Clinical presentation and hospitalisation risk of RSV in primary care among children younger than 5 years in Italy in four seasons between 2019 and 2023: a multicentre prospective cohort study
Rattachement africain : it. Niveau de preuve : code pays fourni par la source.
Le résumé fourni par la source
Background: Respiratory syncytial virus (RSV) significantly contributes to pediatric morbidity globally. Severe cases are more common in infants and children with underlying health conditions, but even mild infections can result in long-term respiratory issues. While the RSV disease is well-documented in hospital settings, its clinical presentation and hospitalization risk in primary care, the initial point of healthcare access, remains unclear. Methods: We conducted a multi-center prospective cohort study across multiple regions in Italy during four seasons (from 2019 to 2020 to 2023-2024), excluding 2020-2021. Children ≤5 years with acute respiratory infection (ARI), meeting the WHO case definition for community-based surveillance, were enrolled through primary care pediatricians. Nasopharyngeal swabs were collected and tested with RT-PCR. Clinical data were collected at baseline for all participants and at follow-up intervals of 14 and 30 days post-enrollment for RSV-positive children. Findings: Among 1410 enrolled children with ARIs, RSV was laboratory-confirmed in 40.2% (n = 566). The mean duration of illness among RSV-positive children was 15.2 days (SD 8.8 days), with symptoms persisting in 40.9% of cases at day 14 and 15.4% at day 30. Hospitalization occurred in 4.4% (25/566) of RSV-positive cases, with a median hospital stay of 5 days (IQR: 4-7 days). Younger age was identified as the primary predictor of hospitalization (observed hospitalization rate of 16.2% in children under 6 months), with an estimated hospitalization risk of 12.5% at birth (95% CI: 3.4-33.1%). Fever did not differentiate RSV infection from other respiratory pathogens (p = 0.084). Interpretation: Our study highlights the significant hospitalization risks associated with RSV infections among children presenting in primary care settings, offering detailed age-specific risk estimates crucial for accurate health technology assessments (HTAs) of preventive strategies. The findings strongly support exploring the expansion of RSV preventive interventions beyond the conventional age threshold of 24 months, considering the persisting risk in older children. Furthermore, we emphasize the importance of adopting a case definition without a mandatory fever criterion to enhance the sensitivity of RSV surveillance and thus improve the validity of disease-related estimates. Funding: RSV ComNet is a collaborative study funded by Sanofi and AstraZeneca. Study design and planning were undertaken in collaboration with Sanofi researchers. All data collection, analyses, interpretation, manuscript drafting, and the decision to submit for publication were performed independently by the authors. No datasets were shared with the funding parties.
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Le contrôle bibliographique ouvert
DOI retrouvé dans Crossref DOI retrouvé ; titre concordant.
- Titre Crossref
- Clinical presentation and hospitalisation risk of RSV in primary care among children younger than 5 years in Italy in four seasons between 2019 and 2023: a multicentre prospective cohort study
- Date Crossref
- 01/06/2026
- Éditeur
- Elsevier BV
- Type
- journal-article
Ce recoupement confirme des métadonnées liées au DOI. Il ne confirme ni la méthode ni les conclusions de l’étude, et il ne compte pas comme une seconde source scientifique indépendante.
Où se fait cette recherche
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University of Pisa Department of Translational Research and New Technologies in Medicine and Surgery pays non établi dans la noticeUniversité ou école supérieure
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University of Genoa Department of Health Sciences pays non établi dans la noticeUniversité ou école supérieure
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University of Bari Aldo Moro pays non établi dans la noticeUniversité ou école supérieure
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Azienda Universitaria Ospedaliera Consorziale - Policlinico Bari pays non établi dans la noticeÉtablissement de santé
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University of Milan Department of biomedical Sciences for Health pays non établi dans la noticeUniversité ou école supérieure
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Bambino Gesù Children's Hospital pays non établi dans la noticeÉtablissement de santé
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Istituti di Ricovero e Cura a Carattere Scientifico pays non établi dans la noticeÉtablissement de santé
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University of Bari "A. Moro" Department of Interdisciplinary Medicine pays non établi dans la noticeUniversité ou école supérieure
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Azienda Ospedaliero-Universitaria Consorziale Policlinico of Bari Hygiene Unit pays non établi dans la noticeÉtablissement de santé
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Predictive and Preventive Medicine Research Unit pays non établi dans la noticeStructure de recherche
Department of Translational Research and New Technologies in Medicine and Surgery — University of Pisa, Department of Health Sciences — University of Genoa et University of Bari Aldo Moro, avec 7 autres affiliations.
Une affiliation ne permet pas de déduire la nationalité d’un auteur.