INFECÇÃO POR VÍRUS SINCICIAL RESPIRATÓRIO NA SÍNDROME RESPIRATÓRIA AGUDA GRAVE NA POPULAÇÃO PEDIÁTRICA DE MATO GROSSO DO SUL ENTRE 2019 E 2023

Abstract

Lower respiratory infections, mainly caused by Respiratory Syncytial Virus, are one of the main causes of global mortality and pediatric hospitalizations. For this reason, the study aimed to describe the epidemiological scenario of Respiratory Syncytial Virus infections in cases of Severe Acute Respiratory Syndrome in children under 5 years of age in the state of Mato Grosso do Sul between 2019 and 2023. A descriptive, cross-sectional, retrospective and quantitative study was carried out. Secondary data from the Influenza Epidemiological Surveillance System, obtained between January 2019 and December 2023, covering the 79 municipalities of the state, were used. The following aspects were considered for case definition and data collection in the system: absolute numbers of hospitalizations and deaths due to Severe Acute Respiratory Syndrome caused by Respiratory Syncytial Virus with laboratory diagnosis by the RT-PCR methodology for the age group of children under 5 years old, living in Mato Grosso do Sul. The data obtained were tabulated in the R software version 4.4.0 and submitted to statistical analysis. The chi-square test was used to compare the frequency distribution of categorical variables. For numerical variables, the difference in means was verified with the Mann-Whitney test. A total of 2,060 cases of Severe Acute Respiratory Syndrome caused by Respiratory Syncytial Virus were recorded in children under five years old, resulting in a cumulative incidence of 9.4 cases per thousand children in this age group. Most cases (73.9%) occurred in children under one year of age. Of the total, 46 cases resulted in death, resulting in a fatality rate of 2.2%. In addition, 14.2% of hospitalizations resulted in admission to the Intensive Care Unit. The municipalities with the highest incidence, above 22 cases per thousand children, were located mainly in the northern and central parts of the state, especially Paraíso das Águas and São Gabriel do Oeste. Risk factors, such as heart disease, immunosuppression and Down syndrome, showed a significant association with death. The need for invasive ventilatory support was significantly associated with cases of prematurity, age, with a higher number of cases in children under one year old, heart disease and immunosuppression. There was a progressive increase in cases of Severe Acute Respiratory Syndrome due to Respiratory Syncytial Virus from 2021 onwards, especially during and after the COVID-19 pandemic. When analyzing the epidemiological characteristics of RSV infections in the pediatric population in Mato Grosso do Sul, it was possible to verify the predominance in children under one year of age and with comorbidities, mainly heart disease, immunosuppression, prematurity and Down syndrome, which were the most related to high rates of hospitalization, use of ventilatory support and death. These findings can support the formulation of preventive strategies in order to reduce the incidence and negative outcomes associated with RSV.

Keywords: Respiratory Syncytial Virus Infection; Child; Hospitalization; Mortality; Epidemiological Monitoring