RSV poses greater risk of hospitalization for children than flu or COVID-19, Qatar study finds

Researchers at Weill Cornell Medicine-Qatar (WCM-Q) and Sidra Medicine, in collaboration with the Ministry of Public Health and Hamad Medical Corporation, have found that respiratory syncytial virus (RSV) was associated with substantially more severe illness than influenza or COVID-19 among children in Qatar. The findings underscore the importance of strengthening preventive strategies, including increasing vaccination uptake and expanding access to long-acting monoclonal antibodies against RSV, to reduce the burden of severe respiratory illness among children.

Published in the prestigious journal The Lancet Regional Health – Eastern Mediterranean, the study analyzed a large, systematically collected dataset comprising 4,360 respiratory illness episodes among 3,932 children younger than 18 years who attended Sidra Medicine’s emergency department between January 2022 and December 2025. Sidra Medicine serves as Qatar’s national referral center for specialized pediatric care. The study encompassed the entire pediatric age spectrum, from infancy through adolescence, and assessed disease severity based on hospitalization and intensive care unit admission.

The study is the first from the Eastern Mediterranean Region to directly compare the severity of RSV, influenza, and COVID-19 across the full pediatric age spectrum, from infancy through adolescence. By examining all three viruses over four years of concurrent circulation within a single national pediatric referral setting, the study addresses important limitations of previous research worldwide, which has often been restricted to comparisons between two viruses, specific age groups, or different periods of viral circulation. These findings make an important contribution to the international evidence base while providing much-needed regional evidence to inform clinical care, public health strategies, and immunization policies.

The study found that RSV was associated with substantially more severe illness than either influenza or COVID-19, while the latter two infections showed broadly similar severity. Influenza accounted for 65% of the illness episodes studied, followed by COVID-19 at 22% and RSV at just 13%. Despite its smaller share of illnesses, hospital admission was approximately four times as common with RSV as with either of the other infections, and intensive care admission was more than three times as common. This pattern remained after accounting for differences in patient characteristics and was consistent across age groups, although RSV predominantly affected younger children.

Dr. Andres Perez-Lopez, chief of the microbiology division at Sidra Medicine, who co-led the study and oversaw its microbiological and clinical components, said: “One of the most striking findings was how strongly a child’s underlying health influenced the severity of respiratory infections. Children with pre-existing medical conditions had nearly seven times greater chances of hospitalization and twelve times greater chances of requiring intensive care compared with children without these conditions. These findings highlight the importance of identifying vulnerable children early and ensuring they receive appropriate monitoring, preventive care, and medical care.”

Dr. Hiam Chemaitelly, assistant professor of research in population health sciences at WCM-Q, who designed and co-led the study and oversaw its epidemiological component, said: “It was striking to see how frequently RSV led to hospitalization and how much could be gained through prevention. Fortunately, effective interventions are now available, including RSV vaccination during pregnancy to protect newborns and long-acting monoclonal antibodies that protect infants during their most vulnerable early months. Increasing uptake of these interventions, supported by conversations with families during routine pregnancy care, could help prevent severe illness and avoidable hospitalizations. Equally important is improving influenza and COVID-19 vaccination uptake among children, as these infections can also cause serious illness. Raising awareness among families and encouraging the use of these preventive measures are essential to protecting children’s health.”

The study, titled “Relative severity of severe acute respiratory syndrome coronavirus 2, influenza, and respiratory syncytial virus among pediatric emergency department attendees in Qatar: a retrospective cohort study,” was supported by the Qatar Research, Development and Innovation Council through grant ARG02-0402-240119. Collaborators included Qatar’s Ministry of Public Health, and Hamad Medical Corporation.