TY - JOUR
T1 - Respiratory Syncytial Virus Burden in Premature Infants
T2 - The Role of Season With and Without RSV Immunoprophylaxis in a Multicenter Study
AU - Domany, Keren Armoni
AU - Mandelberg, Avigdor
AU - Burrack, Nitzan
AU - Golan-Tripto, Inbal
AU - Masarweh, Kamal
AU - Gur, Michal
AU - Rochman, Mika
AU - Be'er, Moria
AU - Prais, Dario
AU - Mor, Merav
AU - Opek, Moran Weinberger
AU - Nasrallah, Elias
AU - Megged, Orli
AU - Shatzman Steuerman, Rachel
AU - Stein, Michal
AU - Steinberg, Zohar
AU - Shehadeh, Shereen
AU - Glatman-Freedman, Aharona
AU - Tasher, Diana
N1 - Publisher Copyright:
© 2025 The Author(s). Pediatric Pulmonology published by Wiley Periodicals LLC.
PY - 2025/3
Y1 - 2025/3
N2 - Objective: To compare the Respiratory Syncytial Virus (RSV) hospitalization burden among 29–34 weeks gestational age (wGA) preterm infants between seasons with and without routine palivizumab prophylaxis, by utilizing the 2021 off-season RSV surge. Methods: This multi-center retrospective study was conducted in 11 medical centers across Israel. We included infants > 1 year-old, with wGA data, hospitalized with RSV infection from November 2017-August 2021. National palivizumab compliance data were collected separately. We compared two periods: in-season (November−March) with routine palivizumab prophylaxis as the reference, and off-season (April−October) without prophylaxis as the primary risk factor. The primary outcome was the proportion of RSV hospitalizations in 29–34 wGA infants relative to total RSV admissions, calculated separately for each period. Secondary outcomes included clinical severity parameters. Results: A total of 3296 infants were admitted during the RSV in-season, and 1044 during the off-season. National palivizumab compliance among eligible infants during the in-season study years was 91%−95%. The proportion of 29−34 wGA infants was significantly higher during the off-season compared to the in-season period (7% vs. 2.1%, p < 0.001). In a multivariable logistic regression model, the odds of hospitalization for 29–34 wGA preemies were 2.6 times higher during the off-season compared to the in-season (95% CI: 1.8–3.9, p < 0.001), independent of demographic covariates. Clinical severity was similar between the two periods. Conclusions: Our results revealed a significantly higher proportion of 29−34 wGA infants hospitalized during seasons without palivizumab prophylaxis compared to seasons with palivizumab prophylaxis. These findings highlight the importance of including 29−34 wGA infants into future RSV immunoprophylaxis recommendations.
AB - Objective: To compare the Respiratory Syncytial Virus (RSV) hospitalization burden among 29–34 weeks gestational age (wGA) preterm infants between seasons with and without routine palivizumab prophylaxis, by utilizing the 2021 off-season RSV surge. Methods: This multi-center retrospective study was conducted in 11 medical centers across Israel. We included infants > 1 year-old, with wGA data, hospitalized with RSV infection from November 2017-August 2021. National palivizumab compliance data were collected separately. We compared two periods: in-season (November−March) with routine palivizumab prophylaxis as the reference, and off-season (April−October) without prophylaxis as the primary risk factor. The primary outcome was the proportion of RSV hospitalizations in 29–34 wGA infants relative to total RSV admissions, calculated separately for each period. Secondary outcomes included clinical severity parameters. Results: A total of 3296 infants were admitted during the RSV in-season, and 1044 during the off-season. National palivizumab compliance among eligible infants during the in-season study years was 91%−95%. The proportion of 29−34 wGA infants was significantly higher during the off-season compared to the in-season period (7% vs. 2.1%, p < 0.001). In a multivariable logistic regression model, the odds of hospitalization for 29–34 wGA preemies were 2.6 times higher during the off-season compared to the in-season (95% CI: 1.8–3.9, p < 0.001), independent of demographic covariates. Clinical severity was similar between the two periods. Conclusions: Our results revealed a significantly higher proportion of 29−34 wGA infants hospitalized during seasons without palivizumab prophylaxis compared to seasons with palivizumab prophylaxis. These findings highlight the importance of including 29−34 wGA infants into future RSV immunoprophylaxis recommendations.
KW - COVID-19
KW - bronchiolitis
KW - immunoprophylaxis
KW - respiratory syncytial virus
UR - http://www.scopus.com/inward/record.url?scp=86000055618&partnerID=8YFLogxK
U2 - 10.1002/ppul.71022
DO - 10.1002/ppul.71022
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C2 - 40042149
AN - SCOPUS:86000055618
SN - 8755-6863
VL - 60
JO - Pediatric Pulmonology
JF - Pediatric Pulmonology
IS - 3
M1 - e71022
ER -