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Journal Article Multicenter Study Comparative Study Ppublish 4 citations

PubMed: 41657023 DOI: 10.1002/ppul.71500

The Impact of Nirsevimab on Bronchiolitis-Related Hospitalizations: A Multicenter Italian Retrospective Comparative Study.

Pediatr Pulmonol 61(2):e71500

Authors: Sergio Ghirardo, Barbara Madini, Nicola Ullmann, Alessandro Zago, Michele Ghezzi, Enza D'Auria, Marta Minute, Stefano Martelossi, Anna Chiara Vittucci, Sebastian Cristaldi, Sara Procoli, Francesca Castelletti, Vincenzo Guaia, Alessia Rocchi, Beatrice Andrenacci, Francesco Maria Risso, Andrea Trombetta, Luca Barchi, Simone Foti Randazzese, Sara Manti, Eloisa Gitto, Virginia Mirra, Paolo Siani, S Salvatore Aversa, Alessandro De Fanti, Maria Francesca Patria, Alessandro Amaddeo, Egidio Barbi, Renato Cutrera

Affiliations

  • Department of Medicine, Surgery and Health Sciences, University of Trieste, Trieste, Italy.
  • Institute for Maternal and Child Health IRCCS "Burlo Garofolo", Trieste, Italy.
  • Fondazione IRCCS Cà Granda Ospedale Maggiore Policlinico, S.C. Pediatria Pneumoinfettivologia, Milan, Italy.
  • Respiratory and Cystic Fibrosis Unit, Academic Pediatric Department, Bambino Gesù Children Hospital, IRCCS, Rome, Italy.
  • Department of Pediatrics, Buzzi Children's Hospital, Milan, Italy.
  • Department of Biomedical and Clinical Sciences, University of Milan, Milan, Italy.
  • Unit of Pediatrics, Ospedale Regionale Ca Foncello Treviso, Treviso, Italy.
  • Pediatric Unit, Pediatric Emergency Department, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy.
  • Neonatal Intensive Care Unit, Children's Hospital, ASST Spedali Civili, Brescia, Italy.
  • Pediatric Unit, Azienda USL-IRCCS di Reggio Emilia, Reggio Emilia, Italy.
  • Pediatric Unit, Department of Human Pathology in Adult and Developmental Age "Gaetano Barresi", University of Messina, Messina, Italy.
  • Neonatal and Pediatric Intensive Care Unit, Department of Human Pathology in Adult and Developmental Age "Gaetano Barresi", University of Messina, Messina, Italy.
  • Pediatric Unit, Department of Chronic and Multifactorial Diseases, AORN Santobono-Pausilipon, Naples, Italy.

Abstract

INTRODUCTION

Bronchiolitis is the leading cause of infant hospitalizations worldwide, primarily driven by respiratory syncytial virus (RSV).

METHODS

This multicenter retrospective comparative study assessed the impact of immunoprophylaxis with nirsevimab against RSV on bronchiolitis-related hospitalizations in Italy during the 2024-2025 winter season.

RESULTS

Data from nine Italian hospitals showed a substantial 48% decrease in bronchiolitis admissions compared to the previous season (438 vs. 832 admissions). Among hospitalized infants, only 23% had received immunoprophylaxis. RSV positivity dropped significantly among immunized patients (48%) versus non-immunized (73%, p < 0.0001), with fewer RSV-related coinfections.

DISCUSSION

While indicators of illness severity-such as ICU admission, respiratory support needs, and complications-were generally lower, no statistically significant differences in disease course were observed between immunized and non-immunized hospitalized infants. A shift in viral epidemiology was noted, with a reduction in RSV dominance and increased detection of rhinovirus and enterovirus, suggesting a pathogen replacement effect. The 2024-2025 season also saw a lower intubation rate (< 0.5%), pointing to an overall milder disease course.

CONCLUSIONS

This study supports the effectiveness of nirsevimab in reducing RSV-associated hospitalizations and reshaping the virological landscape of bronchiolitis in Italy. Early and widespread implementation of immunoprophylaxis is recommended to maximize public health benefits.

MeSH

Respiratory Syncytial Viruses, Hospitalization, Respiratory System, Viruses, Pediatrics, Bronchiolitis, Infant