Association between nirsevimab coverage and pediatric emergency department visits for bronchiolitis in 12 European countries: An interrupted time-series analysis
Abstract
Background: Nirsevimab was introduced to prevent Respiratory Syncytial Virus (RSV) bronchiolitis in infants. Despite its proven effectiveness and similar guidelines across Europe, bronchiolitis reduction varied across Europe. This study explored whether nirsevimab coverage among targeted populations (born in- and out-of-season) was associated to this variability. Methods and findings: We used routinely collected data from 27 pediatric emergency departments across 12 European countries (01/2018–03/2024). All bronchiolitis cases aged <12 months were included. Regions were classified as intervention or control based on nirsevimab implementation. Coverage was obtained from official regional reports. We estimated changes in monthly case using controlled interrupted time-series models accounting for seasonality and temporal trends, by age-groups (0–3 and 3–12 months) and regions during the intervention period (10/2023–03/2024) and examined their correlation to coverage using Pearson’s test. Urinary tract infections served as a control outcome. Conclusions: This multinational interrupted time-series analysis identified coverage as a key factor associated to bronchiolitis reduction across age-groups and European regions. Implementation choices across Europe likely influenced coverage, highlighting that nirsevimab benefits depend not only on its intrinsic efficacy, but also on how effectively it is delivered. Why was this study done?: What did the researchers do and find?: What do these findings mean?: Using an interrupted time-series analysis, Léa Lenglart and colleagues explore whether heterogeneity in coverage in European countries of the RSV- targeting monoclonal antibody nirsevimab associates with differences in case counts of bronchiolitis in infants.
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BibTeX
@article{lenglart2026association,
title = {{Association between nirsevimab coverage and pediatric emergency department visits for bronchiolitis in 12 European countries: An interrupted time-series analysis}},
author = {Léa Lenglart and Luigi Titomanlio and Ilaria Alberti and Laura Almeida and Camille Aupiais and Esra Akyüz Özkan and Michael Barrett and Romain Basmaci and Ahmet Birbilen and Dorine Borensztajn and Catarina Braz Schönenberger and Silvia Bressan and Danilo Buonsenso and Teresa Campos and Susana Castanhinha and Antonio Chiaretti and Gemma Claret and Francesca de Zan and Sheena Durnin and Laszlo Fodor and Borja Gomez and Susanne Greber-Platzer and Romain Guedj and Alexander Huege and Fiona Leonard and Ian Maconochie and Robin Marlow and Gregorio Milani and Miguel Angel Molina Gutierrez and Anna Maria Musolino and Rianne Oostenbrink and Zanda Pucuka and Simon Rivière and Damian Roland and Malin Ryd Rinder and Maria Chiara Supino and Ozlem Teksam and Victoria Trenchs and Zaba Valtuille and Bento Vanda and Sanne Vrijlandt and Naim Ouldali and Ruud G Nijman},
journal = {PLoS Medicine},
year = {2026},
month = sep,
doi = {10.1371/journal.pmed.1005223},
url = {https://hal.science/hal-05791852v1},
note = {CC BY 4.0},
}
RIS
TY - JOUR
TI - Association between nirsevimab coverage and pediatric emergency department visits for bronchiolitis in 12 European countries: An interrupted time-series analysis
AU - Léa Lenglart
AU - Luigi Titomanlio
AU - Ilaria Alberti
AU - Laura Almeida
AU - Camille Aupiais
AU - Esra Akyüz Özkan
AU - Michael Barrett
AU - Romain Basmaci
AU - Ahmet Birbilen
AU - Dorine Borensztajn
AU - Catarina Braz Schönenberger
AU - Silvia Bressan
AU - Danilo Buonsenso
AU - Teresa Campos
AU - Susana Castanhinha
AU - Antonio Chiaretti
AU - Gemma Claret
AU - Francesca de Zan
AU - Sheena Durnin
AU - Laszlo Fodor
AU - Borja Gomez
AU - Susanne Greber-Platzer
AU - Romain Guedj
AU - Alexander Huege
AU - Fiona Leonard
AU - Ian Maconochie
AU - Robin Marlow
AU - Gregorio Milani
AU - Miguel Angel Molina Gutierrez
AU - Anna Maria Musolino
AU - Rianne Oostenbrink
AU - Zanda Pucuka
AU - Simon Rivière
AU - Damian Roland
AU - Malin Ryd Rinder
AU - Maria Chiara Supino
AU - Ozlem Teksam
AU - Victoria Trenchs
AU - Zaba Valtuille
AU - Bento Vanda
AU - Sanne Vrijlandt
AU - Naim Ouldali
AU - Ruud G Nijman
PY - 2026
DA - 2026/09/03
JO - PLoS Medicine
DO - 10.1371/journal.pmed.1005223
UR - https://hal.science/hal-05791852v1
AB - Background: Nirsevimab was introduced to prevent Respiratory Syncytial Virus (RSV) bronchiolitis in infants. Despite its proven effectiveness and similar guidelines across Europe, bronchiolitis reduction varied across Europe. This study explored whether nirsevimab coverage among targeted populations (born in- and out-of-season) was associated to this variability. Methods and findings: We used routinely collected data from 27 pediatric emergency departments across 12 European countries (01/2018–03/2024). All bronchiolitis cases aged <12 months were included. Regions were classified as intervention or control based on nirsevimab implementation. Coverage was obtained from official regional reports. We estimated changes in monthly case using controlled interrupted time-series models accounting for seasonality and temporal trends, by age-groups (0–3 and 3–12 months) and regions during the intervention period (10/2023–03/2024) and examined their correlation to coverage using Pearson’s test. Urinary tract infections served as a control outcome. Conclusions: This multinational interrupted time-series analysis identified coverage as a key factor associated to bronchiolitis reduction across age-groups and European regions. Implementation choices across Europe likely influenced coverage, highlighting that nirsevimab benefits depend not only on its intrinsic efficacy, but also on how effectively it is delivered. Why was this study done?: What did the researchers do and find?: What do these findings mean?: Using an interrupted time-series analysis, Léa Lenglart and colleagues explore whether heterogeneity in coverage in European countries of the RSV- targeting monoclonal antibody nirsevimab associates with differences in case counts of bronchiolitis in infants.
SN - 1549-1277
SN - 1549-1676
ER -