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. 2025 Apr 26;15(1):56.
doi: 10.1186/s13613-025-01460-0.

Nirsevimab prophylaxis on pediatric intensive care hospitalization for severe acute bronchiolitis: a clinical and economic analysis

Sarah Touati  1 , Alexandre Debs  1 , Luc Morin  1   2 , Laure Jule  1 , Caroline Claude  1 , Pierre Tissieres  3   4 ; PANDORA study group
Collaborators, Affiliations

Nirsevimab prophylaxis on pediatric intensive care hospitalization for severe acute bronchiolitis: a clinical and economic analysis

Sarah Touati et al. Ann Intensive Care. .

Abstract

Background: Severe acute viral bronchiolitis is a common cause of admissions to pediatric intensive care units (PICUs), resulting in a significant organizational burden each winter. The recent introduction of generalized neonatal prophylactic therapies using Nirsevimab, a monoclonal antibody targeting the respiratory syncytial virus (RSV), has significantly reduced consultations and hospitalizations. However, its impact on the medico-economic aspects of the PICU remains poorly defined.

Methods: We analyzed all infants admitted to our unit for severe acute bronchiolitis over six consecutive epidemic periods (September to March) and examined the effect of Nirsevimab generalized prophylaxis on PICU admissions during the 2023-2024 period.

Results: Between 2018 and 2024, 572 out of, 3728 infants under 6 months of age were admitted to the PICU for severe acute bronchiolitis during six epidemic periods. The average percentage of infants with bronchiolitis admitted to the PICU was 15.3% (95% CI 14.2-16.5), with a net decrease during the 2023-2024 period (8.5%) compared to the 2022-2023 period (17.6%). Patients' characteristics were similar, as were the supporting therapies. The causes of bronchiolitis were identical, with 83% and 77% secondary to RSV. PICU duration was significantly reduced during the last period from 4.4 days (95% CI 3.8-5.9) to 3.3 days (95% CI 2.6-4). The medico-economic impact was significant, with a cost reduction for acute severe viral bronchiolitis PICU total stays from €210,105 to €121,044 per annual epidemic without a change in the return on investment.

Conclusions: The introduction of generalized neonatal prophylaxis with Nirsevimab significantly impacts the burden of severe acute bronchiolitis in the PICU.

Keywords: Bronchiolitis; Cost-effectiveness; Intensive care; Nirsevimab; Respiratory syncytial virus.

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Conflict of interest statement

Declarations. Ethics approval and consent to participate: The study (French study classification: MR004) was approved by the local IRB and French Data Protection Authority, waiving the need for written consent. Consent for publication: All authors approved the final version submitted for publication and agreed to be accountable for all aspects of the work to ensure that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved. Competing interests: None of the authors had a conflict of interest related to this work and the conclusion. PT disclose consulting for Sanofi, Baxter, Thermo Fisher and Viatris outside this work. LM disclose consulting for Baxter.

Figures

Fig. 1
Fig. 1
Incidence of severe acute viral bronchiolitis from 2018 to 2024. The incidence of Respiratory Syncytial Virus and other causes of severe acute viral bronchiolitis in children admitted in intensive care. Values are expressed as number
See this image and copyright information in PMC

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