RSV is the main cause of severe respiratory infections in infants and young children in Germany - data from the prospective, multicenter PAPI study 2021–2023

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BACKGROUND: Respiratory syncytial virus (RSV) is one of the main causes of morbidity in infants and young children worldwide. Current data on RSV-associated disease burden in Germany before the introduction of new immunization strategies is lacking. METHODS: The PAPI study is a multicenter, prospective surveillance study of lower respiratory tract infections (LRTI) in children aged ≤ 24 months in Germany. RESULTS: Data from 1607 children with LRTI hospitalized in twelve German hospitals between September 2021 and May 2023 were analyzed. Among these children, RSV was the most frequently detected pathogen (57.1%), followed by rhino/entero-, metapneumo- and parainfluenza virus. Children with RSV were significantly younger than those with LRTI of other causes (mean of 5.6 ± SD 6.1 vs. mean of 10.1 ± SD 7.3 months, p < 0.001) and more frequently affected in their first six months of life. RSV positive children were significantly more likely to develop hypoxemia (61.9% vs. 44.3%, p < 0.001) and need for intravenous or enteral fluid supplementation (48.1% vs. 43.1%, p = 0.009; 13.2% vs. 5.9%, p < 0.001) than those without RSV. CONCLUSION: RSV is the dominant pathogen for LRTI-associated hospitalizations in children ≤ 24 months in Germany and associated with a particularly high need for treatment. The ongoing implemented use of RSV immunization according to current recommendations could lead to significant reduction in early childhood morbidity in Germany.

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