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Background Respiratory syncytial virus (RSV) is the leading cause of acute lower respiratory infection (ALRI) in children. We aimed to describe the clinical–epidemiological pattern and risk factors for mortality associated with RSV infection. Methods Prospective, cross-sectional study of ALRI in children admitted to a Children’s Hospital among 2000–2018. Viral diagnosis was made by fluorescent antibody techniques or real-time PCR. We compared clinical–epidemiological characteristics of RSV infection in nonfatal vs. fatal cases. Multiple logistic regression was used to identify independent predictors of mortality. Results From a total 16,018 patients with ALRI, 13,545(84.6%) were tested for respiratory viruses, 6047 (45%) were positive: RSV 81.1% (4,907), influenza 7.5% (456), parainfluenza 6.9% (419) and adenovirus 4.4% (265). RSV had a seasonal epidemic pattern coinciding with months of lowest average temperature. RSV mortality rate: 1.7% (83/4,855). Fatal cases had a higher proportion of: prematurity (P &lt; 0.01), perinatal respiratory history (P &lt; 0.01), malnourishment (P &lt; 0.01), congenital heart disease (P &lt; 0.01), chronic neurological disease (P &lt; 0.01) and pneumonia as clinical presentation (&lt;0.01). No significant difference between gender was observed. The annual mortality rate distribution was not stable over the study period with the highest mortality in the year 2002. Most deaths occurred among children who had complications: respiratory distress (80.7%), sepsis (31.3%) and atelectasis (13.2%). Independent predictors of RSV mortality were: moderate to severe malnourishment OR 3.64 (95% CI 1.96–6.74)P &lt; 0.01, chronic neurological disease OR 3.99 (95% CI 2.04–7.79) P &lt; 0.01, congenital heart disease OR 4.10 (95% CI 2.36–7.15)P &lt; 0.01 and age under 6 months OR 1.96 (95% CI 1.23–3.11)P &lt; 0.01. Conclusion RSV showed an epidemic seasonal pattern. Malnourishment, chronic neurological disease, congenital heart disease, age under 6 months and pneumonia were the independent risk factors for RSV mortality. Disclosures All authors: No reported disclosures.

2316. RSV Mortality: 19 Years’ Experience in a Pediatric Hospital in Argentina