Background Early recognition of children at risk of severe respiratory syncytial virus (RSV) lower respiratory tract infection is important as it informs management decisions. We aimed to evaluate factors associated with severe disease among young children hospitalised with RSV infection. Methods We conducted a retrospective cohort study of all children <2 years of age hospitalised for RSV lower respiratory tract infection at a single tertiary paediatric hospital over three RSV seasons (January 2017–December 2019). We classified children as having ‘moderate’ or ‘severe’ disease based on the level of respiratory intervention and used univariable and multivariable regression models to determine factors associated with severe disease. Results Of 970 hospitalised children, 386 (40%) were classified as having ‘severe’ and 584 (60%) as having ‘moderate’ RSV disease. On multivariable analyses, age <2 months (OR: 2.3, 95% CI 1.6 to 3.3, p<0.0001), prematurity (OR: 1.6, 95% CI 1.1 to 2.4, p=0.02) and RSV–parainfluenza virus type 3 (PIV3) codetection (OR: 2.6, 95% CI 1.05 to 6.5, p=0.04) were independently associated with severe disease. Conclusion Younger age, prematurity and PIV3 codetection were associated with severe RSV disease in children <2 years of age hospitalised with RSV infection. The association between PIV3 and severe RSV disease is a novel finding and warrants further investigation. Data are available in a public, open access repository.

中文翻译：

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住院儿童重症呼吸道合胞病毒病相关因素的回顾性分析

背景 早期识别有严重呼吸道合胞病毒 (RSV) 下呼吸道感染风险的儿童很重要，因为它可以为管理决策提供信息。我们旨在评估因 RSV 感染住院的幼儿中与严重疾病相关的因素。方法 我们对在三个 RSV 季节（2017 年 1 月至 2019 年 12 月）在一家三级儿科医院因 RSV 下呼吸道感染住院的所有小于 2 岁的儿童进行了一项回顾性队列研究。我们根据呼吸干预水平将儿童分为“中度”或“重度”疾病，并使用单变量和多变量回归模型来确定与严重疾病相关的因素。结果 970 名住院儿童中，386 人 (40%) 被归类为“重度”，584 人 (60%) 被归类为“中度”RSV 疾病。在多变量分析中，年龄<2 个月（OR：2.3，95% CI 1.6 至 3.3，p<0.0001），早产（OR：1.6，95% CI 1.1 至 2.4，p=0.02）和 RSV-副流感病毒 3 型（ PIV3) 联合检测 (OR: 2.6, 95% CI 1.05 to 6.5, p=0.04) 与严重疾病独立相关。结论 年龄小于 2 岁的 RSV 感染住院儿童年龄较小、早产和 PIV3 联合检测与严重 RSV 疾病相关。PIV3 与严重 RSV 疾病之间的关联是一项新发现，值得进一步研究。数据可在公共、开放访问的存储库中获得。02) 和 RSV-副流感病毒 3 型 (PIV3) 联合检测 (OR: 2.6, 95% CI 1.05 至 6.5, p=0.04) 与严重疾病独立相关。结论 年龄小于 2 岁的 RSV 感染住院儿童年龄较小、早产和 PIV3 联合检测与严重 RSV 疾病相关。PIV3 与严重 RSV 疾病之间的关联是一项新发现，值得进一步研究。数据可在公共、开放访问的存储库中获得。02) 和 RSV-副流感病毒 3 型 (PIV3) 联合检测 (OR: 2.6, 95% CI 1.05 至 6.5, p=0.04) 与严重疾病独立相关。结论 年龄小于 2 岁的 RSV 感染住院儿童年龄较小、早产和 PIV3 联合检测与严重 RSV 疾病相关。PIV3 与严重 RSV 疾病之间的关联是一项新发现，值得进一步研究。数据可在公共、开放访问的存储库中获得。PIV3 与严重 RSV 疾病之间的关联是一项新发现，值得进一步研究。数据可在公共、开放访问的存储库中获得。PIV3 与严重 RSV 疾病之间的关联是一项新发现，值得进一步研究。数据可在公共、开放访问的存储库中获得。