Global Respiratory Syncytial Virus–Related Infant Community Deaths

Abstract

Background Respiratory syncytial virus (RSV) is a leading cause of pediatric death, with >99% of mortality occurring in low- and lower middle-income countries. At least half of RSV-related deaths are estimated to occur in the community, but clinical characteristics of this group of children remain poorly characterized. Methods The RSV Global Online Mortality Database (RSV GOLD), a global registry of under-5 children who have died with RSV-related illness, describes clinical characteristics of children dying of RSV through global data sharing. RSV GOLD acts as a collaborative platform for global deaths, including community mortality studies described in this supplement. We aimed to compare the age distribution of infant deaths <6 months occurring in the community with in-hospital. Results We studied 829 RSV-related deaths <1 year of age from 38 developing countries, including 166 community deaths from 12 countries. There were 629 deaths that occurred <6 months, of which 156 (25%) occurred in the community. Among infants who died before 6 months of age, median age at death in the community (1.5 months; IQR: 0.8−3.3) was lower than in-hospital (2.4 months; IQR: 1.5−4.0; P < .0001). The proportion of neonatal deaths was higher in the community (29%, 46/156) than in-hospital (12%, 57/473, P < 0.0001). Conclusions We observed that children in the community die at a younger age. We expect that maternal vaccination or immunoprophylaxis against RSV will have a larger impact on RSV-related mortality in the community than in-hospital. This case series of RSV-related community deaths, made possible through global data sharing, allowed us to assess the potential impact of future RSV vaccines.

Global, regional, and national disease burden estimates of acute lower respiratory infections due to respiratory syncytial virus in children younger than 5 years in 2019: a systematic analysis

“…Although not being a common cause of deaths in the neonatal period, RSV was in the causal chain for about 19% of RSV-attributable deaths in children aged 0–6 months. A study 25 based on global case series of RSV mortality reported a greater proportion of RSV neonatal deaths in community than in hospitals. These findings highlight the need for RSV maternal vaccine or a birth-dose of RSV monoclonal antibody.…”

Repurposing Probenecid to Inhibit SARS-CoV-2, Influenza Virus, and Respiratory Syncytial Virus (RSV) Replication

“…Respiratory viruses are the most frequent cause of disease in humans, having significant impacts on morbidity and mortality worldwide [ 21 , 22 , 23 ]. The most common respiratory viruses are endemic agents such as coronaviruses (CoVs), respiratory syncytial viruses (RSVs), and influenza (flu) viruses.…”

“…RSV strains A and B co-circulate having no significant correlation with disease severity [ 31 , 32 ]. RSV is estimated to cause >3 million hospitalizations and 95,000–150,000 deaths globally each year, where up to 175,000 hospitalizations in the United States are children < 5 years of age [ 21 , 33 , 34 ]. RSV is also estimated to cause > 14,000 deaths/year in adults in the United States.…”

Avaliação das intercorrências respiratórias em coorte de prematuros não contemplados com o anticorpo monoclonal palivizumabe

“…As Infecções Respiratórias Agudas (IRA) continuam sendo a principal causa de morbimortalidade em todo mundo, principalmente em crianças menores de cinco anos (1)(2) . Um dos vírus causadores de IRA é o Vírus Sincicial Respiratório (VSR); é mais prevalente em crianças; a maioria delas é infectada até 12 meses de idade e quase todas, até completarem dois anos de vida (3)(4)(5) . O VSR responde como principal agente causador da bronquiolite e pneumonia e relaciona-se, mundialmente, a surtos e infecções simultâneas em doenças respiratórias (6) .…”