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. 2023 Aug 30:25:100582.
doi: 10.1016/j.lana.2023.100582. eCollection 2023 Sep.

Respiratory syncytial virus epidemiology and clinical severity before and during the COVID-19 pandemic in British Columbia, Canada: a retrospective observational study

Marina Viñeta Paramo  1   2   3 , Lilian P L Ngo  1 , Bahaa Abu-Raya  1   3 , Frederic Reicherz  1   3 , Rui Yang Xu  1   3 , Jeffrey N Bone  2   3 , Jocelyn A Srigley  3   4 , Alfonso Solimano  1 , David M Goldfarb  3   4 , Danuta M Skowronski  5 , Pascal M Lavoie  1   2   3
Affiliations

Respiratory syncytial virus epidemiology and clinical severity before and during the COVID-19 pandemic in British Columbia, Canada: a retrospective observational study

Marina Viñeta Paramo et al. Lancet Reg Health Am. .

Abstract

Background: The COVID-19 pandemic has perturbed the seasonality of respiratory syncytial virus (RSV) infections. However, we lack data on how this impacted the severity of paediatric RSV cases. The objective of this study was to describe the clinical severity of RSV cases before, during and after pandemic measures in British Columbia (BC), Canada.

Methods: Retrospective study of RSV cases from September 1st, 2017 to May 15th, 2023, with a review of RSV outcomes in children below 18 years old at BC's paediatric hospital. Temporal changes in RSV cases and hospitalisations were quantified using interrupted time series.

Findings: BC experienced only 11 RSV cases (from 95,266 tests) between September 2020 and August 2021. This was followed by a resurgence of 9,529 RSV cases (219,566 tests [4.3% positive tests]) in 2021-22 and 8,215 cases (124,449 tests [6.6% positive tests]) in 2022-23, increased compared to 1,750 cases (48,664 tests [3.6% positive tests]) per corresponding yearly period in 2017-20. From September 2017 to May 2023, the median age of children with RSV at BC Children's Hospital increased from 8.7 [IQR: 2.0-26.0] to 19.6 [3.9-43.7] months per yearly period. More children were hospitalised in 2022-23 (n = 360), compared to 2017-20 (n = 168 per period) and 2021-22 (n = 172). However, we detected no increase in hospitalisations or ICU admissions in children born prematurely or with chronic cardiorespiratory conditions.

Interpretation: The increased detection of symptomatic RSV cases in older children in 2021-22 and increased RSV-related hospitalisations in 2022-23 suggest a gradual increase in the pool of immunologically vulnerable children due to a prolonged lack of viral exposure.

Funding: Government of Canada via its COVID-19 Immunity Task Force.

Keywords: COVID-19; Children; Hospitalisation; Interrupted time series analysis; Pandemic; RSV; Respiratory syncytial virus.

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Conflict of interest statement

PML received an honorarium from Sanofi, for participation on advisory board meetings. BA received honoraria for participation in live meetings from Sanofi Pasteur France and Canada related to pertussis (for BA) and RSV products, but not related to this study. JAS received grants from WorkSafe BC, BC Children's Hospital Research Institute, and COVID-19 Immunity Task Force, which were not related to this study. DMG received a grant from bioMerieux Inc. as investigator-initiated research for a blood culture study, not related to this study. DMS received grants from Michael Smith Foundation for Health Research, Canadian Institutes of Health Research, Public Agency of Canada, and BCCDC Foundation for public health which were not related to this study. Other authors declare no other relevant conflicts of interest.

Figures

Fig. 1
Fig. 1
Interrupted time series analysis for respiratory syncytial virus (RSV) (a) cases and (b) related hospitalisations at BC Children's Hospital (BCCH). Poisson generalized additive models (GAMs) were used, including terms for the weeks' since the pandemic start (March 11th, 2020), and seasonality, modeled with thin-plate and cyclical splines, respectively. Dots represent the observed weekly data; red line represents the observed data after March 11th 2020; green line shows expected data from GAM with 95% confidence intervals. The gray vertical line indicates the pandemic start. All children with RSV for whom clinical data were available were included (N = 2566).
See this image and copyright information in PMC

References

    1. Li Y., Wang X., Blau D.M., et al. Global, regional, and national disease burden estimates of acute lower respiratory infections due to respiratory syncytial virus in children younger than 5 years in 2019: a systematic analysis. Lancet. 2022;399:2047–2064. - PMC - PubMed
    1. Public health agency of Canada . Government of Canada; 2023. Respiratory virus detections in Canada.https://www.canada.ca/en/public-health/services/surveillance/respiratory... Available from:
    1. Yeoh D.K., Foley D.A., Minney-Smith C.A., et al. The impact of COVID-19 public health measures on detections of influenza and respiratory syncytial virus in children during the 2020 Australian winter. Clin Infect Dis. 2020;72:2199–2202. - PMC - PubMed
    1. Rodgers L., Sheppard M., Smith A., et al. Changes in seasonal respiratory illnesses in the United States during the coronavirus disease 2019 (COVID-19) pandemic. Clin Infect Dis. 2022;73:S110–S117. - PMC - PubMed
    1. Lavoie P.M., Reicherz F., Solimano A., Langley J.M. Potential resurgence of respiratory syncytial virus in Canada. Can Med Assoc J. 2021;193:E1140–E1141. - PMC - PubMed

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