Evolving Epidemiology of Pediatric Respiratory Syncytial Virus (RSV) Cases Around COVID-19 Pandemic: Impact and Clinical Insights, Retrospective Cohort Study.

BACKGROUND: The burden of respiratory syncytial virus (RSV) in high-risk pediatric patients remains unclear. Therefore, this study aims to characterize pediatric RSV cases from January 2019 to December 2022 and assess the impact of the COVID-19 pandemic on RSV burden and RSV-related outcomes. In addition, examining factors influencing RSV-related hospitalization. METHODS: This is a retrospective study that included pediatric patients (aged 14 and below) who presented at King Faisal Specialist Hospital and Research Centre (KFSHRC) in Riyadh, Saudi Arabia with RSV infection identified using real-time reverse-transcriptase polymerase chain reaction assays. Statistical analyses were performed using STATA. RESULTS: A total of 885 RSV cases were reported; (56.05%) were males and (43.95%) were females with a median age of 24 months [interquartile range (IQR): 11-60]. 534 (60.34%) required hospitalization. As for RSV seasonality, there was a significant increase in RSV prevalence following the COVID-19 pandemic, escalating from 205 cases in 2019 to 425 cases in 2022. The increase in 2022 was evident in January and persisted from September to December, reaching its peak during the months of October (20.70% - 88 cases) and November (32.00% - 136 cases). About (27.12%) of RSV infected children were medically free patients. Symptomatic patients exhibited various clinical manifestations, with ventilation necessary in (13.11%) of cases. Further analysis revealed significant changes in RSV-related outcomes post-COVID-19, including a decrease in hospitalization rates, an increase in medically free patients, and a lower need for ventilation (p < 0.05). Notably, a significant proportion of RSV admissions occurred within the first 6 months of life, with (77.69%) in the age group of 0 to 5 months. In addition, previous RSV infection, prematurity, low birth weight, renal disease, congenital heart disease, endocrine/metabolic disease, neuro/neuromuscular diseases, and genetic disorders were positively associated with hospitalization (P < 0.05). Interestingly, asthma and bone marrow transplantation were negatively associated with hospitalization (P < 0.05). The mortality rate in this study is (2.37%) (21/885). CONCLUSION: This study provides a comprehensive understanding of the demographic and clinical factors influencing RSV outcomes, highlighting the impact of the COVID-19 pandemic and shedding light on potential risk factors for RSV-related hospitalization. The highest prevalence of RSV during (September to January), aligning with global patterns and emphasizing the importance of timing in preventive strategies.

Neonatal Group B Streptococcal Infection in a Tertiary Care Hospital in Saudi Arabia: A 13-year Experience.

BACKGROUND: Group B streptococcus (GBS) is a leading cause of neonatal bacterial sepsis and meningitis globally. Studies concerning the incidence and burden of neonatal GBS disease in Saudi Arabia are lacking. This study determined the incidence and burden of GBS infection among neonates in association with maternal GBS screening. METHODS: A retrospective cohort chart review study included all neonatal GBS disease cases identified through microbiology lab records within the first 90 days of life in the hospital from January 2004 to December 2016. Charts were reviewed to collect maternal and neonatal characteristics using a standardized form. RESULTS: Over 13 years, of 108,609 live births, 55 GBS disease cases were identified (overall incidence, 0.51/1000 live births), 69.1% (n = 38) of those had early onset disease (EOD). The annual incidence in 2015 and 2016 was significantly higher than in any previous year (P < 0.0001), coinciding with the discontinuation of routine universal maternal GBS screening. Median age at presentation was 1 day (range, 0-54 days). We found that 67.3% (n = 37) of mothers were not screened antenatally, 72.9% (n = 27) of whom had neonates present with EOD. Neonates of unscreened mothers were more likely to have GBS disease (P = 0.01) and to present with EOD (P = 0.005). Urinary tract infection was the most common manifestation (47.3%, n = 26), followed by sepsis (43.6%, n = 24). Mortality rate was 3.6% (n = 2). CONCLUSIONS: The incidence of neonatal GBS infection in Saudi Arabia is similar to the worldwide incidence. Universal antenatal screening discontinuation was significantly associated with an increase in EOD incidence.

Prevalence of influenza vaccine hesitancy at a tertiary care hospital in Riyadh, Saudi Arabia.

BACKGROUND: Influenza vaccine hesitancy is a major problem worldwide, with significant public health consequences. We aimed to determine the prevalence of influenza vaccine hesitancy and the effect of vaccine awareness campaigns on vaccine acceptance among three groups (parents, adult patients, and healthcare workers [HCWs]) at King Abdulaziz Medical City, a tertiary care hospital in Riyadh, Saudi Arabia. METHODS: The study was conducted during the 2015-2016 winter season. Participants anonymously completed a validated questionnaire on influenza vaccine hesitancy. RESULTS: Of the 300 study participants, 17% (n=51) expressed vaccine hesitancy. The most common reasons given for vaccine refusal were: "It doesn't have any positive effect or benefit" (n=11 [21%]), "I don't need it because I'm healthy" (n=9 [17%]), and "I think it causes serious side effects" (n=7 [13%]). The most common sources of information about the vaccine were awareness campaigns (98/267 [36%]) and medical staff (98/267 [36%]). One hundred and sixty-three [54%] respondents knew that the effect of the influenza vaccine lasts up to 1year. There was no significant relationship between education level and receiving influenza vaccination. The study showed that confidence towards the Saudi Ministry of Health and medical doctors among three groups of participants was very high; 97% of adults, 95% of parents, and 93% of HCWs expressed trusted information provided to them by the Ministry of Health, and 97% of adults, 99% of parents, and 90% of HCWs trusted their physicians' information. CONCLUSION: Influenza vaccine hesitancy was low at KAMC. The most common reason for vaccine refusal was believing that it had no positive effect and that it is unnecessary. The most common sources of information for influenza vaccine were awareness campaigns and medical staff. Participants had high levels of trust in both the Saudi Ministry of Health and doctors.