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Purpose <p>The second year of life is gaining increased attention in the era of long-acting RSV immunoprophylaxis. This multicenter study, across pre- and post-COVID seasons, aimed to assess the association between specific key risk-factors and severe RSV-related disease among hospitalized children aged 12–23 months.</p> Methods <p>This retrospective study included children aged 12–23 months hospitalized with RSV across 11 medical-centers (2017–2021). We compared outcomes of prolonged hospitalization (&gt; 3 days) and PICU (Pediatric Intensive Care Unit) admission for children with risk factors (prematurity &lt; 37 weeks, major congenital heart disease (CHD), chronic lung disease of prematurity (CLD) or Down syndrome (DS)) and those without the respective risk factor, adjusting for demographic variables and COVID-19 pandemic admission. Clinical outcomes were also compared between children with ≥ 1 risk factors and those with none.</p> Results <p>Among 1023 children, 228 (22%) had ≥ 1 risk factor: prematurity (n = 183), CLD (n = 28), CHD (n = 45) or DS (n = 20). In multivariable analysis, prematurity with CLD (aOR 4.7,95%CI:1.97–11.22) or without CLD (aOR 2.26, 95%CI:1.54–3.3), CHD (aOR-3.29, 95%CI:1.6–6.77), DS (aOR-4.14, 95%CI:1.26–13.6) and having ≥ 1 risk (aOR-3.55, 95%CI:2.55–4.96) were independently associated with prolonged hospitalization. DS (aOR 6.7, 95%CI:2.1–22.4), CHD (aOR 3.0,95%CI:1.04–8.66) and having ≥ 1 risk factor (aOR-3.58, 95%CI:1.89–6.80) were also associated with PICU admission.</p> Conclusion <p>Children aged 12–23 months with prematurity, CLD, major CHD or DS had significantly higher rates of prolonged RSV hospitalization. Those with ≥ 1 risk factor, and presumably patients with DS and CHD are at highest risk for severe complications. Preventive strategies for these high-risk populations should be considered in their second-year of life.</p> <p><Table Float="No" ID="Taba"> <tgroup cols="1"> <colspec align="left" colname="c1" colnum="1" /> <tbody> <row> <entry align="left" colname="c1"> <p><b>What is Known:</b></p> <p>• <i>Children with prematurity, congenital heart disease (CHD), chronic lung disease of prematurity (CLD) or Down syndrome (DS) are at increased risk for severe RSV-related illness in the first year of life.</i></p> <p>• <i>The second year of life is now relevant for long-acting RSV prevention strategies.</i></p> </entry> </row> <row> <entry align="left" colname="c1"> <p><b>What is New:</b></p> <p>• <i>This multicenter study shows that prematurity, CLD, CHD, and DS remain strong predictors of prolonged RSV hospitalization in children aged 12–23 months.</i></p> <p>• <i>Those with ≥ 1 risk factor, and presumably those with DS and major CHD, faced the highest risk, with increased likelihood of PICU admission.</i></p> </entry> </row> </tbody> </tgroup> </Table></p>

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Risk factors associated with severe RSV disease among hospitalized children in the second year of life: a multicenter study

  • 期刊论文

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  • 发表日期：

    2025年11月27日

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  • Keren Armoni Domany,
  • Inbal Golan-Tripto,
  • Nitzan Burrack,
  • Kamal Masarweh,
  • Michal Gur,
  • Mika Rochman,
  • Moria Be’er,
  • Dario Prais,
  • Meirav Mor,
  • Moran Weinberger Opek,
  • Elias Nasrallah,
  • Orli Megged,
  • Rachel Shatzman Steuerman,
  • Michal Stein,
  • Zohar Steinberg,
  • Shereen Shehadeh,
  • Aharona Glatman-Freedman,
  • Diana Tasher

摘要

Purpose

The second year of life is gaining increased attention in the era of long-acting RSV immunoprophylaxis. This multicenter study, across pre- and post-COVID seasons, aimed to assess the association between specific key risk-factors and severe RSV-related disease among hospitalized children aged 12–23 months.

Methods

This retrospective study included children aged 12–23 months hospitalized with RSV across 11 medical-centers (2017–2021). We compared outcomes of prolonged hospitalization (> 3 days) and PICU (Pediatric Intensive Care Unit) admission for children with risk factors (prematurity < 37 weeks, major congenital heart disease (CHD), chronic lung disease of prematurity (CLD) or Down syndrome (DS)) and those without the respective risk factor, adjusting for demographic variables and COVID-19 pandemic admission. Clinical outcomes were also compared between children with ≥ 1 risk factors and those with none.

Results

Among 1023 children, 228 (22%) had ≥ 1 risk factor: prematurity (n = 183), CLD (n = 28), CHD (n = 45) or DS (n = 20). In multivariable analysis, prematurity with CLD (aOR 4.7,95%CI:1.97–11.22) or without CLD (aOR 2.26, 95%CI:1.54–3.3), CHD (aOR-3.29, 95%CI:1.6–6.77), DS (aOR-4.14, 95%CI:1.26–13.6) and having ≥ 1 risk (aOR-3.55, 95%CI:2.55–4.96) were independently associated with prolonged hospitalization. DS (aOR 6.7, 95%CI:2.1–22.4), CHD (aOR 3.0,95%CI:1.04–8.66) and having ≥ 1 risk factor (aOR-3.58, 95%CI:1.89–6.80) were also associated with PICU admission.

Conclusion

Children aged 12–23 months with prematurity, CLD, major CHD or DS had significantly higher rates of prolonged RSV hospitalization. Those with ≥ 1 risk factor, and presumably patients with DS and CHD are at highest risk for severe complications. Preventive strategies for these high-risk populations should be considered in their second-year of life.

What is Known:

• Children with prematurity, congenital heart disease (CHD), chronic lung disease of prematurity (CLD) or Down syndrome (DS) are at increased risk for severe RSV-related illness in the first year of life.

• The second year of life is now relevant for long-acting RSV prevention strategies.

What is New:

• This multicenter study shows that prematurity, CLD, CHD, and DS remain strong predictors of prolonged RSV hospitalization in children aged 12–23 months.

• Those with ≥ 1 risk factor, and presumably those with DS and major CHD, faced the highest risk, with increased likelihood of PICU admission.