PP-064 Infant rhinovirus infection: contribution to hospital bed and ventilation use

AimBronchiolitis is the main cause of infant hospitalization and ventilation worldwide. The respiratory syncytial virus (RSV), is extensively explored while human Rhinovirus (hRV) is less documented. Monoclonal antibodies, and maternal vaccination are promising regarding RSV-control, and reduction of RSV-hospitalizations, but their impact on global burden of bronchiolitis remains questionable. We compared the use of hospital resources related to hRV- and RSV-infections before nirsevimab implementation.Material and MethodWe analyzed a 3-year-historical cohort of infants hospitalized with lab-confirmed infections. Outcomes were expressed as hRV/RSV-burden percentages. RSV-hRV co-infections were equally 0.5-weighted.ResultsFrom 07/01/2019 to 06/30/2022, the hRV-admission rate was 68% (766/1122) of that for RSV. hRV/RSV days of hospitalization was 51% (3608/7017 infant-days), and for days of ventilation was 25% (392/1426 infant-days). Accounting for both viruses, more than 50% of the emergency bed capacity was used during 47 (2019–20), 9 (2020–21), and 80 (2021–22) days. Similarly, more than 100% of the emergency bed capacity was used during 20 (2019–20), 0 (2020–21) and 9 (2021–22) days.ConclusionsFor the first time, we showed that the magnitude of hRV burden was up to two-thirds of RSV-related hospital admissions, half of RSV-related days of hospitalization, and a quarter of RSV-related days of ventilation. As infant Rhinovirus infections is a major contributor for hospital bed and ventilation use, the promised 86.5% individual efficacy of nirsevimab will not translate to an 86.5% reduction in bronchiolitis burden. Protecting hospital and non-hospital pediatric settings from the devastating effects of multi-pathogen winter epidemics still calls for developing home care strategies (enteral nutrition, oxygen-therapy) under precise situations to guaranty safety of infants and attempts to control the flow of infants when pediatric settings are overcrowded. Including hRV in the development of multipathogen vaccines may also be protective in the future. Until then, adherence to universal preventive hygiene measures remains critical.