RESPIRIAMO – Italian hospital surveillance for lower respiratory tract infections: a multicenter retrospective cohort study of respiratory syncytial virus-associated hospitalizations in children under 2 years of age

BACKGROUND: Lower respiratory tract infections (LRTIs) are a leading cause of hospitalization in infants, with respiratory syncytial virus (RSV) representing the most important etiologic agent in children under 2 years of age. Although RSV disease burden is well recognized, multicenter data describing hospitalization characteristics, severity, and risk profiles in Italian infants remain limited, particularly following changes in viral circulation patterns in recent years. The study was established to provide robust hospital-based surveillance data. This study aimed to describe the clinical features and the severity of RSV-associated LRTI hospitalizations in Italian children under 24 months, comparing RSV-positive and RSV-negative cases. METHODS: The study included infants aged 0- < 24 months hospitalized for LRTI between the 2018/2019 and 2020/2021 seasons across 12 Italian pediatric centers. Demographic characteristics, medical history, clinical presentation, laboratory radiologic, and hospitalization data were collected. Patients underwent RSV testing on nasopharyngeal samples and were classified as RSV-positive or RSV-negative. Descriptive statistics and comparative analyses were performed using parametric or non-parametric tests. RESULTS: One thousand five hundred forty-seven infants were included, out of which 1,263 (81.6%) were RSV-positive. RSV-positive infants were significantly younger than RSV-negative infants, more likely to be previously healthy and without a family history of atopy. RSV infection was associated with a more severe clinical course, higher rates of oxygen supplementation (67.6% vs. 39.1%), respiratory support, invasive ventilation, and intensive care unit admission (10.6% vs. 3.1%). Use of RSV prophylaxis (at that time, palivizumab) was rare in both groups. CONCLUSIONS: RSV was the predominant cause of LRTI and was associated with significantly greater disease severity. Most hospitalized infants were previously healthy, underscoring the need for preventive strategies targeting the general infant population.

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Journal
BMC Pediatrics
Published
2026-06-24
DOI
https://doi.org/10.1186/s12887-026-07177-8
Primary Topic
Respiratory viral infections research
Type
article
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article

RESPIRIAMO – Italian hospital surveillance for lower respiratory tract infections: a multicenter retrospective cohort study of respiratory syncytial virus-associated hospitalizations in children under 2 years of age

Raffaella Nenna, Cecilia Basile, Laura Folgori, Emiliano Barbieri et al.
BMC Pediatrics
Respiratory viral infections research
article

RESPIRIAMO – Italian hospital surveillance for lower respiratory tract infections: a multicenter retrospective cohort study of respiratory syncytial virus-associated hospitalizations in children under 2 years of age

Raffaella Nenna, Cecilia Basile, Laura Folgori, Emiliano Barbieri, Giovanni Corsello, Anna Chiara Vittucci, Laura Dotta, Laura Petrarca, Alessandra Simonetti, Claudia Colomba, Sandra Trapani, Daniele Franzone, Gregorio Serra, Michele Ghezzi, Alessandra Coscia, Domenico Cipolla, Emanuela Piccotti, Raffaele Badolato, Silvia Bressan, Alessandra Carmignani, Francesca Tirelli, Roberto Grandinetti, Federica Attaianese, Roberta Forestiero, Flaminia Ruberti, Vincenzo Guaia, Livia Antilici, Elena Bozzola, Anna Benedetta Del Signore, Roberta Ragucci, Enza D'Auria, Diego Peroni, Chiara Martorana, Maria Valentina Catania, Francesca Pulcinelli, Eugenio Baraldi, Claudio Costantino, Fabio Midulla, Respiriamo Study Group, Paolo Rossi, Antonietta Giannattasio, Marta Ferretti, Marco Maglione, Susanna Esposito
article en

Abstract

BACKGROUND: Lower respiratory tract infections (LRTIs) are a leading cause of hospitalization in infants, with respiratory syncytial virus (RSV) representing the most important etiologic agent in children under 2 years of age. Although RSV disease burden is well recognized, multicenter data describing hospitalization characteristics, severity, and risk profiles in Italian infants remain limited, particularly following changes in viral circulation patterns in recent years. The study was established to provide robust hospital-based surveillance data. This study aimed to describe the clinical features and the severity of RSV-associated LRTI hospitalizations in Italian children under 24 months, comparing RSV-positive and RSV-negative cases. METHODS: The study included infants aged 0- < 24 months hospitalized for LRTI between the 2018/2019 and 2020/2021 seasons across 12 Italian pediatric centers. Demographic characteristics, medical history, clinical presentation, laboratory radiologic, and hospitalization data were collected. Patients underwent RSV testing on nasopharyngeal samples and were classified as RSV-positive or RSV-negative. Descriptive statistics and comparative analyses were performed using parametric or non-parametric tests. RESULTS: One thousand five hundred forty-seven infants were included, out of which 1,263 (81.6%) were RSV-positive. RSV-positive infants were significantly younger than RSV-negative infants, more likely to be previously healthy and without a family history of atopy. RSV infection was associated with a more severe clinical course, higher rates of oxygen supplementation (67.6% vs. 39.1%), respiratory support, invasive ventilation, and intensive care unit admission (10.6% vs. 3.1%). Use of RSV prophylaxis (at that time, palivizumab) was rare in both groups. CONCLUSIONS: RSV was the predominant cause of LRTI and was associated with significantly greater disease severity. Most hospitalized infants were previously healthy, underscoring the need for preventive strategies targeting the general infant population.

BMC Pediatrics
University of Rome Tor Vergata (IT), University of Parma (IT), University of Padua (IT), University of Milan (IT), Istituto Giannina Gaslini (IT), Azienda Socio Sanitaria Territoriale degli Spedali Civili di Brescia (IT), Meyer Children's Hospital (IT), Italian Medicines Agency (IT), Bambino Gesù Children's Hospital (IT), Santobono Children's Hospital (IT), Azienda di Rilievo Nazionale ed Alta Specializzazione (IT), Azienda Ospedaliera Universitaria Pisana (IT), University of Florence (IT), University of Turin (IT), Sapienza University of Rome (IT), University of Palermo (IT)
Good health and well-being
Openalex Percentile: Top 7%
Respiratory viral infections research
DOIOpen Access PDFOpenAlex
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