Wildenbeest Joanne G, Bont Louis, Cianci Daniela, Azzari Chiara, Brouard Jacques, Calvo Cristina, Cutrera Renato, Drysdale Simon B, Epaud Ralph, Gupta Atul, Herting Egbert, Liese Johannes, Martinon-Torres Federico, Ruggieri Madelyn, Choi Yoonyoung
Department of Paediatric Infectious Diseases and Immunology, Wilhelmina Children's Hospital, University Medical Center Utrecht, Utrecht, the Netherlands.
Julius Center for Health Sciences and Primary Care, Department of Data Science & Biostatistics, University Medical Center Utrecht, Utrecht University, Utrecht, the Netherlands.
Eur J Pediatr. 2025 Sep 13;184(10):615. doi: 10.1007/s00431-025-06218-1.
With the newly approved RSV preventive strategies enabling universal protection of infants, it is crucial to gain a comprehensive understanding of RSV hospitalization incidence, prior to the introduction of these strategies in order to facilitate an assessment of their impact. Children ≤ 2 years hospitalized with laboratory-confirmed RSV infection between 2020-2023 in France, Germany, Spain, Italy, and United Kingdom were included and compared with the 2018-2019 season. The population-based incidence was calculated as number of RSV hospitalizations divided by market share-adjusted number of children in the catchment area. Across participating countries, we observed a decrease in RSV hospitalization incidence during the 2020-2021 season due to the COVID-19 pandemic, dropping to 5.9/1000 child-years (95%CI 5.4-6.3) compared with 11.3/1000 child-years (95%CI 10.6-11.9) in 2018-2019. This decline was followed by a rebound in incidence, with rates reaching 13.8/1000 child-years (95%CI 13.0-14.5) in 2021-2022 and 18.8/1000 child-years (95%CI 18.0-19.7) in 2022-2023. Distinct patterns of RSV resurgence were observed across countries. During the 2020-2021 season, there was an increase in PICU admissions (29.5% vs 20.0% pre-pandemic, p < 0.001), despite a lower total number of RSV admissions (610 vs 1,238) compared to the 2018-2019 season.
The population-based incidence of RSV hospitalization in children ≤ 2 years is substantial. Considerable variation in incidence was observed between 2020 and 2023, with an initial decline during the COVID-19 pandemic followed by a rebound in the subsequent seasons. Our study underscores the importance of RSV surveillance and flexibility in RSV preventive strategies.
• RSV is a major cause of hospitalization in young children under 5 years of age worldwide. • RSV seasonality was disrupted during the COVID-19 pandemic.
• Distinct patterns of RSV resurgence were observed across five European countries during the COVID-19 pandemic, with an initial decline in incidence of RSV associated hospitalizations in children ≤ 2 years, followed by a rebound in the subsequent seasons, reaching 18.8 per 1,000 child-years (95% CI: 18.0 - 19.7) in 2022-2023.
随着新批准的呼吸道合胞病毒（RSV）预防策略能够为婴儿提供全面保护，在引入这些策略之前，全面了解RSV住院发病率至关重要，以便评估其影响。纳入了2020 - 2023年期间在法国、德国、西班牙、意大利和英国因实验室确诊RSV感染而住院的≤2岁儿童，并与2018 - 2019季节进行比较。基于人群的发病率计算为RSV住院病例数除以集水区经市场份额调整后的儿童数量。在参与研究的国家中，我们观察到由于新冠疫情，2020 - 2021季节RSV住院发病率下降，降至5.9/1000儿童年（95%置信区间5.4 - 6.3），而2018 - 2019年为11.3/1000儿童年（95%置信区间10.6 - 11.9）。这种下降之后发病率出现反弹，2021 - 2022年发病率达到13.8/1000儿童年（95%置信区间13.0 - 14.5），2022 - 2023年达到18.8/1000儿童年（95%置信区间18.0 - 19.7）。各国观察到不同的RSV复苏模式。在2020 - 2021季节，尽管与2018 - 2019季节相比RSV入院总数较低（610例对1238例），但儿科重症监护病房（PICU）入院人数有所增加（29.5%对疫情前的20.0%，p < 0.001）。
≤2岁儿童中基于人群的RSV住院发病率很高。2020年至2023年期间观察到发病率有相当大的差异，在新冠疫情期间最初下降，随后几个季节出现反弹。我们的研究强调了RSV监测以及RSV预防策略灵活性的重要性。
• RSV是全球5岁以下幼儿住院的主要原因。• RSV季节性在新冠疫情期间受到干扰。
• 在新冠疫情期间，五个欧洲国家观察到不同的RSV复苏模式，≤2岁儿童中与RSV相关的住院发病率最初下降，随后几个季节出现反弹，2022 - 2023年达到每1000儿童年发病18.8例（95%置信区间：18.0 - 19.7）。
