Risk factors associated with severe RSV disease among hospitalized children in the second year of life: a…

Cohort studyEuropean journal of pediatrics· Nov 2025

Risk factors associated with severe RSV disease among hospitalized children in the second year of life: a multicenter study.

Keren Armoni Domany, Inbal Golan-Tripto, Nitzan Burrack … Diana Tasher

Pediatric RespiratoryCohort studyQ1IF 3.2

Down syndrome linked to over 6-fold higher odds of Pediatric Intensive Care Unit admission with RSV.

Risk factors associated with severe RSV disease among hospitalized children in the second year of life: a multicenter study.

Keren Armoni Domany … Diana Tasher

European journal of pediatrics · Nov 2025 · Q1 in Pediatrics

Background

The second year of life is gaining increased attention in the era of long-acting RSV immunoprophylaxis.

Purpose

This multicenter study, across pre- and post-COVID seasons, aimed to assess the association between specific key risk-factors and severe RSV-related disease among hospitalized children aged 12-23 months.

Methods

This retrospective study included children aged 12-23 months hospitalized with RSV across 11 medical-centers (2017-2021).

n = 1023 children

Results

children with Down syndrome had far higher odds of Pediatric Intensive Care Unit admission

AOR by subgroup · 95% CI

More results

Among 1023 children, 228 (22%) had ≥ 1 risk factor: prematurity (n = 183), CLD (n = 28), congenital heart disease (n = 45) or down syndrome (n = 20).

More results

In multivariable analysis, prematurity with CLD (aOR 4.7,95%CI:1.97-11.22) or without CLD (aOR 2.26, 95%CI:1.54-3.3), congenital heart disease (aOR-3.29, 95%CI:1.6-6.77), down syndrome (aOR-4.14, 95%CI:1.26-13.6) and having ≥ 1 risk (aOR-3.55, 95%CI:2.55-4.96) were independently associated with prolonged hospitalization.

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Conclusion · 1 of 3

Children aged 12-23 months with prematurity, CLD, major congenital heart disease or down syndrome had significantly higher rates of prolonged RSV hospitalization.

Conclusion · 2 of 3

Those with ≥ 1 risk factor, and presumably patients with down syndrome and congenital heart disease are at highest risk for severe complications.

Conclusion · 3 of 3

Preventive strategies for these high-risk populations should be considered in their second-year of life.

Risk factors associated with severe RSV disease among hospitalized children in the second year of life: a multicenter study.

Risk factors associated with severe RSV disease among hospitalized children in the second year of life: a multicenter study.

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