Chauvel Cécile, Horvat Côme, Javouhey Etienne, Gillet Yves, Hassenboehler Juliette, Chakra Claire Nour Abou, Ragouilliaux Corinne, Plaisant Franck, Ploin Dominique, Butin Marine, Casalegno Jean-Sebastien, Nunes Marta C
Center of Excellence in Respiratory Pathogens (CERP), Hospices Civils de Lyon (HCL), Lyon, France.
Centre International de Recherche en Infectiologie (CIRI), Équipe Santé Publique, Épidémiologie et Écologie Évolutive des Maladies Infectieuses (PHE3ID), Inserm U1111, CNRS UMR5308, ENS de Lyon, Université Claude Bernard Lyon 1, Lyon, France.
Influenza Other Respir Viruses. 2024 Dec;18(12):e70054. doi: 10.1111/irv.70054.
Respiratory Syncytial Virus (RSV) is a major health concern, particularly for infants. In France, Nirsevimab, a long-acting monoclonal antibody to prevent RSV-associated lower respiratory tract infections (LRTI) was available from September 2023. We described RSV-associated LRTI hospitalisations during the 2023-2024 season among infants younger than six months born at the Hospices Civils de Lyon (HCL), and evaluated the effectiveness of Nirsevimab against RSV-LRTI hospitalisation.
This observational study included infants born and hospitalised at the HCL during the 2023-2024 season, along with pre-COVID-19 and 2022-2023 seasons. Information on Nirsevimab immunisation status, clinical and perinatal variables were collected through routine care. Infants' characteristics and incidence rate of hospitalisation per 100 births during 2023-2024 were compared with the historical periods overall and by delay between birth and the onset of the RSV season. Nirsevimab effectiveness was computed by the screening method.
During the 2023-2024 season, 83 infants younger than six months were hospitalised with an RSV-associated LRTI. Compared with the historical periods (640 pre-COVID-19 and 123 in 2022-2023), these infants were older. Incidence rate for infants born during the period when immunisation was available were lower than the previous seasons; incidence rate ratios were 0.45 (95% confidence interval [CI]: 0.33; 0.62) in 2023-2024 compared with pre-COVID-19 period and 0.53 (95%CI: 0.36; 0.77) compared with 2022-2023 season. Nirsevimab effectiveness was 78.3% (95%CI: 55.9; 89.5) with a coverage of 79.3% in the two main HCL maternities.
High Nirsevimab coverage and effectiveness were estimated in a real-world setting. A change in the age distribution of RSV-associated LRTI hospitalisations in 2023-2024 was noted compared with historical seasons.
呼吸道合胞病毒（RSV）是一个主要的健康问题，对婴儿尤其如此。在法国，2023年9月起可使用nirsevimab，这是一种预防RSV相关下呼吸道感染（LRTI）的长效单克隆抗体。我们描述了里昂公民医院（HCL）出生的6个月以下婴儿在2023 - 2024季节期间RSV相关LRTI住院情况，并评估了nirsevimab预防RSV - LRTI住院的有效性。
这项观察性研究纳入了2023 - 2024季节在HCL出生并住院的婴儿，以及新冠疫情前和2022 - 2023季节的婴儿。通过常规护理收集nirsevimab免疫状态、临床和围产期变量的信息。将2023 - 2024期间每100例出生婴儿的住院特征和发病率与历史时期总体情况以及出生与RSV季节开始之间的时间间隔进行比较。通过筛查方法计算nirsevimab的有效性。
在2023 - 2024季节，83名6个月以下婴儿因RSV相关LRTI住院。与历史时期（新冠疫情前640例和2022 - 2023年123例）相比，这些婴儿年龄更大。在可进行免疫接种期间出生的婴儿发病率低于前几个季节；2023 - 2024年与新冠疫情前时期相比发病率比值为0.45（95%置信区间[CI]：0.33；0.62），与2022 - 2023季节相比为0.53（95%CI：0.36；0.77）。在HCL的两个主要产科中，nirsevimab的有效性为78.3%（95%CI：55.9；89.5），覆盖率为79.3%。
在实际环境中估计nirsevimab具有高覆盖率和有效性。与历史季节相比，2023 - 2024年RSV相关LRTI住院的年龄分布有所变化。
