Systematic review and meta-analysis of the prevalence of common respiratory viruses in children < 2 years with bronchiolitis in the pre-COVID-19 pandemic era

Abstract

Introduction The advent of genome amplification assays has allowed description of new respiratory viruses and to reconsider the role played by certain respiratory viruses in bronchiolitis. This systematic review and meta-analysis was initiated to clarify the prevalence of respiratory viruses in children with bronchiolitis in the pre-COVID-19 pandemic era. Methods We performed an electronic search through Pubmed and Global Index Medicus databases. We included observational studies reporting the detection rate of common respiratory viruses in children with bronchiolitis using molecular assays. Data was extracted and the quality of the included articles was assessed. We conducted sensitivity, subgroups, publication bias, and heterogeneity analyses using a random effect model. Results The final meta-analysis included 51 studies. Human respiratory syncytial virus (HRSV) was largely the most commonly detected virus 59.2%; 95% CI [54.7; 63.6]). The second predominant virus was Rhinovirus (RV) 19.3%; 95% CI [16.7; 22.0]) followed by Human bocavirus (HBoV) 8.2%; 95% CI [5.7; 11.2]). Other reported viruses included Human Adenovirus (HAdV) 6.1%; 95% CI [4.4; 8.0]), Human Metapneumovirus (HMPV) 5.4%; 95% CI [4.4; 6.4]), Human Parainfluenzavirus (HPIV) 5.4%; 95% CI [3.8; 7.3]), Influenza 3.2%; 95% CI [2.2; 4.3], Human Coronavirus (HCoV) 2.9%; 95% CI [2.0; 4.0]), and Enterovirus (EV) 2.9%; 95% CI [1.6; 4.5]). HRSV was the predominant virus involved in multiple detection and most codetections were HRSV + RV 7.1%, 95% CI [4.6; 9.9]) and HRSV + HBoV 4.5%, 95% CI [2.4; 7.3]). Conclusions The present study has shown that HRSV is the main cause of bronchiolitis in children, we also have Rhinovirus, and Bocavirus which also play a significant role. Data on the role played by SARS-CoV-2 in children with acute bronchiolitis is needed. Review registration PROSPERO, CRD42018116067.

Seasonal Coronaviruses and Other Neglected Respiratory Viruses: A Global Perspective and a Local Snapshot

“…In children, the virus is linked to rhinitis, acute otitis media, pneumonia, bronchiolitis, and asthma exacerbations ( 97 ). One large meta-analysis showed that HBoV 1 is the third most common viral agent detected in children with bronchiolitis ( 103 ), while other investigators placed HBoV as the third most common virus in children suffering from wheezing with prevalence of 8.1%, following rhinoviruses and respiratory syncytial virus ( 104 ). Due to its non-enveloped nature, HBoV is resistant to disinfectants and detergents, and should be considered as a possible nosocomial pathogen (which is especially pertinent for immunocompromised children) ( 105 ).…”

Association between early viral LRTI and subsequent wheezing development, a meta-analysis and sensitivity analyses for studies comparable for confounding factors

“…The development of molecular diagnostic tests has made it possible to reassess the role of respiratory viruses in bronchiolitis and the description of new viruses [ 11 ]. Systematic reviews have shown that infections with no-HRSV respiratory viruses in childhood are also associated with an increased risk of developing wheezing sequelae [ 18 , 71 ].…”

“…Unfortunately, in this report, we have only recorded 2 studies with patients > 10 and are therefore unable to comment on the decrease in the strength of the association between LRTI in childhood and the subsequent wheezing risk. The development of molecular diagnostic tests has made it possible to reassess the role of respiratory viruses in bronchiolitis and the description of new viruses [11]. Systematic reviews have shown that infections with no-HRSV respiratory viruses in childhood are also associated with an increased risk of developing wheezing sequelae [18,71].…”

“…This question of wheezing after bronchiolitis in childhood have also been incompletely explored in multiple aspects including the age of children at the time of bronchiolitis development, bronchiolitis due to non-HRSV viruses, non-bronchiolitis Lower Respiratory Tract Infections (LRTI), and the influence of confounding factors [8][9][10]. The introduction of molecular diagnostic tests has led to better definition of the role of respiratory virus in bronchiolitis [11]. It is now recognized that Human Metapneumovirus (HMPV), Human Bocavirus (HBoV) or even Rhinovirus (RV) are among common viruses involved in bronchiolitis [12][13][14][15][16].…”

Molecular epidemiology of Enteroviruses and Rhinoviruses in patients with acute respiratory infections in Yaounde, Cameroon

“…6,7 With the development of molecular detection assays, RVs have recently been shown to be also involved in a significant proportion of more severe LRTIs such as wheezing, bronchiolitis, asthma exacerbation and chronic obstructive pulmonary disease. [8][9][10] Rhinoviruses have also been reported in apparently healthy individuals, possibly due to the prolonged viral shedding period. 11,12 Enteroviruses, on the other hand, have a broader tropism and can cause a wide range of human infections including acute respiratory infections, meningitis, encephalitis, gastroenteritis, acute flaccid paralysis or conjunctivitis.…”