The Impact of Nirsevimab on the Transport of Critically Ill Children.

Purpose: Respiratory syncytial virus-positive bronchiolitis continues to be the main diagnosis prompting transportation in children younger than one year of age. It represents approximately 15-20% of all services performed by a specialized pediatric transport team. In October 2023, an immunization p...

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Autores: Alejandre C, Pazos E, Gonzalez-Alvarez P, Girona-Alarcón M, Millán N, Rodriguez M, Covas A, Martinez Planas A, Esteban E
Tipo de recurso: artículo
Estado:Versión publicada
Fecha de publicación:2026
País:España
Institución:Fundació Sant Joan de Déu
Repositorio:r-FSJD. Repositorio Institucional de Producción Científica de la Fundació Sant Joan de Déu
OAI Identifier:oai:fsjd.fundanetsuite.com:p29992
Acceso en línea:https://fsjd.fundanetsuite.com/Publicaciones/ProdCientif/PublicacionFrw.aspx?id=29992
Access Level:acceso abierto
Palabra clave:bronchiolitis
monoclonal antibody
nirsevimab
transport
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spelling The Impact of Nirsevimab on the Transport of Critically Ill Children.Alejandre CPazos EGonzalez-Alvarez PGirona-Alarcón MMillán NRodriguez MCovas AMartinez Planas AEsteban Ebronchiolitismonoclonal antibodynirsevimabtransportPurpose: Respiratory syncytial virus-positive bronchiolitis continues to be the main diagnosis prompting transportation in children younger than one year of age. It represents approximately 15-20% of all services performed by a specialized pediatric transport team. In October 2023, an immunization program with nirsevimab, a monoclonal antibody against RSV, was started in Spain. The purpose of the present study is to describe how nirsevimab affects the rates of bronchiolitis managed by a pediatric team specialized in critical patient transport. Secondary objectives included describing and comparing the clinical aspects of the two cohorts-pre-nirsevimab (pre-n) and post-nirsevimab (post-n)-to quantify how immunization has modified the clinical phenotype of bronchiolitis. Methods: This is a descriptive and observational study. Patients with bronchiolitis transported by a specialized pediatric transport team between September 2021 and August 2025 were included. Demographic, clinical, and microbiological data were collected. The pre-n and post-n periods were compared. Results: From a total of 2347 interfacility transports conducted by the unit between 2021 and 2025, 463 (19.7%) involved bronchiolitis patients, all of whom were recruited: 307 in the pre-n period and 156 in the post-n. The median age was 2.5 months (IQR 1.3-5.7), and 55% were male. There was a significant decrease in bronchiolitis cases that required specialized transport between the two periods: 28.2% (307/1089) pre-n vs. 12.4% (156/1258) post-n (p < 0.001). RSV detection also declined (74.3% vs. 47.4%, p < 0.001), while other viruses increased significantly in the post-n period, including rhinovirus, metapneumovirus and bocavirus. Age at admission showed statistically significant differences across the two periods (2.2 vs. 3.4 months, p < 0.001). There were no differences in severity between the two periods in terms of respiratory and inotropic support and length of stay. No mortality was reported. Conclusions: Universal nirsevimab immunization was associated with a marked reduction in pediatric transports for bronchiolitis, particularly RSV-related cases, without modifying disease severity among those requiring transfer.MDPI2026info:eu-repo/semantics/articleinfo:eu-repo/semantics/publishedVersionhttps://fsjd.fundanetsuite.com/Publicaciones/ProdCientif/PublicacionFrw.aspx?id=29992Children-BaselISSN: 22279067reponame:r-FSJD. Repositorio Institucional de Producción Científica de la Fundació Sant Joan de Déuinstname:Fundació Sant Joan de DéuInglésinfo:eu-repo/semantics/openAccessoai:fsjd.fundanetsuite.com:p299922026-05-27T12:37:41Z
dc.title.none.fl_str_mv The Impact of Nirsevimab on the Transport of Critically Ill Children.
title The Impact of Nirsevimab on the Transport of Critically Ill Children.
spellingShingle The Impact of Nirsevimab on the Transport of Critically Ill Children.
Alejandre C
bronchiolitis
monoclonal antibody
nirsevimab
transport
title_short The Impact of Nirsevimab on the Transport of Critically Ill Children.
title_full The Impact of Nirsevimab on the Transport of Critically Ill Children.
title_fullStr The Impact of Nirsevimab on the Transport of Critically Ill Children.
title_full_unstemmed The Impact of Nirsevimab on the Transport of Critically Ill Children.
title_sort The Impact of Nirsevimab on the Transport of Critically Ill Children.
dc.creator.none.fl_str_mv Alejandre C
Pazos E
Gonzalez-Alvarez P
Girona-Alarcón M
Millán N
Rodriguez M
Covas A
Martinez Planas A
Esteban E
author Alejandre C
author_facet Alejandre C
Pazos E
Gonzalez-Alvarez P
Girona-Alarcón M
Millán N
Rodriguez M
Covas A
Martinez Planas A
Esteban E
author_role author
author2 Pazos E
Gonzalez-Alvarez P
Girona-Alarcón M
Millán N
Rodriguez M
Covas A
Martinez Planas A
Esteban E
author2_role author
author
author
author
author
author
author
author
dc.subject.none.fl_str_mv bronchiolitis
monoclonal antibody
nirsevimab
transport
topic bronchiolitis
monoclonal antibody
nirsevimab
transport
description Purpose: Respiratory syncytial virus-positive bronchiolitis continues to be the main diagnosis prompting transportation in children younger than one year of age. It represents approximately 15-20% of all services performed by a specialized pediatric transport team. In October 2023, an immunization program with nirsevimab, a monoclonal antibody against RSV, was started in Spain. The purpose of the present study is to describe how nirsevimab affects the rates of bronchiolitis managed by a pediatric team specialized in critical patient transport. Secondary objectives included describing and comparing the clinical aspects of the two cohorts-pre-nirsevimab (pre-n) and post-nirsevimab (post-n)-to quantify how immunization has modified the clinical phenotype of bronchiolitis. Methods: This is a descriptive and observational study. Patients with bronchiolitis transported by a specialized pediatric transport team between September 2021 and August 2025 were included. Demographic, clinical, and microbiological data were collected. The pre-n and post-n periods were compared. Results: From a total of 2347 interfacility transports conducted by the unit between 2021 and 2025, 463 (19.7%) involved bronchiolitis patients, all of whom were recruited: 307 in the pre-n period and 156 in the post-n. The median age was 2.5 months (IQR 1.3-5.7), and 55% were male. There was a significant decrease in bronchiolitis cases that required specialized transport between the two periods: 28.2% (307/1089) pre-n vs. 12.4% (156/1258) post-n (p < 0.001). RSV detection also declined (74.3% vs. 47.4%, p < 0.001), while other viruses increased significantly in the post-n period, including rhinovirus, metapneumovirus and bocavirus. Age at admission showed statistically significant differences across the two periods (2.2 vs. 3.4 months, p < 0.001). There were no differences in severity between the two periods in terms of respiratory and inotropic support and length of stay. No mortality was reported. Conclusions: Universal nirsevimab immunization was associated with a marked reduction in pediatric transports for bronchiolitis, particularly RSV-related cases, without modifying disease severity among those requiring transfer.
publishDate 2026
dc.date.none.fl_str_mv 2026
dc.type.none.fl_str_mv info:eu-repo/semantics/article
info:eu-repo/semantics/publishedVersion
format article
status_str publishedVersion
dc.identifier.none.fl_str_mv https://fsjd.fundanetsuite.com/Publicaciones/ProdCientif/PublicacionFrw.aspx?id=29992
url https://fsjd.fundanetsuite.com/Publicaciones/ProdCientif/PublicacionFrw.aspx?id=29992
dc.language.none.fl_str_mv Inglés
language_invalid_str_mv Inglés
dc.rights.none.fl_str_mv info:eu-repo/semantics/openAccess
eu_rights_str_mv openAccess
dc.publisher.none.fl_str_mv MDPI
publisher.none.fl_str_mv MDPI
dc.source.none.fl_str_mv Children-Basel
ISSN: 22279067
reponame:r-FSJD. Repositorio Institucional de Producción Científica de la Fundació Sant Joan de Déu
instname:Fundació Sant Joan de Déu
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collection r-FSJD. Repositorio Institucional de Producción Científica de la Fundació Sant Joan de Déu
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