Predicting ICU Admission Risk in Children with Respiratory Syncytial Virus

Introduction: Respiratory syncytial virus (RSV) is a common infection in young children and a frequent cause of hospitalization. In some cases, RSV can lead to severe lower respiratory tract illness requiring admission to the intensive care unit (ICU). Here, we explore risk factors for RSV-related ICU admission in children. Methods: We conducted a retrospective study using Electronic Medical Record (EMR) data transformed into the Observational Medical Outcomes Partnership (OMOP) Common Data Model (CDM) from three tertiary care centers in Korea between 2008 and 2022. We identified 1529 children hospitalized with RSV according to the CDM and examined risk factors for ICU admission in this population. Results: Of 33,674 children aged 0–9 years who tested for RSV, 1529 (4.5%) were positive. The highest proportion of RSV-positive children were less than 10 months old. The ICU admission rate among RSV-positive children was 1.8% (29/1529), and the highest ICU admission rate occurred in children aged 0–5 months (4.4%). In a multivariable logistic regression model, we found that the odds of ICU admission were higher in younger age groups, with the highest odds of ICU admission occurring in children aged 0–5 months (aOR 10.39, 95% CI 2.33–46.29). We also found that gestational age less than 27 weeks was associated with a 71-fold increased odds of ICU admission (aOR 71.64, 95% CI 4.64–1106.50) and that extremely low birth weight was associated with a 31-fold increase in odds of ICU admission (aOR 31.16, 95% CI 2.35–414.00). Conclusions: We used the OMOP-CDM to identify risk factors for severe RSV infection requiring ICU admission in children. We found that young age, low gestational age, and low birth weight were associated with increased odds of ICU admission. Further research is needed to validate our findings and to examine other potential risk factors for severe RSV infection.