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Scientific Oral Presentation

Pediatric Otolaryngology

Early RSV Infection and Risk of Adenoidectomy and Tonsillectomy in Children

Monday, October 19, 2026
11:00 AM - 11:06 AM PT
Location: 409AB

    Presenting Author(s)

  • Sarah Y. Atallah, BS

    Medical Student
    The University of Toledo College of Medicine and Life Sciences
    Monclova, Ohio, United States

    • Co-Author(s)

  • Murilo W. de Santana Hager, BS

    Medical student
    Jacobs School of Medicine and Biomedical Sciences at the University at Buffalo
    Buffalo, New York, United States

  • CC

    Chelsea N. Cleveland, MD

    Dr. Chelsea Cleveland
    University Hospitals
    Cleveland, Ohio, United States

    • Senior Author(s)

  • MC

    Michele M. Carr, DDS MD MEd PhD

    Professor
    Jacobs School of Medicine and Biomedical Sciences at the University at Buffalo, Dept of Otolaryngology
    Buffalo, New York, United States

Disclosure(s):
Sarah Y. Atallah, BS:

faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.

Introduction: Respiratory syncytial virus (RSV) is a common infant infection that may influence upper airway lymphoid tissue development. We evaluated whether RSV in the first year of life, and in particular severe RSV, is associated with increased risk of adenoidectomy and tonsillectomy later in childhood.

Methods: We performed a retrospective cohort study using the TriNetX database comparing patients with RSV infection at ≤ 1 year of age to matched controls, as well as patients with severe versus mild RSV infection within the same age range. In both analyses, patients were 1:1 propensity score–matched for age, sex, race, ethnicity, secondhand smoke exposure, and prematurity. Severe RSV was defined as acute respiratory failure with hypercapnia, hypoxia, or hypoxemia within 2 weeks. Outcomes were adenoidectomy and tonsillectomy 3 months to 3 years post-infection.

Results: Adenoidectomy occurred in 108/17,428 RSV patients (0.62%) versus 64/17,428 control patients (0.37%), yielding an odds ratio (OR) of 1.69 (p < 0.001). Tonsillectomy occurred in 100/17,434 RSV patients (0.57%) versus 17/17,436 control patients (0.10%), with an OR of 5.91 (p < 0.001). Adenoidectomy occurred in 47/3,114 severe RSV patients (1.51%) versus 14/3,116 mild RSV patients (0.45%), with an OR of 3.40 (p < 0.001). Tonsillectomy occurred in 24/3,116 severe RSV patients (0.77%) versus 12/3,116 mild RSV patients (0.39%), with an OR of 2.01 (p = 0.045).

Conclusions: RSV infection within the first year of life is associated with increased risk of adenoidectomy and tonsillectomy, with significantly greater risk observed following severe RSV infection. These findings suggest that early-life RSV, particularly severe disease, may contribute to adenoid and tonsillar hypertrophy that ultimately necessitates surgical intervention later in childhood.