2023, Number 1
Comparison of RSV infection in the 2019-2020 and 2020-2021 epidemic seasons in a Tertiary Hospital in the Balearic Islands
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ABSTRACTIntroduction: respiratory syncytial virus (RSV) is one of the leading causes of respiratory infection in children, with significant morbidity and mortality in children under five years of age, being the second leading global cause of death among lower respiratory tract infections. RSV is classified into two subtypes according to antigenic differences and usually circulates concurrently. Traditionally, subtype A was thought to cause a more severe infection, although recent work has shown conflicting results. It is a stationary virus whose epidemic season occurs in Spain between December and March. Objective: the aim of this study is to describe and compare the epidemic seasons 2019-2020 and 2020-2021 in a tertiary hospital. Material and methods: retrospective and descriptive study in children under 14 years with positive test for RSV in 2019-2020 and 2020-2021season in a tertiary hospital in Mallorca, Spain. Results: 389 patients were included, 139 in the 2019-2020 and 250 patients in the 2020-2021. There were no differences in gender, with a higher median age higher in the last season (9.47; IQR 2.4-23.7 months vs 16.2; IQR 8.8-29 months). The main diagnose in 2019-2020 was bronchiolitis and in the 2020-2021 was upper respiratory tract infection (bronchiolitis: 48.9 vs 26%, p < 0.001; upper respiratory tract infection: 19.4 vs 40.4%, p < 0.001). More patients were admitted on ward and Pediatric Intensive Care Unit (PICU) in the first season (no admission: 43.2 vs 78%, p < 0.001; ward: 43.9 vs 17.6%, p < 0.001; PICU: 12.9 vs 4.4%, p = 0.02). There are no important differences between admitted patients (ward and PICU) in both seasons. There was a greater need for oxygen therapy in 2019-2020 than in 2020-2021 (low flow: 46 vs 16%, p < 0.001; high flow: 16.5 vs 6.4%, p < 0.001; NIV: 10.1 vs 2.8%, p = 0.02). In 2020-2021 no cases were observed in the winter months, being the peak of incidence in July and August. Conclusions: despite increased detection of RSV infection, there has been no change in the profile of patients requiring admission. A change in the usual seasonality has been observed in the 2020-2021 season due to probable influence of the SARS-CoV-2 pandemic.
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