Genetic diversity and its impact on disease severity in respiratory syncytial virus subtype-A and -B bronchiolitis before and after pandemic restrictions in Rome - 06/09/23
, R. Nenna b, 2 , M. Fracella a, 3 , C. Scagnolari a, 4 , G. Oliveto a, 5 , L. Sorrentino a, 6 , F. Frasca a, 7 , M.G. Conti b, 8 , L. Petrarca b, 9 , P. Papoff b, 10 , O. Turriziani a, 11 , G. Antonelli a, 12 , P. Stefanelli c, 13 , A.T. Palamara c, 14 , F. Midulla b, 15 Summary |
Objectives |
To scrutinize whether the high circulation of respiratory syncytial virus (RSV) observed in 2021–2022 and 2022–2023 was due to viral diversity, we characterized RSV-A and -B strains causing bronchiolitis in Rome, before and after the COVID-19 pandemic.
Methods |
RSV-positive samples, prospectively collected from infants hospitalized for bronchiolitis from 2017–2018 to 2022–2023, were sequenced in the G gene; phylogenetic results and amino acid substitutions were analyzed. Subtype-specific data were compared among seasons.
Results |
Predominance of RSV-A and -B alternated in the pre-pandemic seasons; RSV-A dominated in 2021–2022 whereas RSV-B was predominant in 2022–2023. RSV-A sequences were ON1 genotype but quite distant from the ancestor; two divergent clades included sequences from pre- and post-pandemic seasons. Nearly all RSV-B were BA10 genotype; a divergent clade included only strains from 2021–2022 to 2022–2023. RSV-A cases had lower need of O2 therapy and of intensive care during 2021–2022 with respect to all other seasons. RSV-B infected infants were more frequently admitted to intensive care units and needed O2 in 2022–2023.
Conclusions |
The intense RSV peak in 2021–2022, driven by RSV-A phylogenetically related to pre-pandemic strains is attributable to the immune debt created by pandemic restrictions. The RSV-B genetic divergence observed in post-pandemic strains may have increased the RSV-B specific immune debt, being a possible contributor to bronchiolitis severity in 2022–2023.
Le texte complet de cet article est disponible en PDF.Keywords : Respiratory syncytial virus, Genetic variability, Genotypes, Bronchiolitis severity, Post-pandemic strains
Plan
Vol 87 - N° 4
P. 305-314 - octobre 2023 Retour au numéro
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