Real-world impact of nirsevimab immunisation against respiratory disease on emergency department attendances and admissions among infants: a multinational retrospective analysis

IF 13 Q1 HEALTH CARE SCIENCES & SERVICES

Lancet Regional Health-Europe Pub Date : 2025-08-01 DOI:10.1016/j.lanepe.2025.101334

Aida Perramon-Malavez , Danilo Buonsenso , Rosa Morello , Ermengol Coma , Steve Foster , Paul Leonard , Robin Marlow , Montserrat Martínez-Marcos , Jacobo Mendioroz , Jorgina Vila , Anna Creus-Costa , Clara Prats , Damian Roland , Thomas C. Williams , Antoni Soriano-Arandes

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引用次数: 0

Abstract

Background

Nirsevimab, a novel monoclonal antibody with a long half-life, has received European Union approval to prevent lower respiratory tract infections (LRTIs) caused by respiratory syncytial virus (RSV) during the first season of exposure. It was implemented in Catalonia (Spain) in the 2023–2024 season. Our main objective was to analyse the impact of the nirsevimab on LRTIs presenting to the Emergency Department (ED) in Catalonia (Spain) by comparing presentations to those at five sites in the United Kingdom (UK) and Rome (Italy).

Methods

In this multi-national retrospective analysis of emergency department attendances and admissions, we retrospectively collected information for all diagnoses, respiratory diagnoses excluding bronchiolitis, and bronchiolitis, for different age groups from 68 hospitals in Catalonia (Spain), one hospital in Rome (Italy), and four hospitals in the UK (Bristol, Leicester, Glasgow, and Edinburgh), from May 1st, 2018, to April 30th 2024. Applying a generalised linear model (GLM) in Poisson regression, we obtained the risk ratio (RR) and 95% confidence intervals (CI) of bronchiolitis in 2023–2024 season compared to the mean of all previous seasons. We analysed data in annual bins, from May 1st to April 30th, excluding 2020–21 as a COVID year, for a total of 5 years of data.

Findings

Data was available for 1,574,392 ED attendances (96,028 for bronchiolitis) and 255,689 hospital admissions (27,691 for bronchiolitis). In the 2023–2024 season, in Catalonia there was a reduction in the RR for bronchiolitis hospital admissions in the youngest infants aged <6 months (0.52, 95% CI: 0.48–0.55). There was also a reduction in Catalonia in the RR for hospital attendances for bronchiolitis in nirsevimab eligible age groups (0–11 months), with a RR of 0.56 (95% CI: 0.54–0.58) for infants <6 m and 0.93 (95% CI: 0.89–0.97) for infants 6–11 m. None of the other sites or age groups showed a significant reduction in the RR for attendances or admissions for the 2023–2024 season compared to previous years.

Interpretation

Nirsevimab had a clear impact in reducing attendances and admissions for infants with bronchiolitis aged <6 months in Catalonia. However, the impact on older infants was less clear.

Funding

None.

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接种尼西维单抗预防呼吸道疾病对婴儿急诊室就诊和入院的实际影响：一项跨国回顾性分析

nirsevimab是一种具有长半衰期的新型单克隆抗体，已获得欧盟批准，用于预防呼吸道合胞病毒（RSV）在第一季暴露期间引起的下呼吸道感染（LRTIs）。它在2023-2024赛季在加泰罗尼亚（西班牙）实施。我们的主要目标是通过与英国（英国）和罗马（意大利）五个地点的报告进行比较，分析nirsevimab对加泰罗尼亚（西班牙）急诊科（ED）的lrti的影响。方法在这项对急诊科就诊人数和入院人数的多国回顾性分析中，我们回顾性收集了2018年5月1日至2024年4月30日期间加泰罗尼亚（西班牙）68家医院、罗马（意大利）1家医院和英国（布里斯托尔、莱斯特、格拉斯哥和爱丁堡）4家医院不同年龄组的所有诊断信息，呼吸道诊断不包括毛细支气管炎和毛细支气管炎。应用泊松回归中的广义线性模型（GLM），我们获得了2023-2024赛季毛细支气管炎的风险比（RR）和95%置信区间（CI），与之前所有赛季的平均值相比。我们分析了每年5月1日至4月30日的数据，不包括2020-21年作为COVID年的数据，共5年的数据。研究结果：1,574,392例急诊科就诊（96,028例为细支气管炎）和255,689例住院（27,691例为细支气管炎）。在2023-2024赛季，在加泰罗尼亚，6个月以下最小婴儿毛细支气管炎住院的RR降低（0.52,95% CI: 0.48-0.55）。在加泰罗尼亚，尼塞维单抗适用年龄组（0-11个月）毛细支气管炎住院的RR也有所降低，6米婴儿的RR为0.56 (95% CI: 0.54-0.58)， 6 - 11米婴儿的RR为0.93 （95% CI: 0.89-0.97）。与前几年相比，其他地点或年龄组的2023-2024赛季的上座率或入场率都没有明显下降。解释：在加泰罗尼亚，nirsevimab在减少6个月大的毛细支气管炎婴儿的出诊率和入院率方面有明显的影响。然而，对年龄较大的婴儿的影响就不那么明显了。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Lancet Regional Health-Europe Multiple-

CiteScore

19.90

自引率

1.40%

发文量

260

审稿时长

9 weeks

期刊介绍： The Lancet Regional Health – Europe, a gold open access journal, is part of The Lancet's global effort to promote healthcare quality and accessibility worldwide. It focuses on advancing clinical practice and health policy in the European region to enhance health outcomes. The journal publishes high-quality original research advocating changes in clinical practice and health policy. It also includes reviews, commentaries, and opinion pieces on regional health topics, such as infection and disease prevention, healthy aging, and reducing health disparities.