Family costs for pediatric hospitalized respiratory syncytial virus lower respiratory tract infections: an Italian multicenter study

Respiratory syncytial virus (RSV) is a leading cause of severe lower respiratory tract disease, particularly in young children. It represents a significant cause of morbidity and mortality worldwide, as well as a substantial cost driver in cases requiring hospitalization. The aim of the study was to generate data on the direct and indirect costs borne by families of children hospitalized with RSV-associated acute lower respiratory tract infection (ALRTI). Inpatient children aged 24 months of age or below affected by ALRTI were enrolled at nine Italian pediatric hospitals. The study was conducted between November and March of 2022–2024, covering two consecutive RSV seasons in Italy. Direct and indirect costs incurred by families were collected through questionnaires completed by the parents at admission (T0) and again after 7 days (T1). A total of 296 patients were enrolled during the study period and divided into two groups according to nasal swab results: 225 RSV-positive (76%) and 71 RSV-negative (24%). Family finances were reported to be affected by direct costs in 79% of the RSV+ group and 63.1% of the RSV-group. Direct costs were similar at T0 (€ 52.5 ± 94.6 in RSV+ group and € 53.5 ± 171.4 in RSV- group), but higher at T1 in the RSV+ group (€ 53.8 ± 126.6 vs € 32.3 ± 64.4). Regarding indirect costs, a greater proportion of parents in the RSV-positive group reported taking additional paid leave from work at T1 (41.8% vs 25.3%; p-value = 0.0426) as well as more unpaid leave (13.7% vs 7%). This study highlights the substantial economic burden of RSV-related hospitalizations from the household perspective, encompassing both direct out-of-pocket expenses and indirect costs due to work absenteeism across two consecutive epidemic seasons. By documenting the real-life financial impact of RSV on families, our findings provide an important parent-centered perspective, support a more comprehensive evaluation of the RSV burden and underscore the need for broad preventive measures against the disease.