Background Respiratory syncytial virus (RSV) is the leading cause of acute lower respiratory infections (ALRIs) associated hospitalisations in children. It is unclear if hospitalized RSV-ALRI differs in clinically from other viral ALRIs. We aimed to compare the disease impact of hospitalised RSV with other viral ALRI in children under 2 years. Methods We conducted a retrospective study using electronic medical records of children under 2 hospitalized with ALRIs at Sydney Children’s Hospitals Network from 2020-2022. We compared demographics and clinical features between RSV-positive and RSV-negative (positive for other viruses) cases. Poisson quasi-likelihood regression was used to estimate adjusted prevalence ratios (aPRs) for three in-hospital outcomes: length of stay, need for respiratory support and intensive care. Results We examined 330 children under 2 years hospitalized with RSV-positive ALRIs and 330 with RSV-negative ALRIs (positive for other viruses). RSV-positive cases were older (12 vs. 8 months, p<0.001) and more often presented with cough (99% vs. 92%), fever (80% vs. 58%), crackles (89% vs. 76%), hypoxia (50% vs. 36%), and lethargy (36% vs. 20%). They were also more likely to undergo chest x-rays (74% vs. 49%) and receive antibiotics (65% vs. 35%). Adjusted analysis showed RSV-positive children had a higher likelihood of LOS > 2 days (aPR 1.95, 95% CI 1.14-3.36).). However, there were no differences in the need for intensive care or respiratory support. Conclusion Children with RSV-ALRI exhibited more severe symptoms, received more antibiotics, and had longer hospital stays compared to those with other viral ALRIs, underscoring the need for effective prevention and treatment strategies for RSV.

中文翻译：

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与其他病毒性 ALRI 相比，RSV-ALRI 在 2 岁以下住院儿童中的临床特征和院内结局


背景 呼吸道合胞病毒 （RSV） 是儿童急性下呼吸道感染 （ALRI） 相关住院的主要原因。目前尚不清楚住院的 RSV-ALRI 在临床上是否与其他病毒性 ALRI 不同。我们旨在比较住院 RSV 与其他病毒 ALRI 对 2 岁以下儿童的疾病影响。方法 我们使用 2020-2022 年悉尼儿童医院网络 2 岁以下因 ALRI 住院的儿童的电子病历进行了一项回顾性研究。我们比较了 RSV 阳性和 RSV 阴性 （其他病毒阳性） 病例的人口统计学和临床特征。泊松准似然回归用于估计三个住院结局的调整患病率 （aPRs）：住院时间、呼吸支持需求和重症监护。结果：我们检查了 330 例 RSV 阳性 ALRI 住院的 2 岁以下儿童和 330 例 RSV 阴性 ALRI （其他病毒阳性）儿童。RSV 阳性病例年龄较大 （12 个月 vs. 8 个月，p<0.001），更常表现为咳嗽 （99% vs. 92%）、发烧 （80% vs. 58%）、湿啰音 （89% vs. 76%）、缺氧 （50% vs. 36%） 和嗜睡 （36% vs. 20%）。他们也更有可能接受胸部 X 光检查 （74% 对 49%） 和接受抗生素 （65% 对 35%）。调整后的分析显示，RSV 阳性儿童在 2 天内发生 LOS > 的可能性更高 （aPR 1.95,95% CI 1.14-3.36）。然而，在重症监护或呼吸支持的需求方面没有差异。结论 与其他病毒性 ALRI 患儿相比，RSV-ALRI 患儿表现出更严重的症状，接受更多的抗生素治疗，住院时间更长，强调需要有效的 RSV 预防和治疗策略。