Characteristics of Hospital-Acquired Respiratory Syncytial Virus (RSV) Infection in Young Children Prior to the COVID-19 Outbreak

Abstract

Background: Respiratory syncytial virus (RSV) causes healthcare-associated respiratory infections in pediatric patients. Previous studies in developed countries have identified risk factors associated with hospital-acquired RSV (HA-RSV) infection. Those risk factors have a higher mortality rate than the risk factors of community-acquired RSV (CA-RSV) infection. Objective: To investigate risk factors, clinical characteristics, and outcomes of RSV infection in young children within hospitals. Materials and Methods: Data from Siriraj Hospital’s surveillance system between 2014 and 2018 was used to include children under five with laboratory-confirmed HA-RSV infection. Two control groups were formed, the CA-RSV infection and non-RSV hospital-acquired infections (non-RSV HAI), which were time-matched with the study group as a 1:2 ratio. Results: Fifty-one HA-RSV cases were identified, with the highest infection rate during the rainy season, which was July to December. HA-RSV patients had higher rates of underlying neuromuscular disease and malignancy. Fever was common in HA-RSV, while upper respiratory and gastrointestinal symptoms were less frequent than CA-RSV. Antibiotic and oseltamivir treatment did not differ significantly. HA-RSV patients had longer stays in the intensive care unit and hospital, but transfer rates and mortality did not differ significantly among the groups. Conclusion: HA-RSV coincides with community outbreaks, being more severe and affecting vulnerable patients. Targeted surveillance during high RSV seasons is crucial for prevention in hospitals.