Burden of infection and hospitalization from respiratory syncytial virus-associated acute lower respiratory tract infections in Chinese children: Modeling of national, regional, and provincial estimates.

Publication date: Jun 23, 2026

Respiratory syncytial virus (RSV) is a major cause of acute lower respiratory tract infections (ALRIs) in children. To guide policymaking on controlling RSV-associated ALRIs (RSV-ALRIs) in China, we estimated the national, regional, and provincial burdens of RSV-ALRIs and associated hospitalizations for children under 5 years old. We systematically identified publications about RSV-ALRIs in China with epidemiological data before 2020. We compared seasonality data from this period with data during the COVID-19 epidemic. We built a dataset to assess RSV-ALRI burden by age and region, using a generalized linear mixed-effects model and a conceptual proportionality framework to assess hospitalization rates. A risk factor-based model were used to estimate regional and provincial RSV-ALRI incidence. Children aged 0 to 12 months had the highest risk of RSV-ALRI and associated hospitalization. Provincial variations existed, with some southern provinces exhibiting higher incidence and some western provinces higher hospitalization rates. The COVID-19 epidemic shifted RSV hospitalization peaks to early autumn (Guangdong, Shanghai), whereas Hubei and Shandong demonstrated delayed peak onset compared with the pre-pandemic period. Our study of the burden RSV-ALRIs in China identified obvious heterogeneity by age and region. These findings highlight the need for targeted RSV vaccination strategies and resource allocation prioritizing high-risk groups and areas. This work was supported by the Shanghai Municipal Science and Technology Major Project (Grant No. ZD2021CY001), the National Natural Science Foundation of China (Grant No. 82073612), and Shanghai New Three-year Action Plan for Public Health (GWVI-1, GWVI-11. 1-03 and GWVI-11. 1-01).

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Original Article