RSV-Related Disease Burden High in Young Children

The estimated incidence of respiratory syncytial virus (RSV) in children 2 to 5 years of age is 3.0 per 100 children per year and is significantly lower in children aged 0 to 2 years, according to study findings published in Influenza and Other Respiratory Viruses.

To support the development of an RSV surveillance system, investigators conducted a systematic literature review and meta-analysis to estimate the incidence of RSV-related disease incidence, hospitalization, in-hospital mortality, and overall mortality in children 5 years of age and younger.

A search of relevant peer-reviewed articles published from January 1, 2010, to June 2, 2022, in multiple English- and Chinese-language databases yielded 44 studies for meta-analysis; of these, 34 were considered high quality and 10 were moderate quality. The pooled studies involved 149,321,171 participants, with sample sizes ranging from 1153 to 30,417,106 patients.

Of the included studies, 15 reported RSV-related disease incidence (107,527 participants), 25 reported RSV-related hospitalization rates (62,691,095 participants), 9 reported RSV-related in-hospital mortality rates (55,149,680 participants), and 5 reported RSV-related overall mortality (31,317,106 participants).

The pooled incidence, hospitalization rate, in-hospital mortality rate, and overall mortality rate in children 5 years of age and younger were 9.0 (95% CI, 7.0-11.0), 1.7 (95% CI, 1.3-2.1), 0.5 (95% CI, 0.4-0.5), and 0.05 (95% CI, 0.04-0.06), respectively, per 100 children per year, according to the random-effects model.

In a subanalysis of different age groups, the pooled estimated RSV-related disease incidence in 2- to 5-year-old children (3.0 per 100 children per year; 95% CI, 2.0-5.0) was significantly lower compared with that in 0- to 1-year-old children (9.0 per 100 children per year; 95% CI, 6.0-12.0) and 0- to 2-year-old children (9.0 per 100 children per year; 95% CI, 7.0-11.0). A similar trend occurred in RSV-related hospitalization rate, in-hospital mortality rate, and overall mortality rate.

RSV-related disease incidence was greater in high-income countries vs low- and middle-income countries combined (15.0 per 100 children per year; 95% CI, 8.0-23.0 vs 7.0 per 100 children per year, 95% CI, 5.0-9.0), per World Bank classification. In high-income countries, RSV-related overall mortality was lower compared with low- and middle-income countries combined (0.02 per 100 children per year; 95% CI, 0.01-0.02 vs 0.9 per 100 children per year; 95% CI, 0.6-1.2).

The pooled estimated incidence of RSV-related disease in active surveillance studies was significantly greater than that reported in passive surveillance studies (12.0 per 100 children per year; 95% CI, 8.0-17.0 vs 3.0 per 100 children per year; 95% CI, 0-6.0).

Study limitations involve the inclusion of only articles published in English and Chinese; considerable heterogeneity among included studies; and the inclusion of only studies relating to outpatients and community-based surveillance.

“A standardized and unified RSV surveillance system is required. Case definition and surveillance types should be fully considered for surveillance of different age groups,” noted the study authors, who added that children aged 2 and younger should be a high priority target population of surveillance efforts.

This article originally appeared on Pulmonology Advisor