{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,16]],"date-time":"2026-09-16T16:02:45Z","timestamp":1789574565311,"version":"build-2803163510"},"reference-count":44,"publisher":"American Medical Association (AMA)","issue":"9","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JAMA Netw Open"],"abstract":"\n Importance<\/jats:title>\n Data defining respiratory syncytial virus (RSV)\u2013associated critical illness, risk factors, and outcomes among older children and adolescents are limited. As RSV prevention options expand, improved characterization of RSV-associated disease burden across childhood is needed.<\/jats:p>\n <\/jats:sec>\n \n Objectives<\/jats:title>\n To quantify RSV-associated intensive care unit (ICU) admissions and mortality among children aged 2 to 17 years and evaluate associations between pediatric complex chronic conditions (CCCs) and mortality.<\/jats:p>\n <\/jats:sec>\n \n Design, Setting, and Participants<\/jats:title>\n This retrospective, multicenter cohort study was performed from January 1, 2017, to June 1, 2023, among children aged 2 to 17 years admitted to ICUs. Data were analyzed from January to March 2026.<\/jats:p>\n <\/jats:sec>\n \n Exposure<\/jats:title>\n RSV identified by laboratory testing or diagnosis codes.<\/jats:p>\n <\/jats:sec>\n \n Main Outcomes and Measures<\/jats:title>\n Primary outcome was hospital mortality. Bivariate associations between mortality and covariates were calculated, and multivariable logistic regression was used to identify variables associated with mortality.<\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n This study included 6430 RSV-associated ICU admissions for children aged 2 to 17 years (8.3% of 77\u202f395 ICU admissions; median [IQR] age, 6.6 [3.4-12.6] years; 3457 [53.8%] male). The median (IQR) ICU length of stay was 2.9 (1.5-6.8) days, and the median (IQR) hospital LOS was 5.9 (3.0-14.3) days. Positive pressure ventilation was used in 2061 admissions (32.0%), vasoactive agents in 1788 (27.8%), and both in 903 (14.0%). Hospital mortality occurred in 484 admissions (7.5%) and accounted for 484 of 735 RSV-associated deaths (65.9%) across all ages. At least 1 CCC category was present in 3680 admissions (57.2%) and 454 of 484 deaths (93.8%); 3 or more CCC categories were present in 1666 admissions (25.9%) and 332 of 484 deaths (68.6%). Higher CCC burden was associated with mortality, particularly with 3 or more CCCs (mortality odds ratio [MOR 22.56; 95% CI, 15.44-32.97). CCC burden was associated with older age but remained associated with mortality across age strata. In adjusted analyses, malignant neoplasm (adjusted MOR ([aAMOR), 4.27 [95% CI, 3.16-5.77]), neurologic or neuromuscular (aAMOR, 2.66 [95% CI, 2.08-3.39]), respiratory (aAMOR, 2.36 [95% CI, 1.83-3.03]), transplant (aAMOR, 2.18 [95% CI, 1.47-3.23]), congenital or genetic, metabolic, and cardiovascular disease as well as technology dependence remained associated with mortality.<\/jats:p>\n <\/jats:sec>\n \n Conclusions and Relevance<\/jats:title>\n In this cohort study of 6430 RSV-associated ICU admissions among children aged 2 to 17 years, older children and adolescents represented a substantial proportion of severe RSV-associated disease and mortality; deaths were concentrated among children with CCCs. These results suggest that high-risk pediatric subpopulations may benefit from RSV prevention.<\/jats:p>\n <\/jats:sec>","DOI":"10.1001\/jamanetworkopen.2026.34138","type":"journal-article","created":{"date-parts":[[2026,9,16]],"date-time":"2026-09-16T15:03:40Z","timestamp":1789571020000},"page":"e2634138","source":"Crossref","is-referenced-by-count":0,"title":["Respiratory Syncytial Virus\u2013Associated Disease in Children Receiving Intensive Care"],"prefix":"10.1001","volume":"9","author":[{"given":"Taylor L.","family":"Olson","sequence":"first","affiliation":[{"name":"Division of Critical Care Medicine, Children\u2019s National Hospital, Washington, DC"},{"name":"Department of Pediatrics, George Washington University School of Medicine and Health Sciences, Washington, DC"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eduardo A.","family":"Trujillo Rivera","sequence":"additional","affiliation":[{"name":"Division of Critical Care Medicine, Children\u2019s National 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