{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,24]],"date-time":"2026-07-24T04:01:39Z","timestamp":1784865699029,"version":"3.55.0"},"reference-count":19,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2026,7,23]],"date-time":"2026-07-23T00:00:00Z","timestamp":1784764800000},"content-version":"vor","delay-in-days":203,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,1,1]],"date-time":"2026-01-01T00:00:00Z","timestamp":1767225600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Pediatrics International"],"published-print":{"date-parts":[[2026,1]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Since the onset of the coronavirus disease (COVID\u201019) pandemic, changes in the severity of respiratory syncytial virus (RSV) infection have been reported in Japan. However, few studies have compared the severity of RSV infection before and after the COVID\u201019 pandemic. This study aimed to compare the severity of RSV infection before and after the COVID\u201019 pandemic in two pediatric hospitals in Hanshin in Hyogo Prefecture, Japan.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This retrospective study included patients aged \u2264\u200915\u2009years hospitalized with RSV infection in Hyogo Prefectural Amagasaki General Medical Center and Hyogo Prefectural Kobe Children's Hospital between January 1, 2019, and July 31, 2023. Patient characteristics during the pre\u2010pandemic (January to December 2019), pandemic (January 2020 to December 2022), and post\u2010pandemic (January to July 2023) periods were compared.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      The pediatric intensive care unit (PICU) admission rate was significantly higher during the post\u2010pandemic period (26.1%) than during the pre\u2010pandemic period (13.6%) (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001). The proportion of patients who received any form of respiratory support (tracheal intubation, noninvasive positive\u2010pressure ventilation, or high\u2010flow nasal cannula) was significantly higher during the post\u2010pandemic period (26.9%) than during the pre\u2010pandemic period (16.1%) (unadjusted odds ratio: 1.92, 95% confidence interval: 1.23\u20133.04;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.005).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>In children hospitalized with RSV infection, the PICU admission rate and respiratory support requirements were significantly higher during the post\u2010pandemic period than during the pre\u2010pandemic and pandemic periods. Ongoing monitoring of clinical severity is needed to ensure effective prevention of RSV infection and optimal medical resource allocation.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/ped.70491","type":"journal-article","created":{"date-parts":[[2026,7,24]],"date-time":"2026-07-24T03:16:27Z","timestamp":1784862987000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Changes in Characteristics of Severe Respiratory Syncytial Virus Infections Before and After the\n                    <scp>COVID<\/scp>\n                    \u201019 Pandemic"],"prefix":"10.1111","volume":"68","author":[{"ORCID":"https:\/\/orcid.org\/0009-0004-7404-2139","authenticated-orcid":false,"given":"Kaori","family":"Fujimoto","sequence":"first","affiliation":[{"name":"Department of Pediatric Emergency and Critical Care Medicine Hyogo Prefectural Amagasaki General Medical Center  Hyogo Japan"},{"name":"Department of Pediatrics Hyogo Prefectural Amagasaki General Medical Center  Hyogo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9921-6842","authenticated-orcid":false,"given":"Koji","family":"Kanno","sequence":"additional","affiliation":[{"name":"Department of Pediatric Emergency and Critical Care Medicine Hyogo Prefectural Amagasaki General Medical Center  Hyogo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tomoya","family":"Hanada","sequence":"additional","affiliation":[{"name":"Department of Pediatric Emergency and Critical Care Medicine Hyogo Prefectural Amagasaki General Medical Center  Hyogo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chisato","family":"Miyakoshi","sequence":"additional","affiliation":[{"name":"Department of Research Support, Center for Clinical Research and Innovation Kobe City Medical Center General Hospital  Hyogo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yusuke","family":"Ito","sequence":"additional","affiliation":[{"name":"Department of Pediatric Emergency and Critical Care Medicine Hyogo Prefectural Amagasaki General Medical Center  Hyogo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hiroaki","family":"Urata","sequence":"additional","affiliation":[{"name":"Department of Pediatric Critical Care Medicine Hyogo Prefectural Kobe Children's Hospital  Hyogo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Masashi","family":"Kasai","sequence":"additional","affiliation":[{"name":"Department of Pediatrics Infectious Disease Hyogo Prefectural Kobe Children's Hospital  Hyogo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,7,23]]},"reference":[{"key":"e_1_2_10_2_1","doi-asserted-by":"crossref","first-page":"284","DOI":"10.1097\/01.inf.0000121203.33560.f9","article-title":"Risk of Severe Respiratory Syncytial Virus Disease, Identification of High Risk Infants and Recommendations for Prophylaxis With Palivizumab","volume":"23","author":"Meissner H. C.","year":"2004","journal-title":"Pediatric Infectious Disease Journal"},{"key":"e_1_2_10_3_1","unstructured":"National Institute of Infectious Diseases \u201cRespiratory Syncytial Virus Infection January 2014\u2013September 2018 \u201d(2024) https:\/\/www.niid.go.jp\/niid\/en\/iasren\/865\u2010iasr\/8491\u2010466te.html."},{"key":"e_1_2_10_4_1","doi-asserted-by":"crossref","first-page":"593","DOI":"10.1111\/j.1651-2227.2002.tb03282.x","article-title":"Population\u2010Based Rates of Severe Respiratory Syncytial Virus Infection in Children With and Without Risk Factors, and Outcome in a Tertiary Care Setting","volume":"91","author":"Eriksson M.","year":"2002","journal-title":"Acta Paediatrica"},{"key":"e_1_2_10_5_1","doi-asserted-by":"crossref","first-page":"865","DOI":"10.1067\/mpd.2000.110531","article-title":"Rates of Hospitalization for Respiratory Syncytial Virus Infection Among Children in Medicaid","volume":"137","author":"Boyce T. G.","year":"2000","journal-title":"Journal of Pediatrics"},{"key":"e_1_2_10_6_1","doi-asserted-by":"crossref","DOI":"10.3390\/pathogens12020154","article-title":"Prevention and Treatment Strategies for Respiratory Syncytial Virus (RSV)","volume":"12","author":"Gatt D.","year":"2023","journal-title":"Pathogens"},{"key":"e_1_2_10_7_1","doi-asserted-by":"crossref","first-page":"415","DOI":"10.1056\/NEJMoa1913556","article-title":"Single\u2010Dose Nirsevimab for Prevention of RSV in Preterm Infants","volume":"383","author":"Griffin M. P.","year":"2020","journal-title":"New England Journal of Medicine"},{"key":"e_1_2_10_8_1","article-title":"Palivizumab for Preventing Severe Respiratory Syncytial Virus (RSV) Infection in Children","volume":"11","author":"Garegnani L.","year":"2021","journal-title":"Cochrane Database of Systematic Reviews"},{"key":"e_1_2_10_9_1","doi-asserted-by":"crossref","first-page":"661","DOI":"10.2147\/IDR.S396434","article-title":"The Impact of the COVID\u201019 Pandemic on Respiratory Syncytial Virus Infection: A Narrative Review","volume":"16","author":"Chuang Y. 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A.","year":"2024","journal-title":"Clinical Infectious Diseases"},{"key":"e_1_2_10_15_1","doi-asserted-by":"crossref","first-page":"56","DOI":"10.1016\/S1473-3099(22)00525-4","article-title":"Epidemiology of Respiratory Syncytial Virus in Children Younger Than 5\u2009Years in England During the COVID\u201019 Pandemic, Measured by Laboratory, Clinical, and Syndromic Surveillance: A Retrospective Observational Study","volume":"23","author":"Bardsley M.","year":"2022","journal-title":"Lancet Infectious Diseases"},{"key":"e_1_2_10_16_1","doi-asserted-by":"crossref","DOI":"10.1016\/j.lana.2023.100582","article-title":"Respiratory Syncytial Virus Epidemiology and Clinical Severity Before and During the COVID\u201019 Pandemic in British Columbia, Canada: A Retrospective Observational Study","volume":"25","author":"Paramo M. V.","year":"2023","journal-title":"Lancet Regional Health Americas"},{"key":"e_1_2_10_17_1","doi-asserted-by":"crossref","first-page":"730","DOI":"10.1001\/jamapediatrics.2023.1088","article-title":"Shifting Epidemiology and Severity of Respiratory Syncytial Virus in Children During the COVID\u201019 Pandemic","volume":"177","author":"Rao S.","year":"2023","journal-title":"JAMA Pediatrics"},{"key":"e_1_2_10_18_1","doi-asserted-by":"crossref","first-page":"171","DOI":"10.1016\/S2352-4642(22)00371-6","article-title":"Hospital Admissions and Need for Mechanical Ventilation in Children With Respiratory Syncytial Virus Before and During the COVID\u201019 Pandemic: A Danish Nationwide Cohort Study","volume":"7","author":"Nygaard U.","year":"2023","journal-title":"Lancet Child & Adolescent Health"},{"issue":"11","key":"e_1_2_10_19_1","doi-asserted-by":"crossref","DOI":"10.1093\/ofid\/ofac562","article-title":"Impact of the Coronavirus Disease 2019 Pandemic on the Clinical Features of Pediatric Respiratory Syncytial Virus Infection in Japan","volume":"9","author":"Ozeki S.","year":"2022","journal-title":"Open Forum Infectious Diseases"},{"key":"e_1_2_10_20_1","doi-asserted-by":"crossref","first-page":"865","DOI":"10.3201\/eid2904.221834","article-title":"Genomic Characterization of Respiratory Syncytial Virus During 2022\u201323 Outbreak, Washington, USA","volume":"29","author":"Goya S.","year":"2023","journal-title":"Emerging Infectious Diseases"}],"container-title":["Pediatrics International"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/ped.70491","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1111\/ped.70491","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/ped.70491","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,7,24]],"date-time":"2026-07-24T03:16:37Z","timestamp":1784862997000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/ped.70491"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,1]]},"references-count":19,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2026,1]]}},"alternative-id":["10.1111\/ped.70491"],"URL":"https:\/\/doi.org\/10.1111\/ped.70491","archive":["Portico"],"relation":{},"ISSN":["1328-8067","1442-200X"],"issn-type":[{"value":"1328-8067","type":"print"},{"value":"1442-200X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,1]]},"assertion":[{"value":"2025-01-30","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-06-15","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-07-23","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e70491"}}