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A Systematic Literature Review of the Burden of Respiratory Syncytial Virus and Health Care Utilization Among United States Infants Younger Than 1 Year( )

Journal

JOURNAL OF INFECTIOUS DISEASES
Volume 226, Issue SUPPL 2, Pages S195-S212

Publisher

OXFORD UNIV PRESS INC
DOI: 10.1093/infdis/jiac201

Keywords

emergency department; infants; intensive care unit admission; lower respiratory tract infection; mechanical ventilation; outpatient; respiratory syncytial virus; respiratory syncytial virus hospitalization; RSV; systematic literature review

Funding

  1. Sanofi
  2. AstraZeneca

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A systematic review of studies on respiratory syncytial virus (RSV) and bronchiolitis in US infants revealed substantial variability in the burden and healthcare utilization rates. Nationally representative studies are needed to understand the impact of RSV and healthcare utilization.
Background The burden and health care utilization (HCU) of respiratory syncytial virus (RSV) in US infants aged Methods We systematically reviewed studies of RSV and bronchiolitis published 2000-2021 (data years, 1979-2020). Outcomes included RSV hospitalization (RSVH)/bronchiolitis hospitalization rates, emergency department (ED)/outpatient (OP) visit rates, and intensive care unit (ICU) admissions or mechanical ventilation (MV) use among RSV-/bronchiolitis-hospitalized infants. Study quality was determined using standard tools. Results We identified 141 good-/fair-quality studies. Five national studies reported annual average RSVH rates (range, 11.6 per 1000 per year among infants aged 6-11 months in 2006 to 50.1 per 1000 per year among infants aged 0-2 months in 1997). Two national studies provided RSVH rates by primary diagnosis for the entire study period (range, 22.0-22.7 per 1000 in 1997-1999 and 1997-2000, respectively). No national ED/OP data were available. Among 11 nonnational studies, RSVH rates varied due to differences in time, populations (eg, prematurity), and locations. One national study reported that RSVH infants with high-risk comorbidities had 5-times more MV use compared to non-high-risk infants in 1997-2012. Conclusions Substantial data variability was observed. Nationally representative studies are needed to elucidate RSV burden and HCU.

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