Nosocomial RSV-related In-hospital Mortality in Children: A Global Case Series

RSV GOLD study group, Yvette N Löwensteyn, Joukje E Willemsen, Natalie I Mazur, Nienke M Scheltema, Nynke C J van Haastregt, Amber A A Ten Buuren, Ichelle van Roessel, Dunja Scheepmaker, Harish Nair, Peter M van de Ven, Louis J Bont

Research output: Contribution to journalArticlepeer-review

Abstract / Description of output

BACKGROUND: According to the World Health Organization, the global burden of nosocomial infections is poorly characterized as surveillance systems are lacking. Nosocomial infections occur at higher rates in low- and lower-middle-income countries (LMICs) than in high-income countries (HICs). Current global RSV burden estimates are largely based on community-acquired infection. We aimed to characterize children with nosocomial RSV-related mortality and to understand the potential impact of RSV immunization strategies.

MATERIALS: RSV GOLD is a global registry of children younger than 5 years who died with laboratory-confirmed RSV infection. We compared clinical and demographic characteristics of children with nosocomial and community-acquired RSV in-hospital mortality.

RESULTS: We included 231 nosocomial and 931 community-acquired RSV-related in-hospital from deaths from 65 countries. Age at death was similar for both groups (5.4 vs. 6 months). A higher proportion of nosocomial deaths had comorbidities (87% vs. 57%; P < 0.001) or was born preterm (46% vs. 24%; P < 0.001) than community-acquired deaths. The proportion of nosocomial deaths among all RSV deaths was lower in LMICs than in upper-middle-income countries (UMICs) and HICs (12% vs. 18% and 26%, respectively).

CONCLUSIONS: This is the first global case series of children dying with nosocomial RSV infection. Future infant-targeted immunization strategies could prevent the majority of nosocomial RSV-related deaths. Although nosocomial RSV deaths are expected to occur at highest rates in LMICs, the number of reported nosocomial RSV deaths was low in these countries. Hospital-based surveillance is needed to capture the full burden of nosocomial RSV mortality in LMICs.

Original languageEnglish
Pages (from-to)1-7
Number of pages7
JournalThe Pediatric Infectious Disease Journal
Issue number1
Publication statusPublished - 1 Jan 2023

Keywords / Materials (for Non-textual outputs)

  • child mortality
  • community-acquired infection
  • global health
  • nosocomial infection
  • respiratory syncytial virus


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