Clinical Profile, Severity and Intensive Care needs of Children Admitted with Respiratory Syncytial Viral Infections in PICU: Post COVID Trend

Aims: Epidemiology of RSV infection have shown changing trends in the post covid times. Changing pattern in its seasonality have been reported following relaxation of lockdown measures after SARS COVID. Literature describing severity and intensive care needs of pediatric RSV infections are scarce. Our study aims to describe the clinical profile, severity and intensive care needs of pediatric RSV infections requiring PICU admission in post COVID period.

Study Design: Retrospective Study.

Place and Duration of Study: Paediatric Intensive Care Unit of a tertiary care teaching hospital in south India. Study period was from May 2022 and October 2022, over 6 months.

Methodology: All children with clinical diagnosis of viral pneumonia or bronchiolitis were screened. RSV positive cases were taken for the study. The data including age, gender, symptoms, duration of each symptom, respiratory support, duration of oxygen requirement, number of days of PICU stay and outcome of all the children was entered into a structured proforma and data was analysed. The primary objective was to see clinical profile, severity and intensive care needs of RSV affected children aged 1month-12 years admitted in PICU with RSV infections. The secondary objective was to see mortality and length of PICU stay among them.

Results: Out of 36 children with clinical diagnosis of viral pneumonia or acute bronchiolitis, 21 tested positive for respiratory virus, out of which 11 were RSV positive. There was a slight male preponderance. All children were aged less than 18 months. All had respiratory failure and required oxygen support (n=11, 100%). Intensive care needs were high flow nasal cannula requirement in 9 patients (n=9,82%), oxygen via nasal prongs (n=1,9%) and mechanical ventilation (n=1, 9%). Median (IQR) duration of oxygen requirements was 6 (5,9) days. Median (IQR) duration of PICU stay was 6(5,8) days. All 11 children survived.

Conclusion: In the Post Covid era, RSV was the most identified viral etiology behind viral pneumonia or bronchiolitis in our PICU. All children had respiratory failure, which improved with High Flow Nasal Cannula in majority of the children.