Acute respiratory illness duration and quality of life by RSV status in healthy term infants
Abstract
Background: Respiratory syncytial virus (RSV) is a leading cause of acute respiratory tract infections (ARTIs) among young children. While the majority of RSV infections are managed in the community, existing evidence has largely focused on severe or hospitalised cases. We aimed to compare symptom duration and health-related quality of life (HRQoL), between RSV-positive (RSV+) and RSV-negative (RSV-) community ARTIs in healthy term infants.
Methods: Infants were enrolled in a prospective, multi-country cohort across the United Kingdom, Spain, Finland, and the Netherlands. Symptomatic infants were systematically tested for RSV. Caregivers recorded daily symptoms and HRQoL (EQ-VAS) for 14 consecutive days or until symptoms resolved. HRQoL and symptom duration were summarised by RSV status and healthcare resource use (no medical attendance [non-MA] vs ambulatory care [AMB]).
Results: We recruited 1041 infants at birth and identified 1353 ARTIs in 641 children during their first RSV season. RSV+ had longer mean symptom duration than RSV- in non-MA patients (12.2 vs 10.7 days [p < 0.01]), while in AMB patients, the difference was smaller and not significant (12.4 vs 11.9 days). During the first week, RSV+ showed higher proportions of pain/discomfort and worries/sad/unhappy and lower EQ-VAS scores across both AMB and non-MA episodes. Pain/discomfort peaked at day 4 in RSV + (49.5% non-MA; 80.4% AMB) versus day 3 (40.1%) in non-MA and day 5 (60.6%) in AMB for RSV-, while worries/sad/unhappy peaked at day 2 in RSV- (42.7% non-MA; 56.1% AMB) and later in RSV + (day 3: 59.2% non-MA; day 5: 74.7% AMB).
Conclusions: Mild to moderate RSV+ ARTI episodes in healthy term infants, managed in the community, were associated with prolonged symptom duration and measurable declines in HRQoL. These findings are vital to inform RSV prevention policy, as the burden of these non-severe disease episodes may outweigh that of more severe disease episodes, because of their more frequent occurrence.
Key messages: • RSV infection in early life should not be dismissed as a trivial “common cold”-like illness, but recognised as a cause of substantial short-term morbidity, even in otherwise healthy infants.
• Our results underscore the importance for continued attention to RSV prevention strategies in early life, particularly through effective immunisation.
Related
- Sleep Disturbances and Health-Related Quality of Life in Paediatric Oncology: A Comparative Study with Non-Oncological Chronic Illness and Healthy Peers.
- Clinical Relevance of Multiplex PCR for Respiratory Pathogens in Hospitalized Adults with Influenza-Like Illness
- Developing a multi-component immune model for evaluating the risk of respiratory illness in athletes
- Association Between Sleep Duration and Obesity Phenotypes in Apparently Healthy Korean Adults: A Cross-Sectional Study Using the Korea National Health and Nutrition Examination Survey 2013–2015
- Respiratory event duration reveals novel phenotypes beyond the apnea–hypopnea index in obstructive sleep apnea
BibTeX
@article{mao2026acute,
title = {{Acute respiratory illness duration and quality of life by RSV status in healthy term infants}},
author = {Z Mao and X Li and LJ Bont and P Beutels},
journal = {The European Journal of Public Health},
year = {2026},
month = oct,
doi = {10.1093/eurpub/ckag169.973},
url = {https://doi.org/10.1093/eurpub/ckag169.973},
note = {CC BY-NC 4.0},
}
RIS
TY - JOUR
TI - Acute respiratory illness duration and quality of life by RSV status in healthy term infants
AU - Z Mao
AU - X Li
AU - LJ Bont
AU - P Beutels
PY - 2026
DA - 2026/10/01
JO - The European Journal of Public Health
DO - 10.1093/eurpub/ckag169.973
UR - https://doi.org/10.1093/eurpub/ckag169.973
AB - Background: Respiratory syncytial virus (RSV) is a leading cause of acute respiratory tract infections (ARTIs) among young children. While the majority of RSV infections are managed in the community, existing evidence has largely focused on severe or hospitalised cases. We aimed to compare symptom duration and health-related quality of life (HRQoL), between RSV-positive (RSV+) and RSV-negative (RSV-) community ARTIs in healthy term infants. Methods: Infants were enrolled in a prospective, multi-country cohort across the United Kingdom, Spain, Finland, and the Netherlands. Symptomatic infants were systematically tested for RSV. Caregivers recorded daily symptoms and HRQoL (EQ-VAS) for 14 consecutive days or until symptoms resolved. HRQoL and symptom duration were summarised by RSV status and healthcare resource use (no medical attendance [non-MA] vs ambulatory care [AMB]). Results: We recruited 1041 infants at birth and identified 1353 ARTIs in 641 children during their first RSV season. RSV+ had longer mean symptom duration than RSV- in non-MA patients (12.2 vs 10.7 days [p < 0.01]), while in AMB patients, the difference was smaller and not significant (12.4 vs 11.9 days). During the first week, RSV+ showed higher proportions of pain/discomfort and worries/sad/unhappy and lower EQ-VAS scores across both AMB and non-MA episodes. Pain/discomfort peaked at day 4 in RSV + (49.5% non-MA; 80.4% AMB) versus day 3 (40.1%) in non-MA and day 5 (60.6%) in AMB for RSV-, while worries/sad/unhappy peaked at day 2 in RSV- (42.7% non-MA; 56.1% AMB) and later in RSV + (day 3: 59.2% non-MA; day 5: 74.7% AMB). Conclusions: Mild to moderate RSV+ ARTI episodes in healthy term infants, managed in the community, were associated with prolonged symptom duration and measurable declines in HRQoL. These findings are vital to inform RSV prevention policy, as the burden of these non-severe disease episodes may outweigh that of more severe disease episodes, because of their more frequent occurrence. Key messages: • RSV infection in early life should not be dismissed as a trivial “common cold”-like illness, but recognised as a cause of substantial short-term morbidity, even in otherwise healthy infants. • Our results underscore the importance for continued attention to RSV prevention strategies in early life, particularly through effective immunisation.
SN - 1101-1262
SN - 1464-360X
ER -