Comparison of COVID-19 and RSV Infection Courses in Infants and Children under 36 Months Hospitalized in Paediatric Department in Fall and Winter Season 2021/2022

Background: The study aimed to determine the differences between COVID-19 and Respiratory syncytial virus (RSV) infections in young children hospitalized in the pediatric department.

Methods: This retrospective study included 52 children with COVID-19 and 43 children with RSV infection younger than 36 months hospitalized in a pediatric department between September 2021 and March 2022. Clinical and laboratory findings, methods of treatment and hospitalization length were compared.

Results: In the RSV group, significantly higher rates of cough (93.2% vs. 38.5%), rhinitis (83.7% vs. 50%), dyspnea (83.7% vs. 21.1%), crackles (69.8% vs. 5.8%) and wheezes (72.1% vs. 9.6%) were observed. The COVID-19 group had significantly higher rates of fever (80.8% vs. 37.2%) and seizures (13.5% vs. 0%). Patients with RSV infection had significantly higher rates of bronchodilator therapy (88.37% vs. 5.77%) and oxygen therapy (48.8% vs. 7.7%) and required a longer hospital stay (8 vs. 3 days). In admission, the majority of the patients from both groups were not treated with antibiotics, but because of clinical deterioration and suspected bacterial co-infections, antibiotics were administered significantly more frequently in the RSV group (30.2% vs. 9.6%).

Conclusions: RSV infection in infants and small children had a more severe course than COVID-19 infection. RSV infection was associated with a longer hospitalization period and required more elaborate treatment.