Respiratory Syncytial Virus-Associated Hospital Admissions in Children Younger Than 5 Years in 7 European Countries Using Routinely Collected Datasets

Li, You; Reeves, Rachel M; Li, You; Campbell, Harry; Nair, Harish; Wijhe, Maarten van; Fischer, Thea Kølsen; Simonsen, Lone; Trebbien, Ramona; Tong, Sabine; Bangert, Mathieu; Demont, Clarisse; Lehtonen, Toni; Heikkinen, Terho; Teirlinck, Anne; Boven, Michiel van; Hoek, Wim van der; Maas, Nicoline van der; Meijer, Adam; Fernández, Liliana Vázquez; Bøås, Håkon; Bekkevold, Terese; Flem, Elmira; Stona, Luca; Speltra, Irene; Giaquinto, Carlo; Chéret, Arnaud; Leach, Amanda; Stoszek, Sonia K.; Beutels, Philippe; Bont, Louis; Pollard, Andrew J.; Openshaw, Peter; Abram, Michael E.; Swanson, Kena A.; Rosen, Brian; Molero, Eva

doi:10.1093/infdis/jiaa360

Cited by 56 publications

(82 citation statements)

References 19 publications

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“…The observed increase in PICU admissions was unlikely driven by increased comorbidity, as the comorbidity rate remained stable over time and is comparable with the rate reported in previous literature [4,6,14]. Interestingly, an observational study reporting on seven European countries did not report an increase in general ward hospital admission rates for RSV bronchiolitis [15]. The observed rise in PICU admissions for bronchiolitis in our study was accompanied by an increase in the number of children who received non-invasive respiratory support, while the number of patients receiving IMV remained stable.…”

Section: Discussionsupporting

confidence: 86%

Section: Discussionmentioning

confidence: 99%

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Burden of respiratory syncytial virus bronchiolitis on the Dutch pediatric intensive care units

et al. 2021

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Respiratory syncytial virus (RSV) bronchiolitis causes substantial morbidity and mortality in young children, but insight into the burden of RSV bronchiolitis on pediatric intensive care units (PICUs) is limited. We aimed to determine the burden of RSV bronchiolitis on the PICUs in the Netherlands. Therefore, we identified all children ≤ 24 months of age with RSV bronchiolitis between 2003 and 2016 from a nationwide PICU registry. Subsequently we manually checked their patient records for correct diagnosis and collected patient characteristics, additional clinical data, respiratory support modes, and outcome. In total, 2161 children were admitted to the PICU for RSV bronchiolitis. The annual number of admissions increased significantly during the study period (β 4.05, SE 1.27, p = 0.01), and this increase was mostly driven by increased admissions in children up to 3 months old. Concomitantly, non-invasive respiratory support significantly increased (β 7.71, SE 0.92, p < 0.01), in particular the use of high flow nasal cannula (HFNC) (β 6.69, SE 0.96, p < 0.01), whereas the use of invasive ventilation remained stable.Conclusion: The burden of severe RSV bronchiolitis on PICUs has increased in the Netherlands. Concomitantly, the use of non-invasive respiratory support, especially HFNC, has increased. What is Known:• RSV bronchiolitis is a major cause of childhood morbidity and mortality and may require pediatric intensive care unit admission.• The field of pediatric critical care for severe bronchiolitis has changed due to increased non-invasive respiratory support options. What is New:• The burden of RSV bronchiolitis for the Dutch PICUs has increased. These data inform future strategic PICU resource planning and implementation of RSV preventive strategies.• There was a significant increase in the use of high flow nasal cannula at the PICU, but the use of invasive mechanical ventilation did not decrease.

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Section: Discussionsupporting

confidence: 86%

Section: Discussionmentioning

confidence: 99%

Burden of respiratory syncytial virus bronchiolitis on the Dutch pediatric intensive care units

et al. 2021

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“…The younger the age, the greater the risk of RSV infection, as corroborated by several authors, indicating a greater risk especially in children between 3 to 5 months [ 48 , 52 , 53 ], although other studies point out that RSV-associated hospitalizations reach their maximum peak in children under 3 months [ 54 ]. Other authors suggest a higher percentage of infection in children 0 to 12 months of age [ 45 , 54 , 55 , 56 , 57 , 58 ].…”

Section: Discussionmentioning

confidence: 99%

Prevalence and Risk Factors of Respiratory Syncytial Virus in Children under 5 Years of Age in the WHO European Region: A Systematic Review and Meta-Analysis

Suleiman‐Martos

Caballero-Vázquez

Gómez‐Urquiza

et al. 2021

JPM

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A respiratory syncytial virus (RSV) is the major cause of respiratory tract infection in children under 5 years. However, RSV infection in the European Region of the World Health Organization has not been systematically reviewed. The aim was to determine the prevalence and factors associated with RSV in children under 5 years of age in European regions. A systematic review and meta-analysis was performed. CINAHL, Medline, LILACS, ProQuest, SciELO, and Scopus databases were consulted for studies published in the last 5 years, following Preferred Reporting Items for Systematic Reviews and Meta-analysis guidelines. The search equation was “respiratory syncytial virus AND (newborn OR infant OR child) AND (prevalence OR risk factors)”. Studies reporting the prevalence of RSV were eligible for inclusion in the meta-analysis. A total of 20 articles were included. The meta-analytic prevalence estimation of RSV, with a sample of n = 16,115 children, was 46% (95% CI 34–59%). The main risk factors were age, male gender, winter season, and environmental factors such as cold temperatures, higher relative humidity, high concentrations of benzene, exposure to tobacco, and living in urban areas. Robust age-specific estimates of RSV infection in healthy children should be promoted in order to determine the optimal age for immunization. In addition, it is necessary to analyse in greater depth the potentially predictive factors of RSV infection, to be included in prevention strategies.

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“…hospitalization with RSV infections in infants aged less than 5 months is about 2-5 times higher than those aged more than 5 months [1,26]. In this study, children with respiratory support were significantly younger than those without respiratory support.…”

Section: Plos Onementioning

confidence: 49%

“…Respiratory syncytial virus (RSV) infection is a common cause of acute respiratory infection, particularly lower respiratory infection, in children [1,2]. The severity of RSV infections ranges widely from mild to severe disease requiring ventilator support [3].…”

Section: Introductionmentioning

confidence: 99%

Utility of the Global Respiratory Severity Score for predicting the need for respiratory support in infants with respiratory syncytial virus infection

et al. 2021

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Background Respiratory syncytial virus (RSV) is a common cause of acute respiratory infection in children. One of the most important strategies for treatment of an RSV infection is to decide whether the patient needs respiratory support. This study aimed to assess the validity and clinical benefit of the Global Respiratory Severity Score (GRSS) and the Wang bronchiolitis severity score (WBSS) for clinical decision-making regarding providing respiratory support (high-flow nasal cannula, nasal continuous positive airway pressure, or ventilator) in infants with an RSV infection. Study design and methods This retrospective cohort study enrolled 250 infants aged under 10 months who were admitted to Atsugi City Hospital with an RSV infection between January 2012 and December 2019. The utility of these scores was evaluated for assessing the need for respiratory support through decision curve analysis by calculating the optimal GRSS and WBSS cut-offs for predicting the need for respiratory support. Results Twenty-six infants (10.4%) received respiratory support. The optimal cut-offs for the GRSS and the WBSS were 4.52 and 7, respectively. Decision curve analysis suggested that the GRSS was a better predictive tool than the WBSS if the probability of needing respiratory support was 10–40%. Conclusions The GRSS was clinically useful in determining the need for respiratory support in infants aged under 10 months with an RSV infection.

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Respiratory Syncytial Virus-Associated Hospital Admissions in Children Younger Than 5 Years in 7 European Countries Using Routinely Collected Datasets

Cited by 56 publications

References 19 publications

Burden of respiratory syncytial virus bronchiolitis on the Dutch pediatric intensive care units

Burden of respiratory syncytial virus bronchiolitis on the Dutch pediatric intensive care units

Prevalence and Risk Factors of Respiratory Syncytial Virus in Children under 5 Years of Age in the WHO European Region: A Systematic Review and Meta-Analysis

Utility of the Global Respiratory Severity Score for predicting the need for respiratory support in infants with respiratory syncytial virus infection

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