Daily Dose: Characteristics of RSV-Related Critical Illness in Infants during 2022 Peak

Patient Care brings primary care clinicians a lot of medical news every day—it’s easy to miss an important study. The Daily Dose provides a concise summary of one of the website's leading stories you may not have seen.

Last week, we reported on a study published in JAMA Network Open that evaluated the characteristics and outcomes of respiratory syncytial virus (RSV)-related critical illness in US infants during peak 2022 RSV transmission.

The study

Researchers used a public health prospective surveillance registry in 39 pediatric hospitals across 27 states to identify infants who were admitted for ≥24 hours between October 17, 2022, and December 16, 2022, to a unit providing intensive care due to laboratory-confirmed RSV infection.

A total of 600 infants (median age 2.6 months; 60.2% male) were enrolled in the study, of which 81.2% had no underlying medical conditions and 28.9% were born prematurely.

The findings

The primary reasons for admission were LRTI (99%) but infants who were intubated more frequently had apnea or bradycardia (12.8%). Two infants died during hospitalization, but for the remainder of the population, the median hospitalization duration was 5 days.

Investigators observed that 23.8% of infants underwent invasive mechanical ventilation for a median of 6 days, 70.6% of whom were aged <3 months. Among infants who did not require intubation, researchers found that 40.5% received high-flow nasal cannula followed by bilevel positive airway pressure for 25% of infants and continuous positive airway pressure for 8.7%. Four infants (0.7%) required extracorporeal membrane oxygenation.

Authors' commentary

"These findings support the use of new preventative interventions, including long-lasting monoclonal antibodies in all infants and maternal vaccination."

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