Study Links COVID-19 to More Severe RSV Cases

TOPLINE:

Respiratory syncytial virus (RSV) infections resurged earlier after the COVID-19 pandemic than before, with more severe cases requiring increased respiratory support, a study showed.

METHODOLOGY:

• This analysis of the multicentric, prospective PAPI study included hospitalised children younger than 24 months with lower respiratory tract infections from two RSV seasons (2017/2018 to 2022/2023) across three German hospitals.
• Patients were included if they exhibited at least one symptom from each of the two symptom groups: Group A (fever, cough, rhinitis, and pharyngitis) and group B (wheezing, crackles, attenuated breath sounds, tachypnoea, dyspnoea, and hypoxaemia).
• A total of 898 RSV cases were included, with 330 being prospectively analysed and 568 being retrospectively analysed.

TAKEAWAY:

• RSV returned approximately 3.5 months earlier than usual in late 2021, with the overall season duration and patient numbers comparable with those in previous seasons.
• The duration of hospitalisation remained unchanged between the pre- and post-pandemic periods, but significantly higher rates of oxygen supplementation were observed post-pandemic than pre-pandemic (59.4% vs 54.8%; P < .001).
• Non-invasive ventilation rates were significantly higher post-pandemic than pre-pandemic (12.4% vs 7.2%; P < .001).
• No deaths occurred during the entire observational period.

IN PRACTICE:

“Our data aids in understanding the impact of the pandemic on paediatric airway pathogens as it compares RSV seasonality and clinical phenotypes in severely affected infants throughout the phases before, during, and after the emergence of COVID-19,” the authors wrote.

SOURCE:

The study was led by Jessica Bähre, Children’s Hospital Auf Der Bult, Hannover, Germany. It was published online on March 13, 2025, in the European Journal of Pediatrics.

LIMITATIONS:

Data before fall 2020 were retrospective and may have been incomplete. Early atypical RSV cases may have been missed each year because case registration began in late summer. The study exclusively examined hospitalised children younger than 2 years, excluding older children and RSV cases in ambulatory settings, thereby limiting generalisability.

DISCLOSURES:

This study was funded by Sanofi/AstraZeneca. One author reported receiving funding from the German Center for Infection Research, another disclosed receiving support from the Excellence Cluster RESIST, and a third reported receiving consulting and speaker fees from Novartis, GSK, and Abbott.

This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.