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Background Respiratory syncytial virus (RSV) is a leading cause of hospitalizations in children (≤5 years); limited data compare burden by age. Methods This single-center retrospective study included children (≤5 years) hospitalized for &amp;gt;24 hours with RT-PCR-confirmed RSV infection (2015–2018). Hospital length of stay (LoS), intensive care unit (ICU) admissions, ICU-LoS, supplemental oxygen and medication use were assessed. Multivariate logistic regression analyses identified predictors of hospital LoS &amp;gt;5 days. Results 312 patients had RSV infection (0–&amp;lt;6 months [35%]; 6–&amp;lt;12 months [15%]; 1–&amp;lt;2 years [25%]; 2–≤5 years [25%]); 16.3% had predefined comorbidities (excludes preterm infants). Median hospital LoS was 5.0 days and similar across age; 5.1% (16/312) were admitted to ICU (ICU-LoS 5.0 days), with those aged 0–&amp;lt;6 months admitted most frequently (10/108; 9.3%). Supplemental oxygen was administered in 57.7% of patients, with similar need across ages. Antibiotics were administered frequently during hospitalization (43.6%). Predictors of prolonged LoS included pneumonia (odds ratio [OR] = 2.33), supplemental oxygen need (OR = 5.09), and preterm births (OR = 3.37). High viral load (RT-PCR RSV cycle threshold value &amp;lt;25) was associated with greater need for supplemental oxygen. Conclusions RSV causes substantial burden in hospitalized children (≤5 years), particularly preterm infants and those aged &amp;lt;6 months.

Clinical Burden of Respiratory Syncytial Virus in Hospitalized Children Aged ≤5 Years (INSPIRE Study)