Comparing Morbidity of Infants Hospitalised With RSV or SARS-COV-2.

BACKGROUND

While the severity and burden of SARS-CoV-2 infection in children are increasingly described, the literature on the clinical impact of SARS-CoV-2 compared to Respiratory Syncytial Virus (RSV) is still evolving. We compare the morbidity of SARS-CoV-2 with RSV among hospitalised children under 2 years.

METHODS

This was a retrospective, cross-sectional, single-centre study. All children under 24 months, admitted to a quaternary children's hospital in Queensland from January 2021 to December 2022 with SARS-CoV-2 or RSV infection, were included. Demographics, oxygen therapy, antibiotic usage and length of stay were compared.

RESULTS

Of 639 children, 175 had SARS-CoV-2 and 465 had RSV. Proportionally more children with SARS-CoV-2 had medical co-morbidity compared to RSV (25.1% vs. 12.1%, p < 0.001), but there was no significant difference in other demographics. Children with RSV had significantly higher rates of oxygen therapy at admission (25.9% vs. 6.5%, p < 0.001), during admission (61% vs. 15.7%, p < 0.001), and a longer duration of stay (3 vs. 2 days, p = 0.002). Antibiotics were prescribed more often in SARS-CoV-2 (40% vs. 30.2%, p = 0.018).

CONCLUSION

RSV infection in children under 2 years of age was associated with a more severe respiratory illness course than SARS-CoV-2. These findings are relevant to policy regarding RSV and SARS-CoV-2 immunisation in young children.