Australian researchers tracked 639 hospitalized children under two years old, finding RSV patients required oxygen therapy four times more frequently than those with SARS-CoV-2 (61% versus 15.7% during admission) and stayed in hospital one day longer on average. While COVID-19 patients were more likely to have underlying medical conditions, RSV consistently produced more severe acute respiratory symptoms requiring intensive supportive care.
This head-to-head comparison fills a critical gap in pediatric infectious disease understanding. Previous studies have examined each virus separately, but direct comparisons help clinicians and parents contextualize relative risks. The findings align with established RSV pathophysiology—the virus uniquely targets small airways in young children, causing bronchiolitis that frequently requires oxygen support. COVID-19's milder respiratory course in this age group reflects children's generally robust immune response to SARS-CoV-2.
The data carries immediate policy implications for vaccination strategies and parental decision-making. With new RSV vaccines and monoclonal antibodies now available for infants, these results support prioritizing RSV prevention programs. However, the single-center design and observational nature limit broader generalizability, and the study period preceded more recent COVID-19 variants that may behave differently in young children.