Hospitalizations for respiratory syncytial virus (RSV) in Sicily from 2008 to 2021: clinical features and predictors of severity

Abstract Background Respiratory syncytial virus (RSV) is the leading cause of bronchiolitis, resulting in 3.6 million hospitalizations for acute lower respiratory tract infections and 101,400 deaths in children under 5 years of age worldwide each year. In Europe, the estimated incidence of RSV-relat...

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Main Authors: Anna Condemi, Domenico Marrali, Chiara Albano, Giulia Linares, Valeria Garbo, Giovanni Boncori, Laura Venuti, Antonio Cascio, Claudia Colomba
Format: Article
Language:English
Published: BMC 2025-07-01
Series:Italian Journal of Pediatrics
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Online Access:https://doi.org/10.1186/s13052-025-01998-6
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author Anna Condemi
Domenico Marrali
Chiara Albano
Giulia Linares
Valeria Garbo
Giovanni Boncori
Laura Venuti
Antonio Cascio
Claudia Colomba
author_facet Anna Condemi
Domenico Marrali
Chiara Albano
Giulia Linares
Valeria Garbo
Giovanni Boncori
Laura Venuti
Antonio Cascio
Claudia Colomba
author_sort Anna Condemi
collection DOAJ
description Abstract Background Respiratory syncytial virus (RSV) is the leading cause of bronchiolitis, resulting in 3.6 million hospitalizations for acute lower respiratory tract infections and 101,400 deaths in children under 5 years of age worldwide each year. In Europe, the estimated incidence of RSV-related hospitalizations in infants is 1.8%. We describe the incidence of RSV infection in patients hospitalized in Sicily (Italy) between 2008 and 2021, examine the clinical-epidemiological characteristics of RSV-positive patients, and assess comorbidities associated with illness severity. Methods All data were retrospectively collected from standard hospital discharge records (HDRs). Significant factors from the univariate analysis were included in a multivariate logistic regression using the stepwise forward selection method to calculate adjusted odds ratios (aORs) and identify independent risk factors for ICU admission. Results Collectively, within the study time frame, 4,485 hospital admissions were RSV-related, 271 patients (6%) were admitted to the ICU, and eight deceased (0.2%). The majority of hospitalized patients (86%) were infants (up to 1 year old), 16.5% were newborns (<28 days), and 10.1% were in the 1–4-year-old group. Several predictors of ICU admission, including neonatal sepsis, neonatal respiratory distress, and younger age (in months), were identified through multivariate logistic regression analysis. Conclusions RSV-associated pathologies are important causes of hospitalization in Sicily, and young age (particularly 0–3 months) and comorbidities, including nutritional and metabolic disorders (with a stronger effect in the pediatric subgroup) and congenital heart diseases, are important outcome predictors. However, considering that RSV-related diseases continue to require hospitalizations in healthy children and adults, it is important to continue monitoring RSV-related hospitalizations through updated epidemiological studies, which can guide the implementation of existing preventive strategies and inform the cost‒benefit analysis of new ones.
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spelling doaj-art-bb9864c1c2074966a6f15b54d19de65c2025-08-20T03:45:36ZengBMCItalian Journal of Pediatrics1824-72882025-07-0151111410.1186/s13052-025-01998-6Hospitalizations for respiratory syncytial virus (RSV) in Sicily from 2008 to 2021: clinical features and predictors of severityAnna Condemi0Domenico Marrali1Chiara Albano2Giulia Linares3Valeria Garbo4Giovanni Boncori5Laura Venuti6Antonio Cascio7Claudia Colomba8Department of Health Promotion, Maternal and Infant Care, Internal Medicine and Medical Specialties, University of PalermoDepartment of Health Promotion, Maternal and Infant Care, Internal Medicine and Medical Specialties, University of PalermoDepartment of Health Promotion, Maternal and Infant Care, Internal Medicine and Medical Specialties, University of PalermoDepartment of Health Promotion, Maternal and Infant Care, Internal Medicine and Medical Specialties, University of PalermoDepartment of Health Promotion, Maternal and Infant Care, Internal Medicine and Medical Specialties, University of PalermoDepartment of Health Promotion, Maternal and Infant Care, Internal Medicine and Medical Specialties, University of PalermoDepartment of Health Promotion, Maternal and Infant Care, Internal Medicine and Medical Specialties, University of PalermoDepartment of Health Promotion, Maternal and Infant Care, Internal Medicine and Medical Specialties, University of PalermoDepartment of Health Promotion, Maternal and Infant Care, Internal Medicine and Medical Specialties, University of PalermoAbstract Background Respiratory syncytial virus (RSV) is the leading cause of bronchiolitis, resulting in 3.6 million hospitalizations for acute lower respiratory tract infections and 101,400 deaths in children under 5 years of age worldwide each year. In Europe, the estimated incidence of RSV-related hospitalizations in infants is 1.8%. We describe the incidence of RSV infection in patients hospitalized in Sicily (Italy) between 2008 and 2021, examine the clinical-epidemiological characteristics of RSV-positive patients, and assess comorbidities associated with illness severity. Methods All data were retrospectively collected from standard hospital discharge records (HDRs). Significant factors from the univariate analysis were included in a multivariate logistic regression using the stepwise forward selection method to calculate adjusted odds ratios (aORs) and identify independent risk factors for ICU admission. Results Collectively, within the study time frame, 4,485 hospital admissions were RSV-related, 271 patients (6%) were admitted to the ICU, and eight deceased (0.2%). The majority of hospitalized patients (86%) were infants (up to 1 year old), 16.5% were newborns (<28 days), and 10.1% were in the 1–4-year-old group. Several predictors of ICU admission, including neonatal sepsis, neonatal respiratory distress, and younger age (in months), were identified through multivariate logistic regression analysis. Conclusions RSV-associated pathologies are important causes of hospitalization in Sicily, and young age (particularly 0–3 months) and comorbidities, including nutritional and metabolic disorders (with a stronger effect in the pediatric subgroup) and congenital heart diseases, are important outcome predictors. However, considering that RSV-related diseases continue to require hospitalizations in healthy children and adults, it is important to continue monitoring RSV-related hospitalizations through updated epidemiological studies, which can guide the implementation of existing preventive strategies and inform the cost‒benefit analysis of new ones.https://doi.org/10.1186/s13052-025-01998-6RSVRespiratory syncytial virusBronchiolitisRSV epidemiologyChildrenNewborns
spellingShingle Anna Condemi
Domenico Marrali
Chiara Albano
Giulia Linares
Valeria Garbo
Giovanni Boncori
Laura Venuti
Antonio Cascio
Claudia Colomba
Hospitalizations for respiratory syncytial virus (RSV) in Sicily from 2008 to 2021: clinical features and predictors of severity
Italian Journal of Pediatrics
RSV
Respiratory syncytial virus
Bronchiolitis
RSV epidemiology
Children
Newborns
title Hospitalizations for respiratory syncytial virus (RSV) in Sicily from 2008 to 2021: clinical features and predictors of severity
title_full Hospitalizations for respiratory syncytial virus (RSV) in Sicily from 2008 to 2021: clinical features and predictors of severity
title_fullStr Hospitalizations for respiratory syncytial virus (RSV) in Sicily from 2008 to 2021: clinical features and predictors of severity
title_full_unstemmed Hospitalizations for respiratory syncytial virus (RSV) in Sicily from 2008 to 2021: clinical features and predictors of severity
title_short Hospitalizations for respiratory syncytial virus (RSV) in Sicily from 2008 to 2021: clinical features and predictors of severity
title_sort hospitalizations for respiratory syncytial virus rsv in sicily from 2008 to 2021 clinical features and predictors of severity
topic RSV
Respiratory syncytial virus
Bronchiolitis
RSV epidemiology
Children
Newborns
url https://doi.org/10.1186/s13052-025-01998-6
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