Paediatric anaesthesia & critical care
Respiratory Syncytial Virus–Associated Disease in Children Receiving Intensive Care
Authors' conclusion
In this cohort study of 6430 RSV-associated ICU admissions among children aged 2 to 17 years, older children and adolescents represented a substantial proportion of severe RSV-associated disease and mortality; deaths were concentrated among children with CCCs.
Study context
- Population
- Children aged 2 to 17 y admitted to intensive care unit (ICUs) with respiratory syncytial virus (RSV) identified by laboratory testing or diagnosis codes, 2017–2023
- Participants
- 6,430 RSV-associated ICU admissions
- Outcome
- Hospital mortality
Methodological detailsmulticentre
- Multicentre
Main finding
As reported in the abstract
Hospital mortality (admissions)
484
7.5%
Share of RSV-associated deaths across all ages
484 of 735
65.9%
Observational data: associations, not effects.
Further findings
CCC burden and mortality
- ≥1 CCC category: admissions
- 3680 (57.2%)
- ≥1 CCC category: deaths
- 454 of 484 (93.8%)
- ≥3 CCC categories: admissions
- 1666 (25.9%)
- ≥3 CCC categories: deaths
- 332 of 484 (68.6%)
- Mortality OR, ≥3 complex chronic conditions (CCCs)
- 22.56 (95% CI 15.44-32.97)
- CCC burden associated with older age but remained associated with mortality across age strata
CCC categories associated with mortality (adjusted)
- Malignant neoplasm, adjusted mortality OR
- 4.27 (95% CI 3.16-5.77)
- Neurologic or neuromuscular, adjusted mortality OR
- 2.66 (95% CI 2.08-3.39)
- Respiratory, adjusted mortality OR
- 2.36 (95% CI 1.83-3.03)
- Transplant, adjusted mortality OR
- 2.18 (95% CI 1.47-3.23)
- Congenital or genetic, metabolic, cardiovascular disease and technology dependence also remained associated with mortality
- Multivariable logistic regression
ICU and hospital LOS
- ICU LOS, median (IQR 1.5-6.8), days
- 2.9
- Hospital LOS, median (IQR 3.0-14.3), days
- 5.9
Organ support
- Positive pressure ventilation
- 2061 (32.0%)
- Vasoactive agents
- 1788 (27.8%)
- Both
- 903 (14.0%)
Original publication
Respiratory Syncytial Virus–Associated Disease in Children Receiving Intensive Care. JAMA Netw Open. Published 1 September 2026. doi:10.
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