Case Study Review: Association of COVID-19 with respiratory syncytial virus (RSV) infections in children aged 0–5 years in the USA in 2022: a multicentre retrospective cohort study
The cohort study under review, titled "Association of COVID-19 with respiratory syncytial virus (RSV) infections in children aged 0–5 years in the USA in 2022: a multicentre retrospective cohort study," by Lindsey Wang, Pamela B Davis, Nathan Berger, David C Kaelber, Nora Volkow, and Rong Xu investigates the association between COVID-19 infection and the risk of incident respiratory syncytial virus (RSV) infections among children aged 0–5 years. The study aims to explore whether COVID-19 played a role in the surge of severe pediatric RSV cases observed in the USA during 2022.
Methods:
The research employs a retrospective population-based cohort study design, utilizing a nationwide multicentre database of electronic health records (EHRs) encompassing 61.4 million patients in the USA, including 1.7 million children aged 0–5 years. The study compares outcomes related to RSV infections between children with and without prior COVID-19 infection during the RSV seasons of 2022 and 2021. Propensity-score matched cohorts were used to calculate risk ratios (RR) and 95% confidence intervals (CI) for various outcomes, such as overall RSV infection, lab test-confirmed RSV infection, clinically diagnosed RSV diseases, RSV-associated bronchiolitis, and unspecified bronchiolitis.
Results:
For the 2022 study population (average age 2.4 years, 46.8% girls, 61% white, 16% black), children with prior COVID-19 infection exhibited a significantly higher risk of incident RSV infection during October 2022–December 2022 compared to matched children without COVID-19 (RR 1.40, 95% CI 1.27 to 1.55). Similar findings were observed in children aged 0–1 year. The 2021 study population (average age 2.2 years, 46% girls, 57% white, 20% black) also demonstrated an increased risk for RSV infection among children with prior COVID-19 infection during July 2021–December 2021 (RR 1.32, 95% CI 1.12 to 1.56). Again, children aged 0–1 year with prior COVID-19 infection had a higher risk compared to matched counterparts (RR 1.47, 95% CI 1.18 to 1.82).
The study concludes that COVID-19 infection is associated with a significantly increased risk of RSV infections among children aged 0–5 years in both 2022 and 2021. The findings suggest that COVID-19 may have contributed to the surge in RSV cases in 2022 through the accumulation of COVID-19-infected children and potential long-term adverse effects on the immune and respiratory systems. This research underscores the importance of understanding the interplay between respiratory viruses and the potential consequences of COVID-19 on the health of young children. Further research is warranted to explore the mechanisms underlying these associations and inform preventive measures.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10582888/
