Late Breaking Abstract - Global RSV-associated mortality in young children: a case series

Abstract

Background: Respiratory syncytial virus (RSV) infection is an important cause of pneumonia mortality in young children. However, clinical data on fatal RSV infection are scarce. We aimed to identify clinical and socio-economic characteristics of children under five years of age with RSV-related death using individual patient data. Methods: We developed an online questionnaire and obtained patient data through leading research groups on child pneumonia identified through a comprehensive literature search and existent research networks. We collected individual level patient data on children younger than five years who died with community-acquired RSV infection. Results: We studied 358 children with RSV-related in-hospital death from 23 countries in six continents. This included 117 (33%) children from low-income or lower middle-income countries, 77 (22%) from upper middle-income, and 164 (46%) from high-income countries. Available data showed that comorbidities were present in 28% of children from low-income or lower middle-income countries compared to 70% of children from high-income countries. The median age for RSV-related deaths was 5·0 (IQR 2·3-11·0) months in low-income or lower middle-income countries, 4·0 (IQR 2·0-10·0) months in upper middle-income countries, and 7·0 (IQR 3·6-16·8) months in high-income countries. Conclusion: This is the first large case series with individual data of children who died with community-acquired RSV infection. A substantial proportion of children who died with community-acquired RSV infection had comorbidities. Our results demonstrate that perinatal immunisation strategies may have a substantial impact on RSV-related child mortality in low-income and middle-income countries.