Epidemiology and Risk Factors of RSV Infections in Children Under Five Years Old Admitted from December 2023 to December 2024
Genara Santana Chalas, Alicia Emilia Rivas Villalona, Omar Eduardo Despradel, Yaniris RoblesRodríguez, Cristina Liriano, Miguela A CanizaAbstract
Background
Respiratory syncytial virus (RSV) is one of the main causes of lower respiratory tract infections in children, especially those under one year of age. In this age group, RSV can produce bronchiolitis, and often they need hospitalization. Risk factors for RSV hospitalization include prematurity and comorbidities, like heart disease and other congenital anomalies. Healthy young children can also be affected and hospitalized by RSV. In HRIDAG, prior to the introduction of immunochromatography and molecular diagnostic tests, children with suspected RSV were managed empirically and placed in isolation precautions. RSV in the Dominican Republic, as throughout Latin America and the Caribbean, has been more frequently reported especially the last years after the RSV gap during the COVID-19 pandemic years (2020 – 2021).
Methods
A retro-prospective descriptive observational cross-sectional cohort study was carried out in HRIDAG for the period December 2023 to December 2024. 11,170 patients were hospitalized. 278 children with acute respiratory infections were 2.4% of the hospitalizations. The data of these 278 children were extracted from the medical records using a case report form and from the hospital's epidemiology database. We populated an Excel database, and we performed descriptive statistics reporting absolute numbers and percentages. We illustrated the results using tables and graphics.
Results
278 patients were analyzed, 20% were infected and admitted for RSV. The male sex was more affected, the modal age average was 1-month with a range of 1 to 3 months. 61% needed oxygen supplement, 41% treated with antibiotics, hospital stay was 4 to 6 days. 7 premature babies, of which 3 were medicated with Palivizumab at birth, these had a longer stay, 25% were breastfed, 67% were exposed to tobacco, 61% received all the required vaccines for their age, in 42% the radiographic pattern found most frequently was multifocal consolidation and interstitial infiltrate.
Conclusion
RSV infected children can require admission for lower respiratory tract infection. In our study the most affected were male children especially the youngest. Utilization of respiratory support, access to critical care units, and administration of expensive monoclonal antibody were important expenses in our low resource hospital. Our data may justify adopting vaccination during pregnancy against RSV, also to access monoclonal antibody such as Nirsevimab, and administer to babies under 8 months of age before RSV season. These interventions will decrease reduce morbidity and their poor outcomes among young children and those with comorbidities.