Researchers Find Infants in Intensive Care for RSV Did Not Have Preexisting Conditions

New study findings from JAMA Network Open announced that most infants that were admitted to the intensive care or high acuity unit during fall of 2022 due to infection with respiratory syncytial virus (RSV) were healthy and born at term prior to infection.

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The study results aid preventative interactions to protect infants from being infected with RSV, which is reported to be the main cause of lower respiratory infections (LRTI), according to researchers.

“We hope that our study findings will aid in the design of future RSV prophylactic and maternal RSV vaccine effectiveness and usage studies and recommendations,” Natasha Halasa, lead investigator, MD, MPH, Craig Weaver Professor of Pediatrics in the Division of Pediatric Infectious Diseases at Monroe Carell Jr. Children’s Hospital at Vanderbilt, in a press release.

CDC data show that RSV is responsible for around 57,000 to 80,000 hospitalizations in children younger than 5 years old. Among those children, 1 in 5 that tested positive for RSV were admitted to intensive care units.

The study authors noted that researchers across the United States assessed different characteristics and outcomes of illnesses that were connected to critical RSV-related illness. The research included 600 infants from 39 hospitals in 27 states. The data were part of the RSV Pediatric Intensive Care Registry.

“Most of the infants in our study receiving ICU-level care were young, healthy and born at term,” Halasa said in a press release. “Although mortality was rare, our findings emphasize the significant illness caused by RSV in young infants.”

The analysis was conducted during the 2-month peak of RSV season. The results found that the median age for infants that needed intensive care was 2.6 months. Out of the 600 infants, 169 were born prematurely, 487 did not have underlying medical conditions, and 143 had to receive invasive mechanical ventilation.

However, the researchers noted that children that are born premature, have other underlying medical conditions, and are immunocompromised are at a higher risk of life-threatening events when infected with RSV. Because of this, infants that are high-risk are the only group FDA-approved to receive a monoclonal antibody that aids prevention for RSV and LRTI.

“However, most infants in our study admitted to the ICU with severe RSV did not have an underlying medical condition. Therefore, our data support the need for RSV preventative interventions targeting all infants to reduce the burden of severe RSV illness, including nirsevimab, the long-acting RSV-neutralizing monoclonal antibody. The drug was recently approved by the Food and Drug Administration, and a maternal vaccine for RSV prevention is under consideration,” said Halasa, in a press release.

Despite this, the researchers found that among the study, only 2 out of 17 infants that were eligible to receive a monoclonal antibody, were treated. The study authors noted that there is a need to ensure that the infants that can be treated, are receiving it.

With the approval of nirsevimab for all infants that are younger than 8 months that only requires one immunization, versus multiple shots— the researchers are hopeful this will improve outcomes.

Reference

Study finds most infants receiving ICU-level care for RSV had no underlying medical condition. EurekAlert!. News release. August 15, 2023. Accessed December 12, 2023. https://www.eurekalert.org/news-releases/998363.