Risk factors for disease severity and increased medical resource utilization in respiratory syncytial virus (+) hospitalized children

MarijkeProesmans, Annabel Rector, ElsKeyaerts, YannickVandendijck, Francois Vermeulen, Kate Sauer,MarijkeReynders, Ann Verschelde, WimLaffut, KristienGarmyn, Roman Fleischhackl, Jacques Bollekens, Gabriela Ispas


Background: This study aimed to provide regional data on clinical symptoms, medical resource utilization (MRU), and risk factors for increased MRU in hospitalized pediatric patients infected with respiratory syncytial virus (RSV) in Belgium.

Introduction: Respiratory syncytial virus (RSV) is a common cause of respiratory tract infection in infants and young children, leading to significant morbidity and mortality worldwide. The clinical presentation of RSV infection varies according to age and immune response. Understanding the risk factors for increased medical resource utilization can help guide healthcare strategies. This study explores these factors in the Belgian pediatric population.

Methods: This prospective, multicenter study enrolled patients from four Belgian hospitals during the 2013–2014 and 2014–2015 RSV epidemic seasons. Patients diagnosed with RSV were monitored daily until discharge or for a maximum of six days. Baseline characteristics, including age, sex, RSV subtype, underlying risk factors, and symptom duration, were analyzed.

Results: The study included 75 patients, with a median age of 4 months. Most patients were infected with RSV-A. Underlying risk factors were present in 18.7% of patients, with previous or recurrent wheezing and congenital heart disease being the most common. Symptom duration at enrollment was ≤3 days for the majority of patients. The study provides insights into disease progression and medical resource utilization, such as oxygen supplementation and hospitalization length.

Discussion: The study findings shed light on disease burden and predictors for increased medical resource utilization in hospitalized children with RSV infection. Factors such as young age and baseline PES3 total score were associated with the probability and length of oxygen supplementation. However, none of the factors analyzed were associated with the length of hospitalization.

Conclusion: This exploratory study contributes to the understanding of disease severity and medical resource utilization in hospitalized children with RSV infection. It highlights the predictive value of age and baseline PES3 score for oxygen supplementation. The study provides valuable regional data for guiding healthcare strategies in managing RSV infections in children.

Acknowledgments: The authors acknowledge individuals who provided advice and support during the study conductance and medical writing assistance.

Citation: Proesmans M, Rector A, Keyaerts E, Vandendijck Y, Vermeulen F, Sauer K, et al. (2022) Risk factors for disease severity and increased medical resource utilization in respiratory syncytial virus (+) hospitalized children: A descriptive study conducted in four Belgian hospitals. PLoS ONE 17(6): e0268532.

Editor: Brenda M. Morrow, University of Cape Town, SOUTH AFRICA

Received: August 5, 2021; Accepted: May 2, 2022; Published: June 6, 2022

Copyright: © 2022 Proesmans et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

Data Availability: The data sharing policy of Janssen Pharmaceutical Companies of Johnson & Johnson is available at Requests for access to the study data can be submitted through the Yale Open Data Access (YODA) Project site at

Funding: The study was funded by Janssen Pharmaceutica NV. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.

Competing interests: I have read the journal's policy, and the authors of this manuscript have the

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