Burden of severe bronchiolitis in children up to 2 years of age in Spain from 2012 to 2017

Montero, Marco Heppe; Gil-Prieto, Ruth; Walter, Stefan; Blanquer, F. Aleixandre; Miguel, Ángel Gil de

doi:10.1080/21645515.2021.1883379

Cited by 27 publications

(34 citation statements)

References 36 publications

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“…Findings from this study confirm findings from previous studies identifying that, despite the relatively low RSV-associated ICU admission rates, the rate of RSV-related manifestations remains high [ 18 , 23 , 39–41 ]. The trend for bronchiolitis decreasing with age corresponds with previous findings, as bronchiolitis is a leading cause of hospitalization in children aged <2 years [ 19 , 20 , 25 , 34 ].…”

Section: Discussionsupporting

confidence: 88%

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

Hartmann

Liese

Kemmling

et al. 2022

The Journal of Infectious Diseases

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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 >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 >5 days. Results 312 patients had RSV infection (0–<6 months [35%]; 6–<12 months [15%]; 1–<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–<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 <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 <6 months.

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Section: Discussionsupporting

confidence: 88%

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

Hartmann

Liese

Kemmling

et al. 2022

The Journal of Infectious Diseases

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“…Young age is a known risk factor for RSV infection, with about 45% of hospital admissions and in-hospital deaths due to RSV-related bronchiolitis occurring in children younger than 6 months [ 17 , 35 ]. Previous studies have shown that the highest incidence of childhood hospitalization for bronchiolitis in Spain in the last 20 years occurred during the first year of life, particularly among children aged 0–2 months, estimated at about 4000 cases per 100,000 children under 12 months of age; rates decrease significantly thereafter [ 19 , 36 ]. Estimates published for different countries around the world are variable, probably due to different healthcare settings and estimation methods, and to the different underlying characteristics of the study populations [ 21 , 37 – 43 ].…”

Section: Discussionmentioning

confidence: 99%

“…The issue of pediatric hospital discharges for respiratory diseases to which a generic diagnostic code is assigned, e.g., bronchitis or bronchiolitis, has been addressed previously. In a recently published study [ 36 ], we collected data from all patients who had been assigned a generic diagnostic code for bronchiolitis, assuming that 50–80% of cases were caused by RSV infection. In this study, however, the patients were analyzed in different groups based on whether the diagnosis code was generic or specifically RSV-positive.…”

Section: Discussionmentioning

confidence: 99%

Burden of respiratory syncytial virus-associated lower respiratory infections in children in Spain from 2012 to 2018

et al. 2022

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Background Respiratory syncytial virus (RSV) is a major cause of acute lower respiratory tract infection (ALRI) leading to infant hospitalization, morbidity and postnatal mortality in children younger than 5 years of age worldwide. The aim of this study was to collect data on hospitalizations for RSV-related ALRI in children in Spain from 2012 to 2018. Methods We used the discharge reports from the Minimum Basic Data Set (MBDS) to retrospectively analyze hospital discharge data in children ≤ 14 years of age with a diagnosis of acute lower respiratory tract infection, based on the ICD-9-CM and ICD-10-CM diagnosis codes, from 2012 to 2018. Results A total of 190,474 children, 58.1% boys and 41.9% girls, were admitted for lower respiratory tract infections in Spain, including 118,731 cases of bronchiolitis, 53,972 cases of bronchitis, 3710 cases of RSV-positive pneumonia, and 14,061 cases of RSV infections. Of these, 92,426 children (48.5%) had laboratory-confirmed RSV infection. The mean case fatality rate was almost 6 times higher for pneumonia (0.6%) than for bronchiolitis (0.1%) or bronchitis (0.1%). A significant linear increase in the mean annual hospitalization rate for pneumonia of almost 15% per year was found, with no changes in the trend over the study period. Conclusions RSV-related respiratory infections remain a leading cause of infant hospitalization in Spain. Effective antiviral treatments and preventive vaccines are urgently needed for the management of RSV infection in children, especially for those aged 6 to 12 months.

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“…On one hand, studies often include only RSV-specific and/or acute bronchiolitis diagnosis codes—or RSV confirmed cases when laboratory data is available—approaches which are expected to widely underestimate the number of RSV cases, due to lack of systematic testing and coding [ 10 – 12 ]. On the other hand, most studies focus on hospitalizations, leaving outside substantial direct healthcare burden from outpatient visits [ 7 , 13 – 15 ]. In United States, a study found the incidence of RSV cases in the outpatient setting to be over thirty times higher than the incidence of hospitalizations [ 7 ].…”

Section: Introductionmentioning

confidence: 99%

Clinical and economic burden of respiratory syncytial virus in Spanish children: the BARI study

et al. 2022

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Respiratory syncytial virus (RSV) infection is a major cause of morbidity in children. However, its disease burden remains poorly understood, particularly outside of the hospital setting. Our study aimed to estimate the burden of medically attended acute lower respiratory infection (ALRI) cases potentially related to RSV in Spanish children. Longitudinal data from September 2017 to June 2018 of 51,292 children aged < 5 years old from the National Healthcare System (NHS) of two Spanish regions were used. Three case definitions were considered: (a) RSV-specific; (b) RSV-specific and unspecified acute bronchiolitis (RSV-specific and Bronchiolitis), and; (c) RSV-specific and unspecified ALRI (RSV-specific and ALRI). A total of 3460 medically attended ALRI cases potentially due to RSV were identified, of which 257 (7.4%), 164 (4.7%), and 3039 (87.8%) coded with RSV-specific, unspecific bronchiolitis, and unspecific ALRI codes, respectively. Medically attended RSV-specific and ALRI cases per 1000 children was 134.4 in the first year of life, 119.4 in the second, and 35.3 between 2 and 5 years old. Most cases were observed in otherwise healthy children (93.1%). Mean direct healthcare cost per medically attended RSV-specific and ALRI case was €1753 in the first year of life, €896 in the second, and €683 between 2 and 5 years old. Hospitalization was the main driver of these costs, accounting for 55.6%, 38.0% and 33.4%, in each respective age group. In RSV-specific cases, mean direct healthcare cost per medically attended case was higher, mostly due to hospitalization: €3362 in the first year of life (72.9% from hospitalizations), €3252 in the second (72.1%), and €3514 between 2 and 5 years old (74.2%). These findings suggest that hospitalization data alone will underestimate the RSV infections requiring medical care, as will relying only on RSV-specific codes. RSV testing and codification must be improved and preventive solutions adopted, to protect all infants, particularly during the first year of life.

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Burden of severe bronchiolitis in children up to 2 years of age in Spain from 2012 to 2017

Cited by 27 publications

References 36 publications

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

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

Burden of respiratory syncytial virus-associated lower respiratory infections in children in Spain from 2012 to 2018

Clinical and economic burden of respiratory syncytial virus in Spanish children: the BARI study

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