Fergie J, Suh M, Jiang X, Fryzek JP, Gonzales T. 2020. Respiratory syncytial virus and all-cause bronchiolitis hospitalizations among preterm infants using the Pediatric Health Information System (PHIS). J Infectious Dis: open-access accepted ms. ahead of print.
Background: In 2014, the American Academy of Pediatrics stopped recommending palivizumab to otherwise healthy 29-34 weeks’ gestational age (wGA) infants aged <12 months at respiratory syncytial virus (RSV) season start. Here, we compare the burden of RSV hospitalizations (RSVH) and all-cause bronchiolitis hospitalizations (BH) before and after 2014 among otherwise healthy 29-34 wGA infants hospitalized at <6 months of age.
Methods: A historical, observational cohort study was conducted to evaluate RSVH and BH in 29-34 wGA infants during the 2010-2017 RSV seasons using encounter data from 51 US children’s hospitals that comprise the Pediatric Health Information System.
Results: The overall cohort included 67,570 RSVH out of 96,281 patients with BH. wGA was known for 22,937 RSVH and 33,289 BH. For 29-34 wGA infants, there were 8.7% and 14.2% RSVH before and after 2014, respectively (P<0.0001). Intensive care unit admissions increased for RSVH (from 54.5% to 64.2%; P=0.0002) and BH (from 46.7% to 54.5%; P=0.0005) after controlling for sex, race, comorbidity, and cluster. The total cost of care increased for RSVH from $37 million to nearly $60 million.
Discussion: RSVH, BH, and their severity increased among 29-34 wGA infants in the 3 RSV seasons following 2014.