Respiratory Virus Surveillance in Infants across Different Clinical Settings

Haddadin, Zaid; Rankin, Danielle A; Lipworth, Loren; Suh, Mina; McHenry, Rendie; Blozinski, Anna; George, Seifein Salib; Fernandez, Kailee N; Varjabedian, Rebekkah; Spieker, Andrew J.; Shepard, Donald S.; Halasa, Natasha

doi:10.1016/j.jpeds.2021.03.036

Cited by 15 publications

(20 citation statements)

References 30 publications

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“…Respiratory syncytial virus (RSV) infects almost all children by 2 years of age in the United States [ 1 , 2 ]. RSV is the leading cause of hospitalizations in infants [ 3 ] and the most common respiratory virus detected in multiple health care settings [ 4 ]. RSV causes an estimated 2.1 million medically attended infections each year in children under 5 years of age [ 3 ].…”

mentioning

confidence: 99%

Cost of Respiratory Syncytial Virus Infections in US Infants: Systematic Literature Review and Analysis

Bowser

Rowlands

Hariharan

et al. 2022

The Journal of Infectious Diseases

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Background Limited data are available on the economic costs of respiratory syncytial virus (RSV) infections among infants and young children in the United States. Methods We performed a systematic literature review of 10 key databases to identify studies published between 1 January 2014 and 2 August 2021 that reported RSV-related costs in US children aged 0–59 months. Costs were extracted and a systematic analysis was performed. Results Seventeen studies were included. Although an RSV hospitalization (RSVH) of an extremely premature infant costs 5.6 times that of a full-term infant ($10 214), full-term infants accounted for 82% of RSVHs and 70% of RSVH costs. Medicaid-insured infants were 91% more likely than commercially insured infants to be hospitalized for RSV treatment in their first year of life. Medicaid financed 61% of infant RSVHs. Paying 32% less per hospitalization than commercial insurance, Medicaid paid 51% of infant RSVH costs. Infants’ RSV treatment costs $709.6 million annually, representing $187 per overall birth and $227 per publicly funded birth. Conclusions Public sources pay for more than half of infants’ RSV medical costs, constituting the highest rate of RSVHs and the highest expenditure per birth. Full-term infants are the predominant source of infant RSVHs and costs.

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mentioning

confidence: 99%

Cost of Respiratory Syncytial Virus Infections in US Infants: Systematic Literature Review and Analysis

Bowser

Rowlands

Hariharan

et al. 2022

The Journal of Infectious Diseases

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“…ARI episodes in this cohort were mild and may not be representative of more severe illness; other studies of ARIs during the pandemic have measured disease severity among children seeking medical attention at the hospital, among whom respiratory virus positivity may differ. 32 , 33 Generalizability to other populations is limited as participants in the HIVE study may not be representative of the general population.…”

Section: Discussionmentioning

confidence: 99%

Respiratory virus circulation during the first year of the COVID‐19 pandemic in the Household Influenza Vaccine Evaluation (HIVE) cohort

Fine

Bazzi

Callear

et al. 2023

Influenza Resp Viruses

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Background The annual reappearance of respiratory viruses has been recognized for decades. COVID‐19 mitigation measures taken during the pandemic were targeted at respiratory transmission and broadly impacted the burden of acute respiratory illnesses (ARIs). Methods We used the longitudinal Household Influenza Vaccine Evaluation (HIVE) cohort in southeast Michigan to characterize the circulation of respiratory viruses from March 1, 2020, to June 30, 2021, using RT‐PCR of respiratory specimens collected at illness onset. Participants were surveyed twice during the study period, and SARS‐CoV‐2 antibodies were measured in serum by electrochemiluminescence immunoassay. Incidence rates of ARI reports and virus detections were compared between the study period and a preceding pre‐pandemic period of similar duration. Results Overall, 437 participants reported a total of 772 ARIs; 42.6% had respiratory viruses detected. Rhinoviruses were the most frequent virus, but seasonal coronaviruses, excluding SARS‐CoV‐2, were also common. Illness reports and percent positivity were lowest from May to August 2020, when mitigation measures were most stringent. Seropositivity for SARS‐CoV‐2 was 5.3% in summer 2020 and increased to 11.3% in spring 2021. The incidence rate of total reported ARIs for the study period was 50% lower (95% CI: 0.5, 0.6; p < 0.001) than the incidence rate from a pre‐pandemic comparison period (March 1, 2016, to June 30, 2017). Conclusions The burden of ARI in the HIVE cohort during the COVID‐19 pandemic fluctuated, with declines occurring concurrently with the widespread use of public health measures. Rhinovirus and seasonal coronaviruses continued to circulate even when influenza and SARS‐CoV‐2 circulation was low.

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“…wheezing, crackles, rales, diminished breath sounds, shortness of breath, cough, earache, nasal congestion, rhinorrhea, coryza, and/or sore throat) within 14 days of illness onset were eligible for enrollment. 14 Written informed consent was obtained from parents or legal guardians in English, Spanish, or Arabic prior to enrollment.…”

Section: Methodsmentioning

confidence: 99%

“…neonatal abstinence syndrome, congenital defects, etc.). 14 Dates of enrollment were reported using the Centers for Disease Control and Prevention, Morbidity and Mortality Weekly Reporting (MMWR) weeks of the epidemiological year. 16,17 Our study enrollment period took place from MMWR weeks 50 through 18 (i.e.…”

Section: Definitionsmentioning

confidence: 99%

Comparison of clinical presentations and burden of respiratory syncytial virus in infants across three distinct healthcare settings in Davidson County, Tennessee

Rankin

Haddadin

Lipworth

et al. 2022

Therapeutic Advances in Infection

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Background: The burden of respiratory syncytial virus (RSV)-associated acute respiratory illnesses among healthy infants (<1 year) in the inpatient setting is well established. The focus on RSV-associated illnesses in the outpatient (OP) and emergency department (ED) settings are however understudied. We sought to determine the spectrum of RSV illnesses in infants at three distinct healthcare settings. Methods: From 16 December 2019 through 30 April 2020, we performed an active, prospective RSV surveillance study among infants seeking medical attention from an inpatient (IP), ED, or OP clinic. Infants were eligible if they presented with fever and/or respiratory symptoms. Demographics, clinical characteristics, and illness histories were collected during parental/guardian interviews, followed by a medical chart review and illness follow-up surveys. Research nasal swabs were collected and tested for respiratory pathogens for all enrolled infants. Results: Of the 627 infants screened, 475 were confirmed eligible; 360 were enrolled and research tested. Within this final cohort, 101 (28%) were RSV-positive (IP = 37, ED = 18, and OP = 46). Of the RSV-positive infants, the median age was 4.5 months and 57% had ⩾2 healthcare encounters. The majority of RSV-positive infants were not born premature (88%) nor had underlying medical conditions (92%). RSV-positive infants, however, were more likely to have a lower respiratory tract infection than RSV-negative infants (76% vs 39%, p < 0.001). Hospitalized infants with RSV were younger, 65% required supplemental oxygen, were more likely to have lower respiratory tract symptoms, and more often had shortness of breath and rales/rhonchi than RSV-positive infants in the ED and OP setting. Conclusion: Infants with RSV illnesses seek healthcare for multiple encounters in various settings and have clinical difference across settings. Prevention measures, especially targeted toward healthy, young infants are needed to effectively reduce RSV-associated healthcare visits.

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Respiratory Virus Surveillance in Infants across Different Clinical Settings

Cited by 15 publications

References 30 publications

Cost of Respiratory Syncytial Virus Infections in US Infants: Systematic Literature Review and Analysis

Cost of Respiratory Syncytial Virus Infections in US Infants: Systematic Literature Review and Analysis

Respiratory virus circulation during the first year of the COVID‐19 pandemic in the Household Influenza Vaccine Evaluation (HIVE) cohort

Comparison of clinical presentations and burden of respiratory syncytial virus in infants across three distinct healthcare settings in Davidson County, Tennessee

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