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Respiratory syncytial virus in infants ≤2 months in the post-COVID-19 pandemic era: shifting patterns and outcomes

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References

  1. Justice, N. A. & Le, J. K. Bronchiolitis. In StatPearls (StatPearls Publishing, Treasure Island (FL), 2025).

  2. Boccard, V. et al. Bronchiolitis: Increased severity in the post-COVID-19 era. Pediatr. Pulmonol. 59, 3197–3203 (2024).

    Article  PubMed  PubMed Central  Google Scholar 

  3. Cohen, R. et al. Pediatric Infectious Disease Group (GPIP) position paper on the immune debt of the COVID-19 pandemic in childhood, how can we fill the immunity gap? Infect. Dis. Now. 51, 418–423 (2021).

    Article  PubMed  PubMed Central  Google Scholar 

  4. Zhang, L. From imprecise “immune debt” to nuanced “immune shortage”? Infect. Dis. Now. 54, 104894 (2024).

    Article  PubMed  Google Scholar 

  5. Cohen, R. et al. Immune debt: Recrudescence of disease and confirmation of a contested concept. Infect. Dis. Now. 53, 104638 (2023).

    Article  PubMed  Google Scholar 

  6. WHO position paper on immunization to protect infants against respiratory syncytial virus disease, May 2025. https://www.who.int/publications/i/item/who-wer-10022-193-218.

  7. Hammitt, L. L. et al. Nirsevimab for prevention of RSV in healthy late-preterm and term infants. N. Engl. J. Med. 386, 837–846 (2022).

    Article  CAS  PubMed  Google Scholar 

  8. Drysdale, S. B. et al. Nirsevimab for prevention of hospitalizations due to RSV in infants. N. Engl. J. Med. 389, 2425–2435 (2023).

    Article  CAS  PubMed  Google Scholar 

  9. Vittucci, A. C., Antilici, L., Dotta, A., Cutrera, R. & Villani, A. Respiratory syncytial virus infection: new prevention strategies. Glob. Pediatr. 7, 100130 (2024).

    Article  Google Scholar 

  10. Ronchi, A. et al. Severity of respiratory syncytial virus through the COVID-19 pandemic among infants aged ≤2 months: a secondary analysis of the IRIDE cohort study. Pediatr. Res. https://doi.org/10.1038/s41390-025-04161-3 (2025).

  11. Cohen, P. R. et al. Trends in pediatric ambulatory community acquired infections before and during COVID-19 pandemic: A prospective multicentric surveillance study in France. Lancet Reg. Health - Eur. 22, 100497 (2022).

    Article  PubMed  PubMed Central  Google Scholar 

  12. Bardsley, M. et al. Epidemiology of respiratory syncytial virus in children younger than 5 years in England during the COVID-19 pandemic, measured by laboratory, clinical, and syndromic surveillance: a retrospective observational study. Lancet Infect. Dis. 23, 56–66 (2023).

    Article  PubMed  Google Scholar 

  13. Leija-Martínez, J. J., Esparza-Miranda, L. A., Rivera-Alfaro, G. & Noyola, D. E. Impact of nonpharmaceutical interventions during the COVID-19 pandemic on the prevalence of respiratory syncytial virus in hospitalized children with lower respiratory tract infections: a systematic review and meta-analysis. Viruses 16, 429 (2024).

    Article  PubMed  PubMed Central  Google Scholar 

  14. Williams, T. C. et al. Clinical impact of serious respiratory disease in children under the age of 2 years during the 2021–2022 Bronchiolitis Season in England, Scotland, and Ireland. J. Infect. Dis. 230, e111–e120 (2024).

    Article  CAS  PubMed  Google Scholar 

  15. Camporesi, A. et al. 2021/22 and 2022/23 Post-pandemic Bronchiolitis seasons in two major Italian cities: a prospective study. Children 10, 1081 (2023).

    Article  PubMed  PubMed Central  Google Scholar 

  16. Shi, T. et al. Risk factors for respiratory syncytial virus associated with acute lower respiratory infection in children under five years: Systematic review and meta–analysis. J. Glob. Health 5, 020416 (2015).

    Article  PubMed  PubMed Central  Google Scholar 

  17. Vartiainen, P. et al. Risk factors for severe respiratory syncytial virus infection during the first year of life: development and validation of a clinical prediction model. Lancet Digit. Health 5, e821–e830 (2023).

    Article  CAS  PubMed  Google Scholar 

  18. Milani, G. P. et al. Long-lasting effects of COVID-19 pandemic on hospitalizations and severity of bronchiolitis. Eur. J. Pediatr. 183, 1751–1758 (2024).

    Article  PubMed  PubMed Central  Google Scholar 

  19. Baldwin, J. R., Pingault, J.-B., Schoeler, T., Sallis, H. M. & Munafò, M. R. Protecting against researcher bias in secondary data analysis: challenges and potential solutions. Eur. J. Epidemiol. 37, 1–10 (2022).

    Article  PubMed  PubMed Central  Google Scholar 

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Karageorgos, S., Koutroulis, I. Respiratory syncytial virus in infants ≤2 months in the post-COVID-19 pandemic era: shifting patterns and outcomes. Pediatr Res (2025). https://doi.org/10.1038/s41390-025-04471-6

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