Asthma-related Pediatric Healthcare Utilization After Hospitalization for RSV and Other Viral Lower Respiratory Tract Infections

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ID: 319609
2026
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Abstract
Abstract Background Respiratory syncytial virus (RSV) is the leading cause of lower respiratory tract infection (LRTI) in infants. Although influenza, parainfluenza, and human-metapneumovirus also contribute to LRTI-related hospitalizations, their comparative population-level healthcare burden is not well defined. This study compared population-level healthcare utilization (HCU) associated with RSV-LRTI and LRTI caused by other respiratory viruses (ORspV-LRTI). Methods This nationwide retrospective cohort study used electronic health records from Clalit Health Services (CHS), covering more than five million individuals in Israel. Infants born in 2015–2023 and hospitalized before 12 months of age with PCR-confirmed viral LRTI during the RSV season were included. Acute healthcare utilization (HCU) was assessed within 30 days following hospital discharge, and long-term respiratory HCU was evaluated through six years of age. HCU was expressed as population-level event rates per 100,000 live births during the study period., and incidence rate ratios (IRRs) were estimated using quasi-Poisson regression. Results The cohort included 5,822 infants (4,951 RSV-LRTI; 871 ORspV-LRTI). RSV-LRTI infants were younger at hospitalization (median 2.7 vs. 4.4 months; P<0.001); Acute HCU was markedly higher in the RSV-LRTI group, including hospitalization duration (IRR=6.90; 95%CI 4.07–12.6), and anti-asthma medications use (IRR=4.77-8.04, P<0.001 for all). Elevated HCU persisted long-term, with higher rates of respiratory medication use, pediatric pulmonologist visits (94.3 vs. 16.3 per 100,000; IRR 6.44), and respiratory-related hospitalizations (IRR=5.39) through six years of age. These findings remained consistent in subgroups of younger children and those who experienced more severe disease during the index bronchiolitis hospitalization. Conclusions RSV-associated LRTI in infancy is associated with substantially greater population-level HCU than LRTI caused by other respiratory viruses, both acutely and throughout early childhood, supporting prioritization of early-life RSV prevention strategies.
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openalex_W7167230614 Use this key to autocite in the manuscript while using SciMatic Manuscript Manager or Thesis Manager
Authors Guy Hazan, Mai Ofri, Lital Hertz, Oliver Martyn, David Greenberg
Journal Open forum infectious diseases
Year 2026
DOI
10.1093/ofid/ofag402
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