Changes in the global hospitalisation burden of respiratory syncytial virus in young children during the COVID-19 pandemic: a systematic analysis
The COVID-19 pandemic is reported to have affected the epidemiology of respiratory syncytial virus (RSV), which could have important implications for RSV prevention and control strategies. We aimed to assess the hospitalisation burden of RSV-associated acute lower respiratory infection (ALRI) in chi...
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| Veröffentlicht in: | The Lancet infectious diseases 2024-04, Vol.24 (4), p.361-374 |
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| creator | Cong, Bingbing Koç, Uğurcan Bandeira, Teresa Bassat, Quique Bont, Louis Chakhunashvili, Giorgi Cohen, Cheryl Desnoyers, Christine Hammitt, Laura L Heikkinen, Terho Huang, Q Sue Markić, Joško Mira-Iglesias, Ainara Moyes, Jocelyn Nokes, D James Ploin, Dominique Seo, Euri Singleton, Rosalyn Wolter, Nicole Fu Yung, Chee Zar, Heather J Feikin, Daniel R Sparrow, Erin G Mrčela, Dina Milić, Petra Veljačić Visković, Daniela Torres-Fernandez, David Urchueguía, Arantxa Díez-Domingo, Javier Orrico-Sánchez, Alejandro Walaza, Sibongile Gottberg, Anne von Reubenson, Gary Dawood, Halima Mekgoe, Omphile Plessis, Mignon du Baute, Neydis Naby, Fathima Keck, James W Dobson, Jennifer Hartman, Rachel Sandoval, Marqia Bressler, Sara S Bruden, Dana Karseladze, Irakli Shchomak, Zakhar Barreto, Rosário Murunga, Nickson Mutunga, Martin Casalegno, Jean-Sebastien Horvat, Come Nair, Harish Li, You |
| description | The COVID-19 pandemic is reported to have affected the epidemiology of respiratory syncytial virus (RSV), which could have important implications for RSV prevention and control strategies. We aimed to assess the hospitalisation burden of RSV-associated acute lower respiratory infection (ALRI) in children younger than 5 years during the pandemic period and the possible changes in RSV epidemiology from a global perspective.
We conducted a systematic literature search for studies published between Jan 1, 2020, and June 30, 2022, in MEDLINE, Embase, Global Health, Web of Science, the WHO COVID-19 Research Database, CINAHL, LILACS, OpenGrey, CNKI, WanFang, and CqVip. We included unpublished data on RSV epidemiology shared by international collaborators. Eligible studies reported data on at least one of the following measures for children (aged |
| doi_str_mv | 10.1016/S1473-3099(23)00630-8 |
| format | Article |
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We conducted a systematic literature search for studies published between Jan 1, 2020, and June 30, 2022, in MEDLINE, Embase, Global Health, Web of Science, the WHO COVID-19 Research Database, CINAHL, LILACS, OpenGrey, CNKI, WanFang, and CqVip. We included unpublished data on RSV epidemiology shared by international collaborators. Eligible studies reported data on at least one of the following measures for children (aged <5 years) hospitalised with RSV-associated ALRI: hospital admission rates, in-hospital case fatality ratio, and the proportion of hospitalised children requiring supplemental oxygen or requiring mechanical ventilation or admission to intensive care. We used a generalised linear mixed-effects model for data synthesis to measure the changes in the incidence, age distribution, and disease severity of children hospitalised with RSV-associated ALRI during the pandemic, compared with the year 2019.
We included 61 studies from 19 countries, of which 14 (23%) studies were from the published literature (4052 identified records) and 47 (77%) were from unpublished datasets. Most (51 [84%]) studies were from high-income countries; nine (15%) were from upper-middle-income countries, one (2%) was from a lower-middle-income country (Kenya), and none were from a low-income country. 15 studies contributed to the estimates of hospitalisation rate and 57 studies contributed to the severity analyses. Compared with 2019, the rates of RSV-associated ALRI hospitalisation in all children (aged 0–60 months) in 2020 decreased by 79·7% (325 000 cases vs 66 000 cases) in high-income countries, 13·8% (581 000 cases vs 501 000 cases) in upper-middle-income countries, and 42·3% (1 378 000 cases vs 795 000 cases) in Kenya. In high-income countries, annualised rates started to rise in 2021, and by March, 2022, had returned to a level similar to 2019 (6·0 cases per 1000 children [95% uncertainty interval 5·4–6·8] in April, 2021, to March, 2022, vs 5·0 cases per 1000 children [3·6–6·8] in 2019). By contrast, in middle-income countries, rates remained lower in the latest period with data available than in 2019 (for upper-middle-income countries, 2·1 cases [0·7–6·1] in April, 2021, to March, 2022, vs 3·4 [1·2–9·7] in 2019; for Kenya, 2·2 cases [1·8–2·7] in 2021 vs 4·1 [3·5–4·7] in 2019). Across all time periods and income regions, hospitalisation rates peaked in younger infants (aged 0 to <3 months) and decreased with increasing age. A significantly higher proportion of children aged 12–24 months were hospitalised with RSV-associated ALRI in high-income and upper-middle-income countries during the pandemic years than in 2019, with odds ratios ranging from 1·30 (95% uncertainty interval 1·07–1·59) to 2·05 (1·66–2·54). No consistent changes in disease severity were observed.
The hospitalisation burden of RSV-associated ALRI in children younger than 5 years was significantly reduced during the first year of the COVID-19 pandemic. The rebound in hospitalisation rates to pre-pandemic rates observed in the high-income region but not in the middle-income region by March, 2022, suggests a persistent negative impact of the pandemic on health-care systems and health-care access in the middle-income region. RSV surveillance needs to be established (or re-established) to monitor changes in RSV epidemiology, particularly in low-income and lower-middle-income countries.
EU Innovative Medicines Initiative Preparing for RSV Immunisation and Surveillance in Europe (PROMISE), Bill & Melinda Gates Foundation, and WHO.</description><identifier>ISSN: 1473-3099</identifier><identifier>ISSN: 1474-4457</identifier><identifier>EISSN: 1474-4457</identifier><identifier>DOI: 10.1016/S1473-3099(23)00630-8</identifier><identifier>PMID: 38141633</identifier><language>eng</language><publisher>United States: Elsevier Ltd</publisher><subject>Child, Preschool ; COVID-19 - epidemiology ; Global Health ; Hospitalization - statistics & numerical data ; Humans ; Infant ; Infant, Newborn ; Male ; Pandemics ; Respiratory Syncytial Virus Infections - epidemiology ; Respiratory Syncytial Virus, Human ; SARS-CoV-2</subject><ispartof>The Lancet infectious diseases, 2024-04, Vol.24 (4), p.361-374</ispartof><rights>2024 World Health Organization</rights><rights>2024 World Health Organization. Published by Elsevier Ltd. All rights reserved. This is an Open Access article published under the CC BY 3.0 IGO license which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. In any use of this article, there should be no suggestion that WHO endorses any specific organisation, products or services. The use of the WHO logo is not permitted. This notice should be preserved along with the article's original URL.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c468t-75ec91b07c25907ed97888ca871d23c97c304ad7376e6a7433697b78e503bf663</citedby><cites>FETCH-LOGICAL-c468t-75ec91b07c25907ed97888ca871d23c97c304ad7376e6a7433697b78e503bf663</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://www.sciencedirect.com/science/article/pii/S1473309923006308$$EHTML$$P50$$Gelsevier$$Hfree_for_read</linktohtml><link.rule.ids>230,314,776,780,881,3537,27901,27902,65306</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/38141633$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Cong, Bingbing</creatorcontrib><creatorcontrib>Koç, Uğurcan</creatorcontrib><creatorcontrib>Bandeira, Teresa</creatorcontrib><creatorcontrib>Bassat, Quique</creatorcontrib><creatorcontrib>Bont, Louis</creatorcontrib><creatorcontrib>Chakhunashvili, Giorgi</creatorcontrib><creatorcontrib>Cohen, Cheryl</creatorcontrib><creatorcontrib>Desnoyers, Christine</creatorcontrib><creatorcontrib>Hammitt, Laura L</creatorcontrib><creatorcontrib>Heikkinen, Terho</creatorcontrib><creatorcontrib>Huang, Q Sue</creatorcontrib><creatorcontrib>Markić, Joško</creatorcontrib><creatorcontrib>Mira-Iglesias, Ainara</creatorcontrib><creatorcontrib>Moyes, Jocelyn</creatorcontrib><creatorcontrib>Nokes, D James</creatorcontrib><creatorcontrib>Ploin, Dominique</creatorcontrib><creatorcontrib>Seo, Euri</creatorcontrib><creatorcontrib>Singleton, Rosalyn</creatorcontrib><creatorcontrib>Wolter, Nicole</creatorcontrib><creatorcontrib>Fu Yung, Chee</creatorcontrib><creatorcontrib>Zar, Heather J</creatorcontrib><creatorcontrib>Feikin, Daniel R</creatorcontrib><creatorcontrib>Sparrow, Erin G</creatorcontrib><creatorcontrib>Mrčela, Dina</creatorcontrib><creatorcontrib>Milić, Petra</creatorcontrib><creatorcontrib>Veljačić Visković, Daniela</creatorcontrib><creatorcontrib>Torres-Fernandez, David</creatorcontrib><creatorcontrib>Urchueguía, Arantxa</creatorcontrib><creatorcontrib>Díez-Domingo, Javier</creatorcontrib><creatorcontrib>Orrico-Sánchez, Alejandro</creatorcontrib><creatorcontrib>Walaza, Sibongile</creatorcontrib><creatorcontrib>Gottberg, Anne von</creatorcontrib><creatorcontrib>Reubenson, Gary</creatorcontrib><creatorcontrib>Dawood, Halima</creatorcontrib><creatorcontrib>Mekgoe, Omphile</creatorcontrib><creatorcontrib>Plessis, Mignon du</creatorcontrib><creatorcontrib>Baute, Neydis</creatorcontrib><creatorcontrib>Naby, Fathima</creatorcontrib><creatorcontrib>Keck, James W</creatorcontrib><creatorcontrib>Dobson, Jennifer</creatorcontrib><creatorcontrib>Hartman, Rachel</creatorcontrib><creatorcontrib>Sandoval, Marqia</creatorcontrib><creatorcontrib>Bressler, Sara S</creatorcontrib><creatorcontrib>Bruden, Dana</creatorcontrib><creatorcontrib>Karseladze, Irakli</creatorcontrib><creatorcontrib>Shchomak, Zakhar</creatorcontrib><creatorcontrib>Barreto, Rosário</creatorcontrib><creatorcontrib>Murunga, Nickson</creatorcontrib><creatorcontrib>Mutunga, Martin</creatorcontrib><creatorcontrib>Casalegno, Jean-Sebastien</creatorcontrib><creatorcontrib>Horvat, Come</creatorcontrib><creatorcontrib>Nair, Harish</creatorcontrib><creatorcontrib>Li, You</creatorcontrib><creatorcontrib>Respiratory Virus Global Epidemiology Network</creatorcontrib><creatorcontrib>VRS study group in Lyon</creatorcontrib><creatorcontrib>PROMISE investigators</creatorcontrib><title>Changes in the global hospitalisation burden of respiratory syncytial virus in young children during the COVID-19 pandemic: a systematic analysis</title><title>The Lancet infectious diseases</title><addtitle>Lancet Infect Dis</addtitle><description>The COVID-19 pandemic is reported to have affected the epidemiology of respiratory syncytial virus (RSV), which could have important implications for RSV prevention and control strategies. We aimed to assess the hospitalisation burden of RSV-associated acute lower respiratory infection (ALRI) in children younger than 5 years during the pandemic period and the possible changes in RSV epidemiology from a global perspective.
We conducted a systematic literature search for studies published between Jan 1, 2020, and June 30, 2022, in MEDLINE, Embase, Global Health, Web of Science, the WHO COVID-19 Research Database, CINAHL, LILACS, OpenGrey, CNKI, WanFang, and CqVip. We included unpublished data on RSV epidemiology shared by international collaborators. Eligible studies reported data on at least one of the following measures for children (aged <5 years) hospitalised with RSV-associated ALRI: hospital admission rates, in-hospital case fatality ratio, and the proportion of hospitalised children requiring supplemental oxygen or requiring mechanical ventilation or admission to intensive care. We used a generalised linear mixed-effects model for data synthesis to measure the changes in the incidence, age distribution, and disease severity of children hospitalised with RSV-associated ALRI during the pandemic, compared with the year 2019.
We included 61 studies from 19 countries, of which 14 (23%) studies were from the published literature (4052 identified records) and 47 (77%) were from unpublished datasets. Most (51 [84%]) studies were from high-income countries; nine (15%) were from upper-middle-income countries, one (2%) was from a lower-middle-income country (Kenya), and none were from a low-income country. 15 studies contributed to the estimates of hospitalisation rate and 57 studies contributed to the severity analyses. Compared with 2019, the rates of RSV-associated ALRI hospitalisation in all children (aged 0–60 months) in 2020 decreased by 79·7% (325 000 cases vs 66 000 cases) in high-income countries, 13·8% (581 000 cases vs 501 000 cases) in upper-middle-income countries, and 42·3% (1 378 000 cases vs 795 000 cases) in Kenya. In high-income countries, annualised rates started to rise in 2021, and by March, 2022, had returned to a level similar to 2019 (6·0 cases per 1000 children [95% uncertainty interval 5·4–6·8] in April, 2021, to March, 2022, vs 5·0 cases per 1000 children [3·6–6·8] in 2019). By contrast, in middle-income countries, rates remained lower in the latest period with data available than in 2019 (for upper-middle-income countries, 2·1 cases [0·7–6·1] in April, 2021, to March, 2022, vs 3·4 [1·2–9·7] in 2019; for Kenya, 2·2 cases [1·8–2·7] in 2021 vs 4·1 [3·5–4·7] in 2019). Across all time periods and income regions, hospitalisation rates peaked in younger infants (aged 0 to <3 months) and decreased with increasing age. A significantly higher proportion of children aged 12–24 months were hospitalised with RSV-associated ALRI in high-income and upper-middle-income countries during the pandemic years than in 2019, with odds ratios ranging from 1·30 (95% uncertainty interval 1·07–1·59) to 2·05 (1·66–2·54). No consistent changes in disease severity were observed.
The hospitalisation burden of RSV-associated ALRI in children younger than 5 years was significantly reduced during the first year of the COVID-19 pandemic. The rebound in hospitalisation rates to pre-pandemic rates observed in the high-income region but not in the middle-income region by March, 2022, suggests a persistent negative impact of the pandemic on health-care systems and health-care access in the middle-income region. RSV surveillance needs to be established (or re-established) to monitor changes in RSV epidemiology, particularly in low-income and lower-middle-income countries.
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Orrico-Sánchez, Alejandro ; Walaza, Sibongile ; Gottberg, Anne von ; Reubenson, Gary ; Dawood, Halima ; Mekgoe, Omphile ; Plessis, Mignon du ; Baute, Neydis ; Naby, Fathima ; Keck, James W ; Dobson, Jennifer ; Hartman, Rachel ; Sandoval, Marqia ; Bressler, Sara S ; Bruden, Dana ; Karseladze, Irakli ; Shchomak, Zakhar ; Barreto, Rosário ; Murunga, Nickson ; Mutunga, Martin ; Casalegno, Jean-Sebastien ; Horvat, Come ; Nair, Harish ; Li, You</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c468t-75ec91b07c25907ed97888ca871d23c97c304ad7376e6a7433697b78e503bf663</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2024</creationdate><topic>Child, Preschool</topic><topic>COVID-19 - epidemiology</topic><topic>Global Health</topic><topic>Hospitalization - statistics & numerical data</topic><topic>Humans</topic><topic>Infant</topic><topic>Infant, Newborn</topic><topic>Male</topic><topic>Pandemics</topic><topic>Respiratory Syncytial Virus Infections - epidemiology</topic><topic>Respiratory Syncytial Virus, Human</topic><topic>SARS-CoV-2</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Cong, Bingbing</creatorcontrib><creatorcontrib>Koç, Uğurcan</creatorcontrib><creatorcontrib>Bandeira, Teresa</creatorcontrib><creatorcontrib>Bassat, Quique</creatorcontrib><creatorcontrib>Bont, Louis</creatorcontrib><creatorcontrib>Chakhunashvili, Giorgi</creatorcontrib><creatorcontrib>Cohen, Cheryl</creatorcontrib><creatorcontrib>Desnoyers, Christine</creatorcontrib><creatorcontrib>Hammitt, Laura L</creatorcontrib><creatorcontrib>Heikkinen, Terho</creatorcontrib><creatorcontrib>Huang, Q Sue</creatorcontrib><creatorcontrib>Markić, Joško</creatorcontrib><creatorcontrib>Mira-Iglesias, Ainara</creatorcontrib><creatorcontrib>Moyes, Jocelyn</creatorcontrib><creatorcontrib>Nokes, D James</creatorcontrib><creatorcontrib>Ploin, Dominique</creatorcontrib><creatorcontrib>Seo, Euri</creatorcontrib><creatorcontrib>Singleton, Rosalyn</creatorcontrib><creatorcontrib>Wolter, Nicole</creatorcontrib><creatorcontrib>Fu Yung, Chee</creatorcontrib><creatorcontrib>Zar, Heather J</creatorcontrib><creatorcontrib>Feikin, Daniel R</creatorcontrib><creatorcontrib>Sparrow, Erin G</creatorcontrib><creatorcontrib>Mrčela, Dina</creatorcontrib><creatorcontrib>Milić, Petra</creatorcontrib><creatorcontrib>Veljačić Visković, Daniela</creatorcontrib><creatorcontrib>Torres-Fernandez, David</creatorcontrib><creatorcontrib>Urchueguía, Arantxa</creatorcontrib><creatorcontrib>Díez-Domingo, Javier</creatorcontrib><creatorcontrib>Orrico-Sánchez, Alejandro</creatorcontrib><creatorcontrib>Walaza, Sibongile</creatorcontrib><creatorcontrib>Gottberg, Anne von</creatorcontrib><creatorcontrib>Reubenson, Gary</creatorcontrib><creatorcontrib>Dawood, Halima</creatorcontrib><creatorcontrib>Mekgoe, Omphile</creatorcontrib><creatorcontrib>Plessis, Mignon du</creatorcontrib><creatorcontrib>Baute, Neydis</creatorcontrib><creatorcontrib>Naby, Fathima</creatorcontrib><creatorcontrib>Keck, James W</creatorcontrib><creatorcontrib>Dobson, Jennifer</creatorcontrib><creatorcontrib>Hartman, Rachel</creatorcontrib><creatorcontrib>Sandoval, Marqia</creatorcontrib><creatorcontrib>Bressler, Sara S</creatorcontrib><creatorcontrib>Bruden, Dana</creatorcontrib><creatorcontrib>Karseladze, Irakli</creatorcontrib><creatorcontrib>Shchomak, Zakhar</creatorcontrib><creatorcontrib>Barreto, Rosário</creatorcontrib><creatorcontrib>Murunga, Nickson</creatorcontrib><creatorcontrib>Mutunga, Martin</creatorcontrib><creatorcontrib>Casalegno, Jean-Sebastien</creatorcontrib><creatorcontrib>Horvat, Come</creatorcontrib><creatorcontrib>Nair, Harish</creatorcontrib><creatorcontrib>Li, You</creatorcontrib><creatorcontrib>Respiratory Virus Global Epidemiology Network</creatorcontrib><creatorcontrib>VRS study group in Lyon</creatorcontrib><creatorcontrib>PROMISE investigators</creatorcontrib><collection>ScienceDirect Open Access Titles</collection><collection>Elsevier:ScienceDirect:Open Access</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>The Lancet infectious diseases</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Cong, Bingbing</au><au>Koç, Uğurcan</au><au>Bandeira, Teresa</au><au>Bassat, Quique</au><au>Bont, Louis</au><au>Chakhunashvili, Giorgi</au><au>Cohen, Cheryl</au><au>Desnoyers, Christine</au><au>Hammitt, Laura L</au><au>Heikkinen, Terho</au><au>Huang, Q Sue</au><au>Markić, Joško</au><au>Mira-Iglesias, Ainara</au><au>Moyes, Jocelyn</au><au>Nokes, D James</au><au>Ploin, Dominique</au><au>Seo, Euri</au><au>Singleton, Rosalyn</au><au>Wolter, Nicole</au><au>Fu Yung, Chee</au><au>Zar, Heather J</au><au>Feikin, Daniel R</au><au>Sparrow, Erin G</au><au>Mrčela, Dina</au><au>Milić, Petra</au><au>Veljačić Visković, Daniela</au><au>Torres-Fernandez, David</au><au>Urchueguía, Arantxa</au><au>Díez-Domingo, Javier</au><au>Orrico-Sánchez, Alejandro</au><au>Walaza, Sibongile</au><au>Gottberg, Anne von</au><au>Reubenson, Gary</au><au>Dawood, Halima</au><au>Mekgoe, Omphile</au><au>Plessis, Mignon du</au><au>Baute, Neydis</au><au>Naby, Fathima</au><au>Keck, James W</au><au>Dobson, Jennifer</au><au>Hartman, Rachel</au><au>Sandoval, Marqia</au><au>Bressler, Sara S</au><au>Bruden, Dana</au><au>Karseladze, Irakli</au><au>Shchomak, Zakhar</au><au>Barreto, Rosário</au><au>Murunga, Nickson</au><au>Mutunga, Martin</au><au>Casalegno, Jean-Sebastien</au><au>Horvat, Come</au><au>Nair, Harish</au><au>Li, You</au><aucorp>Respiratory Virus Global Epidemiology Network</aucorp><aucorp>VRS study group in Lyon</aucorp><aucorp>PROMISE investigators</aucorp><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Changes in the global hospitalisation burden of respiratory syncytial virus in young children during the COVID-19 pandemic: a systematic analysis</atitle><jtitle>The Lancet infectious diseases</jtitle><addtitle>Lancet Infect Dis</addtitle><date>2024-04-01</date><risdate>2024</risdate><volume>24</volume><issue>4</issue><spage>361</spage><epage>374</epage><pages>361-374</pages><issn>1473-3099</issn><issn>1474-4457</issn><eissn>1474-4457</eissn><abstract>The COVID-19 pandemic is reported to have affected the epidemiology of respiratory syncytial virus (RSV), which could have important implications for RSV prevention and control strategies. We aimed to assess the hospitalisation burden of RSV-associated acute lower respiratory infection (ALRI) in children younger than 5 years during the pandemic period and the possible changes in RSV epidemiology from a global perspective.
We conducted a systematic literature search for studies published between Jan 1, 2020, and June 30, 2022, in MEDLINE, Embase, Global Health, Web of Science, the WHO COVID-19 Research Database, CINAHL, LILACS, OpenGrey, CNKI, WanFang, and CqVip. We included unpublished data on RSV epidemiology shared by international collaborators. Eligible studies reported data on at least one of the following measures for children (aged <5 years) hospitalised with RSV-associated ALRI: hospital admission rates, in-hospital case fatality ratio, and the proportion of hospitalised children requiring supplemental oxygen or requiring mechanical ventilation or admission to intensive care. We used a generalised linear mixed-effects model for data synthesis to measure the changes in the incidence, age distribution, and disease severity of children hospitalised with RSV-associated ALRI during the pandemic, compared with the year 2019.
We included 61 studies from 19 countries, of which 14 (23%) studies were from the published literature (4052 identified records) and 47 (77%) were from unpublished datasets. Most (51 [84%]) studies were from high-income countries; nine (15%) were from upper-middle-income countries, one (2%) was from a lower-middle-income country (Kenya), and none were from a low-income country. 15 studies contributed to the estimates of hospitalisation rate and 57 studies contributed to the severity analyses. Compared with 2019, the rates of RSV-associated ALRI hospitalisation in all children (aged 0–60 months) in 2020 decreased by 79·7% (325 000 cases vs 66 000 cases) in high-income countries, 13·8% (581 000 cases vs 501 000 cases) in upper-middle-income countries, and 42·3% (1 378 000 cases vs 795 000 cases) in Kenya. In high-income countries, annualised rates started to rise in 2021, and by March, 2022, had returned to a level similar to 2019 (6·0 cases per 1000 children [95% uncertainty interval 5·4–6·8] in April, 2021, to March, 2022, vs 5·0 cases per 1000 children [3·6–6·8] in 2019). By contrast, in middle-income countries, rates remained lower in the latest period with data available than in 2019 (for upper-middle-income countries, 2·1 cases [0·7–6·1] in April, 2021, to March, 2022, vs 3·4 [1·2–9·7] in 2019; for Kenya, 2·2 cases [1·8–2·7] in 2021 vs 4·1 [3·5–4·7] in 2019). Across all time periods and income regions, hospitalisation rates peaked in younger infants (aged 0 to <3 months) and decreased with increasing age. A significantly higher proportion of children aged 12–24 months were hospitalised with RSV-associated ALRI in high-income and upper-middle-income countries during the pandemic years than in 2019, with odds ratios ranging from 1·30 (95% uncertainty interval 1·07–1·59) to 2·05 (1·66–2·54). No consistent changes in disease severity were observed.
The hospitalisation burden of RSV-associated ALRI in children younger than 5 years was significantly reduced during the first year of the COVID-19 pandemic. The rebound in hospitalisation rates to pre-pandemic rates observed in the high-income region but not in the middle-income region by March, 2022, suggests a persistent negative impact of the pandemic on health-care systems and health-care access in the middle-income region. RSV surveillance needs to be established (or re-established) to monitor changes in RSV epidemiology, particularly in low-income and lower-middle-income countries.
EU Innovative Medicines Initiative Preparing for RSV Immunisation and Surveillance in Europe (PROMISE), Bill & Melinda Gates Foundation, and WHO.</abstract><cop>United States</cop><pub>Elsevier Ltd</pub><pmid>38141633</pmid><doi>10.1016/S1473-3099(23)00630-8</doi><tpages>14</tpages><oa>free_for_read</oa></addata></record> |
| fulltext | fulltext |
| identifier | ISSN: 1473-3099 |
| ispartof | The Lancet infectious diseases, 2024-04, Vol.24 (4), p.361-374 |
| issn | 1473-3099 1474-4457 1474-4457 |
| language | eng |
| recordid | cdi_pubmedcentral_primary_oai_pubmedcentral_nih_gov_11290460 |
| source | MEDLINE; Elsevier ScienceDirect Journals |
| subjects | Child, Preschool COVID-19 - epidemiology Global Health Hospitalization - statistics & numerical data Humans Infant Infant, Newborn Male Pandemics Respiratory Syncytial Virus Infections - epidemiology Respiratory Syncytial Virus, Human SARS-CoV-2 |
| title | Changes in the global hospitalisation burden of respiratory syncytial virus in young children during the COVID-19 pandemic: a systematic analysis |
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