Children under two years of age hospitalized for COVID-19 are more likely to die or become seriously ill than babies with respiratory syncytial virus (RSV), according to a study published this week in Open Forum Infectious Diseases.
Babies can become sick and die from both respiratory viruses, even if they were healthy before becoming infected, according to the study, which was led by researchers from the US Centers for Disease Control and Prevention.
2.9% death rate for COVID, 0.4% for RSV
In the study, 39% of babies admitted to an intensive care unit (ICU) because of COVID-19 needed to be put on a ventilator to breathe, compared with 16% of babies with RSV. Children hospitalized for COVID-19 also stayed in the hospital longer than those with RSV in the study, which included 33 hospitals in 28 states and was conducted from November 2023 to March 2024.
In addition, babies hospitalized for COVID-19 were more likely than babies with RSV to receive vasoactive infusions—drugs given intravenously to manage blood pressure, heart rate, and cardiac output by widening or constricting blood vessels. They were also more likely to need extracorporeal membrane oxygenation, a temporary mechanical breathing and heart support used when standard treatments for those problems have already been tried.
In the study, 2.9% of children with COVID-19 died, along with 0.4% of those with RSV. The 1,406 babies in the study arrived at the hospital with acute respiratory failure, a medical emergency in which the lungs cannot provide enough oxygen or remove carbon dioxide. All were hospitalized in the ICU for at least 24 hours. More than 89% of the babies had RSV, 7.5% had COVID-19, and 3.4% were infected with both viruses.
Children hospitalized for RSV or both viruses were younger than those hospitalized with COVID-19. Twenty percent of babies with RSV had an underlying medical condition, compared with 44% of those with COVID-19.
Medical societies recommend vaccination
Although RSV immunizations were approved in 2023, they were not yet widely available during the study. Only 5.5% of babies age six to 23 months were vaccinated against COVID-19 in the study.
Research shows that vaccinations for both RSV and COVID-19 are safe and effective. The American College of Obstetricians and Gynecologists recommends women receive a COVID-19 vaccine at any time during pregnancy and an RSV vaccine between the 32nd and 36th week of pregnancy. Both vaccines can protect newborns too young to be vaccinated.
For babies whose mothers weren’t vaccinated against RSV, the American Academy of Pediatrics recommends newborns under 8 months receive an injection of lab-grown antibodies. The pediatric group also recommends babies age six to 23 months be vaccinated against COVID-19.
