months old were hospitalized for RSV infection. The hospitalization rate of RSV infection in children receiving palivizumab prophylaxis (0.7 %) was significantly lower than that in children without the prophylaxis (3.1 %, P < 0.001), indicating that the timing of prophylaxis was roughly appropriate in preventing hospitalization for RSV infection. In contrast, palivizumab prophylaxis was performed during the non-endemic period of RSV infection due to changes in RSV infection endemics due to the impact of the COVID-19 pandemic.
Palivizumab is useful in preventing hospitalization for RSV infection in children with a high risk of developing severe respiratory tract infections. However, since the RSV infection endemics varies not only during the occurrence of an emerging infectious disease, such as COVID-19, but also from year to year, a system that can quickly recognized the endemics is needed to avoid the inappropriate use of palivizumab. Furthermore, it is also necessary to actively promote maternal RSV vaccination to prevent severe RSV infection in all infants and young children.
冠状病毒病（COVID-19）大流行影响了呼吸道合胞病毒（RSV）感染的流行病学。本研究评估了在COVID-19大流行期间使用帕利珠单抗预防是否合适。
这项前瞻性研究纳入了2019年4月至2023年3月期间因RSV感染住院的24个月以下儿童。我们比较了接受帕利珠单抗预防和未接受预防的RSV感染住院患者的临床特征。
在调查期间，2133名24个月以下儿童因RSV感染住院。接受帕利珠单抗预防的儿童中RSV感染的住院率（0.7%）显著低于未接受预防的儿童（3.1%，P<0.001），这表明预防时机在预防RSV感染住院方面大致合适。相比之下，由于COVID-19大流行的影响，RSV感染流行情况发生变化，帕利珠单抗预防是在RSV感染的非流行期进行的。
帕利珠单抗可有效预防发生严重呼吸道感染风险较高的儿童因RSV感染而住院。然而，由于RSV感染流行情况不仅在出现如COVID-19这样的新发传染病期间会有所不同，而且每年也有所变化，因此需要一个能够快速识别流行情况的系统，以避免帕利珠单抗的不当使用。此外，还需要积极推广孕妇RSV疫苗接种，以预防所有婴幼儿发生严重RSV感染。
