Is respiratory syncytial virus infection more dangerous than COVID 19 in the neonatal period?

J Matern Fetal Neonatal Med. 2022 Nov;35(22):4398-4403. doi: 10.1080/14767058.2020.1849125. Epub 2020 Nov 22.


Objective: We aimed to compare the clinical features, laboratory findings and primary outcomes of the neonates with RSV and neonates with SARS-CoV-2 infections.

Materials and methods: This nested case-control study included the neonates who were administered in the neonatal intensive care unit (NICU) of the University of Health Sciences, Dr Behçet Uz Children's Hospital during the period of 01 March-30 April 2020. Respiratory PCR samples and COVID-19 samples were taken simultaneously. Only RSV positive and COVID-19 positive infants were compared. Demographic, epidemiological and clinical data were obtained from hospital electronic information system medical records. The chest radiographs at the admission were evaluated by using standard definitions for normal chest X-ray, atelectasis, bronchopenumonia, peribronchial thickening and hyperinflation in various lung volumes.

Results: A total of 30 infants were enrolled in the study and RSV was identified in 20/30 infants (66%). No significant differences were observed between the two groups in terms of general characteristics. Comparing to the infants with Covid-19 infections, infants with RSV infections had significantly higher rates of having oxygen support (p = .03). Total NICU duration time was 6.7 ± 1.6 days in COVID positive group and 11.1 ± 5.1 days in the RSV group (p = .01). Infants with COVID-19 had more normal chest X-rays. Infants with RSV-positive had a significantly higher proportion of atelectasis than those with COVID-19 infants (p = .04).

Discussion: This is the first study that compares RSV infection and COVID-19 infection. RSV infection can be more serious in the neonatal period. In cases with suspected COVID-19 infection, it should be kept in mind if atelectasis is seen on chest radiography. Respiratory failure may be more serious in RSV positive infants and RSV infection may be more dangerous for the neonatal period.

Keywords: COVID-19 infection; chest X-ray; neonate; respiratory syncytial virus.

MeSH terms

  • COVID-19* / complications
  • Case-Control Studies
  • Child
  • Hospitalization
  • Humans
  • Infant
  • Infant, Newborn
  • Pulmonary Atelectasis* / diagnostic imaging
  • Pulmonary Atelectasis* / epidemiology
  • Respiratory Syncytial Virus Infections* / complications
  • Respiratory Syncytial Virus Infections* / epidemiology
  • SARS-CoV-2