630 - Characteristics of Respiratory Syncytial Virus in Children Aged 0-5 Years Before and During COVID-19 Pandemic in an Urban Multiethnic Community Hospital

Saturday, April 29, 2023

3:30 PM – 6:00 PM ET

Poster Number: 630
Publication Number: 630.226

jose Boris Trigueros Montes, Flushing Hospital Medical Center, Flushing, NY, United States; Diego Montes, Baylor University, Garland, TX, United States; Lily Q. Lew, Flushing Hospital Medical Center, Flushing, NY, United States; Won Baik-Han, Flushing Hospital Medical Center, Flushing, NY, United States; Gagan Gulati, Flushing Hospital Medical Center, Flushing, NY, United States

Presenting Author(s)

jT

jose Boris Vicente Trigueros Montes (he/him/his)

Resident
Flushing Hospital Medical Center
Flushing, New York, United States

Background: Respiratory syncytial virus (RSV) is a common and major cause of bronchiolitis in children < 2 yrs of age. RSV season in temperate regions is from mid-Oct to early May with median national peak in early Feb. After declaration of COVID-19 pandemic, restricted activities, mask-wearing, and social distancing resulted in “seasonal shift and delayed peak” of respiratory infections. Climate change could cause RSV outbreaks to occur earlier, be more frequent, of lower severity and to show biennial peaks. There are no studies comparing incidence (incid) and severity of RSV before and during COVID-19 in an urban multiethnic community hospital.

Objective:

To compare incid and severity of RSV before and during COVID-19 pandemic in an urban multiethnic community hospital.

Design/Methods: Retrospective chart review of patients aged 0-60 mos who tested positive for RSV in the ED of Flushing Hospital in Queens, NY between May 2018 and May 2022. Demographics, hospitalization and length of stay (LOS) were extracted from EHR. Seasons 2018-19, 2019-20 were considered before and seasons 2020-21 and 2021-22 as during the pandemic. Severity of RSV was assessed for each patient using bronchiolitis severity score (BSS). BSS evaluates respiratory rate, retractions, wheezing and general appearance; score of 0-3 mild, 4-6 moderate, >6 severe illness. Data were analyzed using one-way ANOVA and chi-square test, p< 0.05 was considered significant

Results:

Of 306 with RSV, 51% were male and the most prevalent ethnicities were Hispanic (74%) followed by Asian (24%). Season 2020-21 had the lowest incid (1%) and season 2021-22 the highest incid (37%). Differences in incid across seasons were significant (X² (4)=606, p< 0.001), table 1. Peak mos shifted in the last two seasons; cases in season 2021-22 presented over a greater period of time, but with less frequency at any given point, figure 1. Patients seen in 2021-22 were older (H (2, 196.63)=12.467), p< 0.001) and had milder illness (median BSS=0, IQR=3, H (2, 187.52)=7.53), p< 0.01) compared to patients seen in previous seasons. Hospitalizations (season 2020-21 was excluded due to low incid) declined the least in season 2021-22 (X² (2)=17.179, p< 0.001) and their median LOS 3 days (IQR=2, H (2, 86.95)=0.10), p=0.907.

Conclusion(s): During COVID-19 pandemic, there were almost no cases of RSV in the 1^st yr followed by higher incid in the 2^nd yr. Peak mos of RSVshifted to earlier onset. Patients seen in 2021-22 season were older and the majority had mild illness. The decline in hospitalizations was most likely due to milder illness