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Growing Number of Children Hospitalized with COVID-19, RSV

August 17, 2021 by Reece Nations

As a record number of children are being hospitalized with COVID-19, pediatric hospitals are reporting heightened outbreaks of respiratory syncytial virus which can be life-threatening to infants and young adults.

Usually, outbreaks of RSV hit their peak between December and February, according to Department of Health and Human Services data. However, pediatric hospitals are beginning to treat an increased number of children diagnosed with both COVID-19 and RSV.

The delta variant of COVID-19 has exhibited advanced transmissibility leading to a spike in hospitalizations among unvaccinated patients. Confirmed and suspected pediatric COVID-19 hospitalizations have risen in conjunction with the delta variant’s spread, leading to a pandemic record high of over 1,900 hospitalized child patients.

“As we enter a new school year amidst a rapidly spreading delta variant and lagging public vaccination rates, it is clear that the vaccination of those eligible is one of the most effective ways to keep schools safe, and they must be coupled with other proven mitigation strategies,” National Education Association President Becky Pringle said in a written statement.

Currently, children comprise around 2.4% of the country’s overall COVID-19 hospitalizations, according to Reuters. At Texas Children’s Hospital located in Houston, 25 of 45 hospitalized pediatric patients were diagnosed with both RSV and COVID-19, while even more tested positive for both viruses but were not admitted.

“Pediatricians play a vital role in caring for children and adolescents after they’ve been infected with COVID-19,” Dr. Sarah Risen, pediatric neurologist at Texas Children’s Hospital, said in a written statement. “A follow-up visit allows doctors to assess if there are any lingering or new symptoms or complications from the COVID-19 infection and gives pediatricians the chance to discuss the COVID-19 vaccination. Importantly, pediatricians are able to check for mental health and cognitive/learning issues and recommend the appropriate support for children returning to daily life as seamlessly as possible.”

Infants around the age of one month have been found to be at the greatest risk of RSV hospitalization, according to a study by the American Academy of Pediatrics. RSV is a leading cause of lower respiratory tract infection in young children worldwide and RSV infections result in an average of more than 57,000 hospitalizations and 2 million outpatient visits each year among children aged 5 years and younger in the United States.

Despite the virus’ prevalence, no vaccinations against RSV infection exist yet, according to the Centers for Disease Control and Prevention.

Although RSV infections were down nationwide last year, thousands of children are now being diagnosed with the virus ahead of the start of the school year. Pediatric experts believe the low number of RSV diagnoses last year was caused by mask mandates and quarantining.

Over 121,000 child COVID-19 cases were reported between Aug. 5 and Aug. 12 and children represented 18% of the weekly reported cases, according to data from the American Academy of Pediatrics. Although there is little data available on the effects of contracting both respiratory viruses in patients, health officials are concerned that young patients not yet eligible for the vaccine are at greater risk of complications.

“We also support regular COVID-19 testing in lieu of vaccination for those not yet vaccinated or those for whom vaccination is not medically appropriate or effective,” Pringle said in a written statement. “We believe that such vaccine requirements and accommodations are an appropriate, responsible, and necessary step to ensure the safety of our school communities and to protect our students.”

Although the recent RSV surge has been traced to southern states battling another wave of COVID-19, hospitals throughout the country are reporting cases at rates typically only seen in peak RSV season. Pediatric hospitals from Los Angeles to Raleigh, North Carolina, have reported substantial upticks in RSV hospitalizations.

Additionally, RSV infection poses significant risks not only to young children but older adults as well. Annually in the U.S. alone, RSV infections lead to roughly 14,000 deaths in adults age 65 and older, according to the CDC. 

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