RSV is the main cause of severe respiratory infections in infants and young children in Germany - data from the prospective, multicenter PAPI study 2021–2023

• DOI: 10.1007/s15010-025-02484-1
• Publication Date: 2025-02-19T19:36:39Z
• Authors: Martin Wetzke; Matthias Lange; Cordula Koerner-R...; Alexander Kiefer; Michael Kabesch; Sven Armbrust; Kerim Abdelkhalek; Christiane Lex; Markus Hufnagel; Sebastian Bode; Michael Dördelmann; Michael Lorenz; Stefan Arens; Markus Panning; Holger Köster; Rolf Kramer; Mathieu Bangert; Frank Eberhardt; Grit Barten-Neiner; Christine Happle

Summary

Background Respiratory syncytial virus (RSV) is one of the main causes of morbidity in infants and young children worldwide. Current data on RSV-associated disease burden in Germany before the introduction of new immunization strategies is lacking.

Methods The PAPI study is a multicenter, prospective surveillance study of lower respiratory tract infections (LRTI) in children aged ≤ 24 months in Germany.

Results Data from 1607 children with LRTI hospitalized in twelve German hospitals between September 2021 and May 2023 were analyzed. Among these children, RSV was the most frequently detected pathogen (57.1%), followed by rhino/entero-, metapneumo- and parainfluenza virus. Children with RSV were significantly younger than those with LRTI of other causes (mean of 5.6 ± SD 6.1 vs. mean of 10.1 ± SD 7.3 months, p < 0.001) and more frequently affected in their first six months of life. RSV positive children were significantly more likely to develop hypoxemia (61.9% vs. 44.3%, p < 0.001) and need for intravenous or enteral fluid supplementation (48.1% vs. 43.1%, p = 0.009; 13.2% vs. 5.9%, p < 0.001) than those without RSV.

Conclusion RSV is the dominant pathogen for LRTI-associated hospitalizations in children ≤ 24 months in Germany and associated with a particularly high need for treatment. The ongoing implemented use of RSV immunization according to current recommendations could lead to significant reduction in early childhood morbidity in Germany.