Postpandemic Trends in Pediatric Respiratory Virus Hospitalizations: A Multicenter Study, 2019–2025
ABSTRACT Background The COVID‐19 pandemic profoundly altered the circulation of respiratory viruses in children, changing the epidemiology of acute lower respiratory tract infections. In the postpandemic period, respiratory pathogens showed marked temporal variability. The 2024–2025 season was the first respiratory syncytial virus (RSV) season in Italy during which RSV immunoprophylaxis with nirsevimab was implemented, allowing evaluation of recent trends in pediatric hospitalizations. Methods We conducted a retrospective multicenter study across 16 pediatric hospitals in Italy. Hospitalizations of children younger than 18 years with RSV, influenza, adenovirus, parainfluenza virus, rhinovirus infection, or bronchiolitis of unspecified viral etiology were identified from January 2019 to March 2025 using ICD‐9‐CM diagnostic codes. Annual and monthly hospitalization rates per 100,000 children were calculated using national demographic data. Temporal trends were assessed across six consecutive seasons. Results Overall, 23,981 hospitalizations were recorded. RSV was the most frequent pathogen (42.5%), followed by influenza (18.6%), adenovirus (9.9%), and rhinovirus (7.3%). Hospitalizations declined sharply in 2020 and subsequently increased, peaking in 2024 ( n = 4903; +30.8% vs. 2022). During the 2024–2025 season, total admissions decreased by 17.2% compared with 2023–2024 (3390 vs. 4095), mainly due to a marked reduction in RSV‐related hospitalizations (−41.6%, 1230 vs. 2107), with modest increases in influenza‐, adenovirus‐, and rhinovirus‐associated admissions. Conclusions This nationwide analysis describes postpandemic trends in pediatric respiratory virus hospitalizations in Italy, highlighting changing pathogen‐specific patterns and the need for continued viral surveillance.
Authors
- Enrico Felici (ORCID: https://orcid.org/0000-0002-5997-7057)
- Giuseppe Indolfi (ORCID: https://orcid.org/0000-0003-3830-9823)
- Fiorentina Guida (ORCID: https://orcid.org/0000-0002-1727-5372)
- Maria Moriondo (ORCID: https://orcid.org/0000-0001-9653-8371)
- Anna Frusciante
- Felice Nunziata (ORCID: https://orcid.org/0000-0002-9184-1694)
- Fabio Savoia (ORCID: https://orcid.org/0000-0001-7132-0050)
- Carlo Dani (ORCID: https://orcid.org/0000-0002-1639-621X)
- Claudia Mandato (ORCID: https://orcid.org/0000-0003-2425-5449)
- Sandra Trapani (ORCID: https://orcid.org/0000-0003-1105-1500)
- Salvatore Cazzato (ORCID: https://orcid.org/0000-0002-0523-3546)
- Alessandro Zago (ORCID: https://orcid.org/0000-0003-3465-6676)
- Eloisa Gitto (ORCID: https://orcid.org/0000-0001-7442-8630)
- Maria Antonia Galeone
- Silvia Garazzino (ORCID: https://orcid.org/0000-0001-5773-5356)
- Desireé Caselli (ORCID: https://orcid.org/0000-0002-5716-3703)
- Emanuela Piccotti (ORCID: https://orcid.org/0000-0002-1569-0222)
- Alice Manzini
- Immacolata Rulli (ORCID: https://orcid.org/0009-0006-7552-3932)
- Antonella Sisto (ORCID: https://orcid.org/0000-0003-3216-4870)
- Antonio Guerriero (ORCID: https://orcid.org/0000-0002-8104-3832)
- Eduardo Ponticiello
- Giulia Bertolucci (ORCID: https://orcid.org/0000-0003-1605-2895)
- I. Alberti (ORCID: https://orcid.org/0000-0001-8803-718X)
- Lucia Dora Notarangelo (ORCID: https://orcid.org/0000-0001-5532-7375)
- Maurizio Aricò (ORCID: https://orcid.org/0000-0002-1908-6671)
- Francesco Chiarelli
- Marina Attanasi (ORCID: https://orcid.org/0000-0001-6513-3160)
- Roberta Pellegrino (ORCID: https://orcid.org/0000-0001-6454-9383)
- Veronica Casotto (ORCID: https://orcid.org/0000-0001-5846-1377)
- Erika Silvestro (ORCID: https://orcid.org/0000-0001-6111-5053)
- Federica Attaianese (ORCID: https://orcid.org/0009-0007-7463-8567)
- Marcello Lanari (ORCID: https://orcid.org/0000-0002-2586-314X)
- Giovanna Iudica (ORCID: https://orcid.org/0000-0001-7538-828X)
- Federica Soro
- Gaia Martelli
- Stefania Tonetto (ORCID: https://orcid.org/0009-0009-8565-8672)
- Silvia Campani
- Diego Peroni
- Chiara Azzari
- Antonietta Giannattasio
- Silvia Ricci
- Silvia Bressan
- Gregorio Paolo Milani
Institutions
- University of Pisa (IT)
- University of Messina (IT)
- University of Salerno (IT)
- University of Padua (IT)
- University of Trieste (IT)
- University of Milan (IT)
- Istituto Giannina Gaslini (IT)
- Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico (IT)
- University of Chieti-Pescara (IT)
- Ospedale Maggiore (IT)
- Azienda Socio Sanitaria Territoriale degli Spedali Civili di Brescia (IT)
- Azienda Ospedaliera S.Giuseppe Moscati (IT)
- Meyer Children's Hospital (IT)
- Azienda Ospedaliero-Universitaria Careggi (IT)
- Fondazione Ospedale Salesi (IT)
- Santobono Children's Hospital (IT)
- Ospedali Riuniti San Giovanni di Dio e Ruggi d'Aragona (IT)
- Ospedale Regina Margherita (IT)
- Ospedale Pediatrico Giovanni XXIII (IT)
- Azienda USL di Pescara (IT)
- Ospedale Sant'Anna (IT)
- Azienda Ospedaliera Nazionale SS. Antonio e Biagio e Cesare Arrigo (IT)
- Azienda Ospedaliera Universitaria Pisana (IT)
- University of Florence (IT)
- University of Bari Aldo Moro (IT)
- University of Brescia (IT)
- University of Genoa (IT)
- University of Bologna (IT)
Publication Details
- Journal
- Influenza and Other Respiratory Viruses
- Published
- 2026-09-28
- DOI
- https://doi.org/10.1111/irv.70296
- Primary Topic
- Respiratory viral infections research
- Type
- article
- Field-Weighted Citation Impact
- 0.00