Changes in Characteristics of Severe Respiratory Syncytial Virus Infections Before and After the COVID-19 Pandemic.

BACKGROUND

Since the onset of the coronavirus disease (COVID-19) pandemic, changes in the severity of respiratory syncytial virus (RSV) infection have been reported in Japan. However, few studies have compared the severity of RSV infection before and after the COVID-19 pandemic. This study aimed to compare the severity of RSV infection before and after the COVID-19 pandemic in two pediatric hospitals in Hanshin in Hyogo Prefecture, Japan.

METHODS

This retrospective study included patients aged ≤ 15 years hospitalized with RSV infection in Hyogo Prefectural Amagasaki General Medical Center and Hyogo Prefectural Kobe Children's Hospital between January 1, 2019, and July 31, 2023. Patient characteristics during the pre-pandemic (January to December 2019), pandemic (January 2020 to December 2022), and post-pandemic (January to July 2023) periods were compared.

RESULTS

The pediatric intensive care unit (PICU) admission rate was significantly higher during the post-pandemic period (26.1%) than during the pre-pandemic period (13.6%) (p < 0.001). The proportion of patients who received any form of respiratory support (tracheal intubation, noninvasive positive-pressure ventilation, or high-flow nasal cannula) was significantly higher during the post-pandemic period (26.9%) than during the pre-pandemic period (16.1%) (unadjusted odds ratio: 1.92, 95% confidence interval: 1.23-3.04; p = 0.005).

CONCLUSIONS

In children hospitalized with RSV infection, the PICU admission rate and respiratory support requirements were significantly higher during the post-pandemic period than during the pre-pandemic and pandemic periods. Ongoing monitoring of clinical severity is needed to ensure effective prevention of RSV infection and optimal medical resource allocation.