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Pérez Martín JJ, Zornoza Moreno M. Implementation of the first respiratory syncytial (RSV) immunization campaign with nirsevimab in an autonomous community in Spain. Hum Vaccin Immunother 2024; 20:2365804. [PMID: 39137331 PMCID: PMC11188787 DOI: 10.1080/21645515.2024.2365804] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2024] [Accepted: 06/05/2024] [Indexed: 08/15/2024] Open
Abstract
Respiratory syncytial virus (RSV) is the main cause of low respiratory tract infections in infants under one year of age. In the 2023/2024 season, the monoclonal antibody nirsevimab was available to protect children from RSV, and Spain has become one of the first countries worldwide to implement this strategy. It is essential to evaluate the results of this first campaign and different characteristics of the immunized population in order to plan next campaigns, especially for countries that are going to include this immunization. Our coverage was high (91.5% for those born during the season and 88.3% globally). For those born during the season, only 4.9% preferred not to immunize at the maternity hospital, which meant an average delay of 27.45 days. We observed a lower coverage in the population of immigrant origin. There was a rapid pace of immunization, since for those born before the beginning of the campaign the mean to be immunized was 15.63 days, without differences between healthy and at-risk children. This allows immunization before the RSV season (90% of the catch-up children had been immunized on November 3). The average age at which all the immunized children have received nirsevimab was lower in healthy children compared to those with risk conditions (49.65 versus 232.85 days). For those born during the campaign, the average age was also lower in healthy children (3.14 versus 14.58 days). In conclusion, we consider that the implementation of the immunization strategy with nirsevimab in the Region of Murcia, Spain, has been a success.
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Mendoza-Cano O, Trujillo X, Huerta M, Ríos-Silva M, Lugo-Radillo A, Bricio-Barrios JA, Cuevas-Arellano HB, Camacho-de la Cruz AA, Sánchez V, Murillo-Zamora E. Risk factors for severe disease in pediatric respiratory syncytial virus infections. Public Health 2024; 235:167-172. [PMID: 39141965 DOI: 10.1016/j.puhe.2024.06.023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2024] [Revised: 06/03/2024] [Accepted: 06/17/2024] [Indexed: 08/16/2024]
Abstract
OBJECTIVES To assess factors associated with the risk of severe disease in children aged 5 years or younger with laboratory-confirmed respiratory syncytial virus (RSV) infection. STUDY DESIGN We conducted a nationwide retrospective cohort study in Mexico. METHODS Eligible participants included children aged 5 years or younger with laboratory-confirmed RSV infection January 1, 2023, and May 15, 2024. We collected relevant clinical and epidemiological data. Risk ratios (RR) and 95% confidence intervals (CI) were employed to identify factors associated with the risk of severe disease, characterized by clinical and radiographic evidence of bronchiolitis or pneumonia requiring hospital admission. RESULTS Data from 2022 children were analyzed and the overall risk of severe disease was 21.0% (n = 424/2022). In multiple generalized linear regression analysis, a personal history of immunosuppression (due to any cause) showed a protective effect (RR = 0.14, 95% CI 0.05-0.42, P = 0.001) against severe RSV disease, while an increased risk was documented for each additional day elapsed between the date of symptom onset and the date of seeking healthcare RR = 1.06, 95% CI 1.02-1.10, P = 0.004). CONCLUSION These findings provide insights into risk stratification and suggest specific directions for future research. This information informs the development of targeted intervention strategies to mitigate the impact of RSV infections in this vulnerable population.
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Affiliation(s)
- O Mendoza-Cano
- Facultad de Ingeniería Civil, Universidad de Colima, km. 9 Carretera Colima-Coquimatlán, Coquimatlán 28400, Colima, Mexico; Centro de Estudios e Investigación en Biocultura, Agroecología, Ambiente y Salud, Ex Hacienda Nogueras S/N, Nogueras 28450, Mexico.
| | - X Trujillo
- Centro Universitario de Investigaciones Biomédicas, Universidad de Colima, Av. 25 de Julio 965, Col. Villas San Sebastián, Colima 28045, Mexico.
| | - M Huerta
- Centro Universitario de Investigaciones Biomédicas, Universidad de Colima, Av. 25 de Julio 965, Col. Villas San Sebastián, Colima 28045, Mexico.
| | - M Ríos-Silva
- Facultad de Medicina, Universidad de Colima, Av. Universidad 333, Col. Las Víboras, Colima 28045, Mexico.
| | - A Lugo-Radillo
- CONAHCyT -Facultad de Medicina y Cirugía, Universidad Autónoma Benito Juárez de Oaxaca, Ex Hacienda Aguilera S/N, Carr. a San Felipe del Agua, Oaxaca 68020, Mexico.
| | - J A Bricio-Barrios
- Facultad de Medicina, Universidad de Colima, Av. Universidad 333, Col. Las Víboras, Colima 28045, Mexico.
| | - H B Cuevas-Arellano
- Facultad de Ciencias, Universidad de Colima, Bernal Díaz del Castillo 340, Colima 28045, Mexico.
| | - A A Camacho-de la Cruz
- Facultad de Ingeniería Civil, Universidad de Colima, km. 9 Carretera Colima-Coquimatlán, Coquimatlán 28400, Colima, Mexico.
| | - V Sánchez
- Facultad de Medicina, Universidad de Colima, Av. Universidad 333, Col. Las Víboras, Colima 28045, Mexico.
| | - E Murillo-Zamora
- Unidad de Investigación en Epidemiología Clínica, Instituto Mexicano del Seguro Social, Av. Lapislázuli 250, Col. El Haya, Villa de Álvarez 28984, Mexico.
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Brault A, Pontais I, Enouf V, Debeuret C, Bloch E, Paireau J, Rameix-Welti MA, White M, Baudemont G, Lina B, Parent du Châtelet I, Casalegno JS, Vaux S, Cauchemez S. Effect of nirsevimab on hospitalisations for respiratory syncytial virus bronchiolitis in France, 2023-24: a modelling study. THE LANCET. CHILD & ADOLESCENT HEALTH 2024; 8:721-729. [PMID: 39208833 DOI: 10.1016/s2352-4642(24)00143-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/09/2024] [Revised: 06/04/2024] [Accepted: 06/05/2024] [Indexed: 09/04/2024]
Abstract
BACKGROUND Respiratory syncytial virus (RSV) is a major cause of hospitalisations and deaths among infants worldwide. France was one of the first countries to implement a national programme (beginning on Sept 15, 2023) for administration of nirsevimab, a single-dose long-acting monoclonal antibody treatment, to infants born on or after Feb 6, 2023, to prevent lower respiratory tract infection caused by RSV. We aimed to estimate the effectiveness of nirsevimab and the number of hospitalisations averted in children younger than 24 months in real-world settings. METHODS In this modelling study, we developed an age-structured deterministic model characterising RSV transmission as well as plausible scenarios for the administration of nirsevimab doses based on maternity ward and community pharmacy supply data. We retrospectively estimated nirsevimab effectiveness in infants younger than 24 months during the 2023-24 RSV season in France (excluding overseas territories) and the number of averted hospitalisations for RSV bronchiolitis occurring after emergency department visits, by calibrating the model to hospital and virological surveillance data from Aug 21, 2017, to Feb 4, 2024, alongside serological data from a previous cross-sectional study. To assess the robustness of our estimates, we conducted sensitivity analyses in which we modified our assumptions about the number of doses administered, the reconstruction of the number of RSV-associated hospitalisations for bronchiolitis, the duration of maternal and post-infection immunity to RSV, and the number of contacts in children aged 0-2 months. FINDINGS We estimated that nirsevimab administration prevented 5800 (95% credible interval 3700-7800) RSV-associated hospitalisations for bronchiolitis after emergency department visits among children younger than 24 months, including 4200 (2900-5600) hospitalisations among those aged 0-2 months, between Sept 15, 2023 (the date nirsevimab was introduced), and Feb 4, 2024-a 23% (16-30) reduction in the total number of hospitalisations and a 35% (25-44) reduction in the 0-2 months age group, compared with the scenario without administration. In our baseline scenario, in which we estimated that 215 000 doses of nirsevimab were administered by Jan 31, 2024, the estimated effectiveness against RSV-associated hospitalisations for bronchiolitis was 73% (61-84), corresponding to one hospitalisation averted for every 39 (26-54) doses administered. In sensitivity analyses, nirsevimab remained effective against RSV-associated hospitalisations for bronchiolitis after emergency department attendance. INTERPRETATION Our findings show that nirsevimab administration campaigns could effectively reduce the RSV-related hospital burden of bronchiolitis in children younger than 24 months. FUNDING European Commission, Laboratoire d'Excellence Integrative Biology of Emerging Infectious Diseases programme, and INCEPTION project.
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Affiliation(s)
- Antoine Brault
- Mathematical Modelling of Infectious Diseases Unit, Institut Pasteur, Université Paris Cité, CNRS UMR 2000, Paris, France
| | - Isabelle Pontais
- Direction Appui, Traitements et Analyses de données, Santé publique France, Saint-Maurice, France
| | - Vincent Enouf
- Molecular Mechanisms of Multiplication of Pneumovirus, Université Paris-Saclay-Versailles St Quentin, Institut Pasteur, Université Paris Cité, INSERM UMR 1173 (2I), Paris, France; France National Reference Center for Respiratory viruses, Université Paris Cité, Institut Pasteur, Paris, France; Mutualized Platform of Microbiology, Pasteur International Bioresources Network, Université Paris Cité, Institut Pasteur, Paris, France
| | - Christine Debeuret
- Direction alerte et crise, établissement pharmaceutique, Santé publique France, Saint-Maurice, France
| | - Emma Bloch
- Infectious Disease Epidemiology and Analytics G5 Unit, Department of Global Health, Université Paris Cité, Institut Pasteur, Paris, France
| | - Juliette Paireau
- Mathematical Modelling of Infectious Diseases Unit, Institut Pasteur, Université Paris Cité, CNRS UMR 2000, Paris, France; Direction des Maladies Infectieuses, Santé publique France, Saint-Maurice, France
| | - Marie-Anne Rameix-Welti
- Molecular Mechanisms of Multiplication of Pneumovirus, Université Paris-Saclay-Versailles St Quentin, Institut Pasteur, Université Paris Cité, INSERM UMR 1173 (2I), Paris, France; Assistance Publique des Hôpitaux de Paris, Paris, France; France National Reference Center for Respiratory viruses, Université Paris Cité, Institut Pasteur, Paris, France
| | - Michael White
- Infectious Disease Epidemiology and Analytics G5 Unit, Department of Global Health, Université Paris Cité, Institut Pasteur, Paris, France
| | - Gaëlle Baudemont
- Infectious Disease Epidemiology and Analytics G5 Unit, Department of Global Health, Université Paris Cité, Institut Pasteur, Paris, France
| | - Bruno Lina
- Virology Laboratory, CNR des Virus des Infections Respiratoires, Institut des Agents Infectieux, Hôpital de la Croix Rousse, Hospices Civils de Lyon, Lyon, France
| | | | - Jean-Sébastien Casalegno
- Virology Laboratory, CNR des Virus des Infections Respiratoires, Institut des Agents Infectieux, Hôpital de la Croix Rousse, Hospices Civils de Lyon, Lyon, France
| | - Sophie Vaux
- Direction des Maladies Infectieuses, Santé publique France, Saint-Maurice, France
| | - Simon Cauchemez
- Mathematical Modelling of Infectious Diseases Unit, Institut Pasteur, Université Paris Cité, CNRS UMR 2000, Paris, France.
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Lade C, Bayer L, Huebbe B, Riedel J, Melnik S, Brestrich G, von Eiff C, Tenenbaum T. Clinical and economic inpatient burden of respiratory syncytial virus (RSV) infections in children < 2 years of age in Germany, 2014-2019: a retrospective health claims analysis. Infection 2024:10.1007/s15010-024-02391-x. [PMID: 39325356 DOI: 10.1007/s15010-024-02391-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2024] [Accepted: 08/31/2024] [Indexed: 09/27/2024]
Abstract
BACKGROUND Respiratory syncytial virus (RSV) is a common cause for severe lower respiratory tract infections (LRTI) in children < 2 years of age in Germany - though little is known about the clinical and economic burden of RSV in children with and without risk factors per month of life. METHODS In a retrospective health claims analysis, we identified RSV inpatient cases between 2014 and 2019. We assessed incidence rates, mortality rate, healthcare resource utilization, associated direct costs per case and excess costs for 30, 90 and 365 days after hospital admission matched to a control group. The outcomes are reported separately for the first and second year of life (i.e., for infants and toddlers) and were stratified by month of life, preterm and risk status (i.e., presence of underlying disease: chronic respiratory or cardiac disease, immunosuppression, neurological diseases, diabetes, conditions originating in the perinatal period). RESULTS RSV-attributable hospital incidence rate was higher in infants (30.25/1,000) than toddlers (14.52/1,000), highest in the first three months of life (44.21/1,000), in infants born preterm (64.76/1,000) or with any underlying disease (54.85/1,000). Mortality rate was also higher for infants (0.08/1,000) than toddlers (0.04/1,000). Mean 30-day excess costs ranged from 2,953 € for infants born full-term at no risk, hospitalized for 5 days, to 6,694 € for infants born extremely premature, hospitalized for 7 days. CONCLUSION In Germany, the clinical and economic burden of RSV is substantial, especially in the most vulnerable population, that is, very young infants, those born premature and/or those with an underlying disease.
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Affiliation(s)
| | | | | | | | - Sima Melnik
- Gesundheitsforen Leipzig GmbH, Leipzig, Germany
| | | | | | - Tobias Tenenbaum
- Clinic for Child and Adolescent Medicine, Sana Klinikum Lichtenberg, Academic Teaching Hospital Charité-Universitätsmedizin Berlin, Berlin, Germany
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Banoun H. Analysis of Beyfortus ® (Nirsevimab) Immunization Campaign: Effectiveness, Biases, and ADE Risks in RSV Prevention. Curr Issues Mol Biol 2024; 46:10369-10395. [PMID: 39329969 PMCID: PMC11431526 DOI: 10.3390/cimb46090617] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2024] [Revised: 08/27/2024] [Accepted: 09/17/2024] [Indexed: 09/28/2024] Open
Abstract
Respiratory infections with respiratory syncytial virus (RSV) account for an important part of hospital admissions for acute respiratory infections. Nirsevimab has been developed to reduce the hospital burden of RSV infections. Compared with the product previously used, it has a stronger binding capacity to RSV F protein and a high affinity for FcRn (neonatal receptor for the Fc fragment of IgG), which extends its lifespan. Nirsevimab has been shown to be highly effective in reducing hospitalization rates of RSV infections but a large or unknown number of treated subjects have been excluded in clinical and post-marketing studies. However, analysis of these studies cannot exclude that, in rare cases, nirsevimab facilitates and worsens RSV infection (or other respiratory infections). This could be attributable to antibody-dependent enhancement (ADE) which has been observed with RSV F protein antibodies in inactivated vaccine trials. This risk has been incompletely assessed in pre-clinical and clinical trials (incomplete exploration of nirsevimab effector functions and pharmacokinetics). ADE by disruption of the immune system (not studied and due to FcRn binding) could explain why there is no reduction in all-cause hospital admissions in treated age groups. Given the high price of nirsevimab, the cost-effectiveness of mass immunization campaigns may therefore be debated from an economic as well as a scientific point of view.
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Dallagiacoma G, Radó MK, Odone A, Alfvén T, Rhedin SA. School holidays and respiratory syncytial virus transmission in Sweden: An interrupted time series analysis. Acta Paediatr 2024; 113:2081-2090. [PMID: 38847423 DOI: 10.1111/apa.17313] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/14/2023] [Revised: 05/20/2024] [Accepted: 05/27/2024] [Indexed: 08/15/2024]
Abstract
AIM Respiratory syncytial virus (RSV) represents a significant cause of morbidity for children worldwide, especially for newborns. As RSV vaccines are not routinely used for children yet, non-pharmaceutical interventions (NPIs) represent the main strategy for prevention. The objective of this study was to investigate the correlation between school holidays and RSV transmission. METHODS Data were collected from the weekly reports on RSV incidence for the 2021/2022 and 2022/2023 seasons in Sweden. The 7-day cumulative incidence of RSV was compared before and after the designated school holidays (Fall, Christmas, and Winter holidays). RESULTS Our findings reveal an immediate (-1.7%, p < 0.001, 95% CI [-3.1%, -0.4%]) and gradual (-1.4%/week, p < 0.001, 95%CI [-1.8, -1.0]) reduction in RSV incidence following the Fall holiday in 2021, especially among children under 1 year of age, both immediately (-107.6%, p < 0.05, 95% CI [-203.7, -11.5]) and gradually afterwards (-58.5%/week, p < 0.001, 95% CI [-72.7, -44.3]). Mixed results were obtained for the Fall in 2022/2023 and for the Winter and holidays in both the studied years. CONCLUSIONS While the Fall holiday in 2021/2022 was associated with a decrease in RSV incidence in Sweden, our results do not support a universal effect of school holidays on reducing RSV transmission.
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Affiliation(s)
- Giulia Dallagiacoma
- Department of Global Public Health, Karolinska Institutet, Stockholm, Sweden
- Department of Public Health, Experimental and Forensic Medicine, School of Public Health, University of Pavia, Pavia, Italy
| | - Márta K Radó
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
| | - Anna Odone
- Department of Public Health, Experimental and Forensic Medicine, School of Public Health, University of Pavia, Pavia, Italy
| | - Tobias Alfvén
- Department of Global Public Health, Karolinska Institutet, Stockholm, Sweden
- Sachs' Children and Youth Hospital, Stockholm, Sweden
| | - Samuel A Rhedin
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
- Sachs' Children and Youth Hospital, Stockholm, Sweden
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Lastrucci V, Pacifici M, Puglia M, Alderotti G, Berti E, Del Riccio M, Bonaccorsi G, Moriondo M, Resti M, Peroni D, Martini M, Azzari C, Gini R, Voller F. Seasonality and severity of respiratory syncytial virus during the COVID-19 pandemic: a dynamic cohort study. Int J Infect Dis 2024; 148:107231. [PMID: 39222708 DOI: 10.1016/j.ijid.2024.107231] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2024] [Revised: 08/28/2024] [Accepted: 08/28/2024] [Indexed: 09/04/2024] Open
Abstract
OBJECTIVES To investigate seasonality, epidemiologic characteristics, and clinical severity variations of respiratory syncytial virus (RSV)-associated hospitalizations following the easing of COVID-19 restrictions in Tuscany, Italy, up to the 2022-2023 season. METHODS From 2017 to 2023, a dynamic cohort consisting of all resident children aged ≤2 years was followed up in regional registries. The person-time incidence rate of RSV-associated hospitalizations per 1,000 person-years and risk of severe hospitalization (intensive care unit, continuous positive airway pressure, or mechanical ventilation) per 100 RSV hospitalizations were calculated. RSV seasonality was investigated with retrospective methods. RESULTS A total of 193,244 children were followed up. After the easing of restrictions, RSV epidemics showed earlier seasonality and shorter duration compared with pre-pandemic (2017 to 2019), with this deviation decreased in 2022-2023. In 2021-2022 and 2022-2023, the incidence rate of RSV-associated hospitalizations significantly increased compared with pre-pandemic (2022-2023 risk ratio 3.6, 95% confidence interval 3.3-4.0), with larger increases among older age groups. Among hospitalized children, only those aged ≥12 months showed an increased risk of severe hospitalization, particularly during 2021-2022 (risk ratio 4.7, 95% confidence interval 1.5-24.3). CONCLUSIONS Our findings suggest a gradual return of RSV epidemics to the pre-pandemic pattern, although relevant increases in disease incidence persist. Reduced regular RSV exposure among older children may lead to declining immunity and increased severe outcome risks.
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Affiliation(s)
- Vieri Lastrucci
- Epidemiology Unit, Meyer Children's Hospital IRCCS, Firenze, Italy.
| | - Martina Pacifici
- Epidemiologic Observatory, Regional Healthcare Agency of Tuscany, Firenze, Italy
| | - Monia Puglia
- Epidemiologic Observatory, Regional Healthcare Agency of Tuscany, Firenze, Italy
| | | | - Elettra Berti
- Neonatal Intensive Care Unit, Meyer Children's Hospital IRCCS, Firenze, Italy
| | - Marco Del Riccio
- Department of Health Sciences, University of Florence, Firenze, Italy
| | | | - Maria Moriondo
- Immunology Unit, Meyer Children's Hospital IRCCS, Firenze, Italy
| | - Massimo Resti
- Pediatric Unit, Meyer Children's Hospital IRCCS, Firenze, Italy
| | - Diego Peroni
- Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | | | - Chiara Azzari
- Department of Health Sciences, University of Florence, Firenze, Italy; Immunology Unit, Meyer Children's Hospital IRCCS, Firenze, Italy
| | - Rosa Gini
- Epidemiologic Observatory, Regional Healthcare Agency of Tuscany, Firenze, Italy
| | - Fabio Voller
- Epidemiologic Observatory, Regional Healthcare Agency of Tuscany, Firenze, Italy
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Poshtiban A, Wick M, Bangert M, Damm O. Burden of respiratory syncytial virus (RSV) infection in Germany: a systematic review. BMC Infect Dis 2024; 24:844. [PMID: 39164625 PMCID: PMC11337829 DOI: 10.1186/s12879-024-09758-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2023] [Accepted: 08/14/2024] [Indexed: 08/22/2024] Open
Abstract
BACKGROUND Respiratory syncytial virus (RSV) is a major cause of acute lower respiratory infection and hospitalizations among infants, young children, and the elderly. This systematic literature review aimed to summarize the epidemiological and economic burden estimates of RSV infection at any age in Germany. METHODS We conducted a systematic literature search to identify full-text articles published from 2003 to 2023 and reporting data on the epidemiological or economic burden of RSV in Germany. Based on pre-specified eligibility criteria, data on incidence, rates of hospital and intensive care unit (ICU) admission, clinical manifestation, underlying conditions, seasonality, health care resource use and costs were extracted. RESULTS After screening 315 full-text articles, we included 42 articles in the review. The characteristics of the included studies were heterogenous regarding study population, setting, age groups and RSV-related outcome measures. The most frequently reported epidemiological outcome measures were RSV detection rate (n = 33), followed by clinical manifestation (n = 19), seasonality (n = 18), and underlying conditions of RSV infection (n = 13). RSV detection rates were reported across heterogenous study populations, ranging from 5.2 to 55.4% in pediatric inpatient cases and from 2.9 to 14% in adult inpatient cases. All articles that reported RSV detection rates across several age groups demonstrated the highest burden in infants and young children. Few articles reported RSV-related outcome measures distinctively for the outpatient setting. Health care resource use, such as hospital length of stay, ICU admission rate and treatment of patients with RSV infection were described in 23 articles, of which only one study quantified associated costs from 1999 to 2003 for children ≤ 3 years. In-hospital ICU admission rates varied between 3.6 and 45%, depending on population characteristics as age and underlying conditions. CONCLUSIONS This systematic review revealed that RSV imposes substantial disease burden in infants, young children, and the elderly in Germany, whereby infants are particularly affected. To date, there has been limited exploration of the impact of RSV infection on healthy children or the elderly in Germany. Given their notably high reported burden in studies, the medical and economic RSV burden in these groups should move more into focus.
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Affiliation(s)
- Anahita Poshtiban
- Sanofi-Aventis Deutschland GmbH, Lützowstr. 107, 10785, Berlin, Germany.
| | - Moritz Wick
- Sanofi-Aventis Deutschland GmbH, Lützowstr. 107, 10785, Berlin, Germany
| | | | - Oliver Damm
- Sanofi-Aventis Deutschland GmbH, Lützowstr. 107, 10785, Berlin, Germany
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Papagiannis D, Tiganis N, Kotsiou OS, Lampropoulos IC, Fradelos EC, Malli F, Gourgoulianis KI. Assessment of Knowledge, Attitudes, and Vaccination Practices Regarding the New RSV Vaccine among Health Professionals in Greece. Healthcare (Basel) 2024; 12:1536. [PMID: 39120239 PMCID: PMC11311648 DOI: 10.3390/healthcare12151536] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2024] [Revised: 07/31/2024] [Accepted: 08/01/2024] [Indexed: 08/10/2024] Open
Abstract
The introduction of a new vaccine into immunization programs represents a significant advancement in the global effort to combat vaccine-preventable diseases. Data from the World Health Organization support that immunization prevents between 2 and 3 million deaths each year across various diseases, underscoring its pivotal role in global health. The present study aims to assess the knowledge, attitudes, and anticipated vaccination practices among health professionals in Central Greece in response to the potential introduction of new Respiratory Syncytial Virus (RSV) vaccination guidelines by the National Vaccines Committee. Among the 450 health professionals solicited for the study, 219 provided responses, yielding a response rate of approximately 55%. A substantial majority (70.3%) accurately identified the vaccine's current availability, and 62.1% were aware of the current recommendation for RSV vaccination in pregnant women. In response to whether health professionals support the inclusion of an RSV vaccine in the national vaccination program if it becomes commercially available and is recommended by the Greek National Immunization Program, general practitioners showed the most support, with an average score of 4.86 (95% CI, 4.69-5.00), followed by pediatricians at 4.76 (95% CI, 4.63-4.89), pulmonologists at 4.68 (95% CI, 4.36-5.00), and obstetricians at 4.33 (95% CI, 3.95-4.71). Concerning general opinions on vaccinations, a high level of agreement was noted among the majority of health professionals, excluding nurses. Pharmacists recorded the highest agreement, with a perfect score of 5 (CI, 5.00-5.00), followed closely by pediatricians at 4.99 (CI, 4.97-5.00), GPs at 4.95 (CI, 4.85-5.00), pulmonologists at 4.93 (CI, 4.83-5.00), obstetricians at 4.74 (CI, 4.42-5.00), and nurses at 3.80 (CI, 3.06-4.54). A tailored approach to education is needed to ensure that healthcare professionals can communicate more effectively about RSV risks and vaccination benefits, fostering a proactive stance towards disease prevention and patient care. In essence, our study underscores the importance of knowledge in shaping a compassionate and responsive healthcare environment, ready to meet the challenges of RSV head-on.
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Affiliation(s)
- Dimitrios Papagiannis
- Public Health & Adults Immunization Laboratory, School of Health Sciences, Faculty of Nursing, University of Thessaly, 41110 Larissa, Greece
| | - Nikolaos Tiganis
- Primary Health Care Postgraduate Program, University of Thessaly, 41500 Larissa, Greece;
| | - Ourania S. Kotsiou
- Department of Human Pathophysiology, Faculty of Nursing, University of Thessaly, 41500 Larissa, Greece;
| | - Ioannis C. Lampropoulos
- Respiratory Disorders Laboratory, Faculty of Nursing, University of Thessaly, 41110 Larissa, Greece; (I.C.L.); (F.M.)
| | - Evangelos C. Fradelos
- Laboratory of Clinical Nursing, Department of Nursing, University of Thessaly, 41500 Larissa, Greece;
| | - Foteini Malli
- Respiratory Disorders Laboratory, Faculty of Nursing, University of Thessaly, 41110 Larissa, Greece; (I.C.L.); (F.M.)
| | - Konstantinos I. Gourgoulianis
- Department of Respiratory Medicine, School of Health Sciences, Faculty of Medicine, University of Thessaly, 41500 Larissa, Greece;
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Ares-Gómez S, Mallah N, Santiago-Pérez MI, Pardo-Seco J, Pérez-Martínez O, Otero-Barrós MT, Suárez-Gaiche N, Kramer R, Jin J, Platero-Alonso L, Alvárez-Gil RM, Ces-Ozores OM, Nartallo-Penas V, Mirás-Carballal S, Piñeiro-Sotelo M, Malvar-Pintos A, González-Pérez JM, Rodríguez-Tenreiro-Sánchez C, Rivero-Calle I, Salas A, Durán-Parrondo C, Martinón-Torres F. Effectiveness and impact of universal prophylaxis with nirsevimab in infants against hospitalisation for respiratory syncytial virus in Galicia, Spain: initial results of a population-based longitudinal study. THE LANCET. INFECTIOUS DISEASES 2024; 24:817-828. [PMID: 38701823 DOI: 10.1016/s1473-3099(24)00215-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/07/2024] [Revised: 03/15/2024] [Accepted: 03/19/2024] [Indexed: 05/05/2024]
Abstract
BACKGROUND Galicia (Spain) was one of the first regions worldwide to incorporate nirsevimab for universal respiratory syncytial virus (RSV) prophylaxis in infants into its immunisation programme. The NIRSE-GAL longitudinal population-based study aimed to assess nirsevimab effectiveness in preventing hospitalisations (ie, admittance to hospital). METHODS The 2023-24 immunisation campaign with nirsevimab in Galicia began on Sept 25, 2023, and concluded on March 31, 2024. The campaign targeted three groups: infants born during the campaign (seasonal group), infants younger than 6 months at the start of the campaign (catch-up group), and infants aged 6-24 months with high-risk factors at the start of the campaign (high-risk group). Infants in the seasonal group were offered immunisation on the first day of life before discharge from hospital. Infants in the catch-up and high-risk groups received electronic appointments to attend a public hospital or health-care centre for nirsevimab administration. For this interim analysis, we used data collected from Sept 25 to Dec 31, 2023, from children born up to Dec 15, 2023. Data were retrieved from public health registries. Nirsevimab effectiveness in preventing RSV-associated lower respiratory tract infection (LRTI) hospitalisations; severe RSV-related LRTI requiring intensive care unit admission, mechanical ventilation, or oxygen support; all-cause LRTI hospitalisations; and all-cause hospitalisations was estimated using adjusted Poisson regression models. Data from five past RSV seasons (2016-17, 2017-18, 2018-19, 2019-20, and 2022-23), excluding the COVID-19 pandemic period, were used to estimate the number of RSV-related LRTI hospitalisations averted along with its IQR. The number needed to immunise to avoid one case in the 2023-24 season was then estimated from the averted cases. Nirsevimab safety was routinely monitored. The NIRSE-GAL study protocol was registered on ClinicalTrials.gov (NCT06180993), and follow-up of participants is ongoing. FINDINGS 9408 (91·7%) of 10 259 eligible infants in the seasonal and catch-up groups received nirsevimab, including 6220 (89·9%) of 6919 in the catch-up group and 3188 (95·4%) of 3340 in the seasonal group. 360 in the high-risk group were offered nirsevimab, 348 (97%) of whom received it. Only infants in the seasonal and catch-up groups were included in analyses to estimate nirsevimab effectiveness and impact because there were too few events in the high-risk group. In the catch-up and seasonal groups combined, 30 (0·3%) of 9408 infants who received nirsevimab and 16 (1·9%) of 851 who did not receive nirsevimab were hospitalised for RSV-related LRTI, corresponding to an effectiveness of 82·0% (95% CI 65·6-90·2). Effectiveness was 86·9% (69·1-94·2) against severe RSV-related LRTI requiring oxygen support, 69·2% (55·9-78·0) against all-cause LRTI hospitalisations, and 66·2% (56·0-73·7) against all-cause hospitalisations. Nirsevimab effectiveness against other endpoints of severe RSV-related LRTI could not be estimated because of too few events. RSV-related LRTI hospitalisations were reduced by 89·8% (IQR 87·5-90·3), and the number needed to immunise to avoid one RSV-related LRTI hospitalisation was 25 (IQR 24-32). No severe adverse events related to nirsevimab were registered. INTERPRETATION Nirsevimab substantially reduced infant hospitalisations for RSV-associated LRTI, severe RSV-associated LRTI requiring oxygen, and all-cause LRTI when given in real-world conditions. These findings offer policy makers and health authorities robust, real-world, population-based evidence to guide the development of strategies for RSV prevention. FUNDING Sanofi and AstraZeneca. TRANSLATION For the Spanish translation of the abstract see Supplementary Materials section.
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Affiliation(s)
- Sonia Ares-Gómez
- Genetics, Vaccines, and Pediatric Infectious Diseases Research Group (GENVIP), Instituto de Investigación Sanitaria de Santiago de Compostela (IDIS), Santiago de Compostela, Spain; WHO Collaborating Centre for Vaccine Safety, Santiago de Compostela, Spain; Centro de Investigación Biomédica en Red de Enfermedades Respiratorias, Instituto de Salud Carlos III, Madrid, Spain
| | - Narmeen Mallah
- Genetics, Vaccines, and Pediatric Infectious Diseases Research Group (GENVIP), Instituto de Investigación Sanitaria de Santiago de Compostela (IDIS), Santiago de Compostela, Spain; WHO Collaborating Centre for Vaccine Safety, Santiago de Compostela, Spain; Centro de Investigación Biomédica en Red de Epidemiología y Salud Pública, Instituto de Salud Carlos III, Madrid, Spain; Department of Preventive Medicine, University of Santiago de Compostela (USC), Santiago de Compostela, Spain
| | - María-Isolina Santiago-Pérez
- Department of Epidemiology, Dirección Xeral de Saúde Pública, Consellería de Sanidade, Xunta de Galicia, Galicia, Spain
| | - Jacobo Pardo-Seco
- Genetics, Vaccines, and Pediatric Infectious Diseases Research Group (GENVIP), Instituto de Investigación Sanitaria de Santiago de Compostela (IDIS), Santiago de Compostela, Spain; WHO Collaborating Centre for Vaccine Safety, Santiago de Compostela, Spain; Centro de Investigación Biomédica en Red de Enfermedades Respiratorias, Instituto de Salud Carlos III, Madrid, Spain; Genética de Poblaciones en Biomedicina (GenPoB) Research Group, Instituto de Investigación Sanitaria (IDIS), Hospital Clínico Universitario de Santiago (SERGAS), Galicia, Spain
| | - Olaia Pérez-Martínez
- Department of Epidemiology, Dirección Xeral de Saúde Pública, Consellería de Sanidade, Xunta de Galicia, Galicia, Spain
| | - María-Teresa Otero-Barrós
- Department of Epidemiology, Dirección Xeral de Saúde Pública, Consellería de Sanidade, Xunta de Galicia, Galicia, Spain
| | - Nuria Suárez-Gaiche
- Department of Epidemiology, Dirección Xeral de Saúde Pública, Consellería de Sanidade, Xunta de Galicia, Galicia, Spain
| | | | | | | | - Rosa-María Alvárez-Gil
- Department of Communicable Diseases, Dirección Xeral de Saúde Pública, Consellería de Sanidade, Xunta de Galicia, Galicia, Spain
| | - Olga-María Ces-Ozores
- Department of Communicable Diseases, Dirección Xeral de Saúde Pública, Consellería de Sanidade, Xunta de Galicia, Galicia, Spain
| | - Victoria Nartallo-Penas
- Department of Communicable Diseases, Dirección Xeral de Saúde Pública, Consellería de Sanidade, Xunta de Galicia, Galicia, Spain
| | - Susana Mirás-Carballal
- Department of Communicable Diseases, Dirección Xeral de Saúde Pública, Consellería de Sanidade, Xunta de Galicia, Galicia, Spain
| | - Marta Piñeiro-Sotelo
- Department of Epidemiology, Dirección Xeral de Saúde Pública, Consellería de Sanidade, Xunta de Galicia, Galicia, Spain
| | - Alberto Malvar-Pintos
- Department of Epidemiology, Dirección Xeral de Saúde Pública, Consellería de Sanidade, Xunta de Galicia, Galicia, Spain
| | - Juan-Manuel González-Pérez
- Subdirección de Sistemas y Tecnologías de la Información, Consellería de Sanidade, Xunta de Galicia, Galicia, Spain
| | - Carmen Rodríguez-Tenreiro-Sánchez
- Genetics, Vaccines, and Pediatric Infectious Diseases Research Group (GENVIP), Instituto de Investigación Sanitaria de Santiago de Compostela (IDIS), Santiago de Compostela, Spain; WHO Collaborating Centre for Vaccine Safety, Santiago de Compostela, Spain; Centro de Investigación Biomédica en Red de Enfermedades Respiratorias, Instituto de Salud Carlos III, Madrid, Spain
| | - Irene Rivero-Calle
- Genetics, Vaccines, and Pediatric Infectious Diseases Research Group (GENVIP), Instituto de Investigación Sanitaria de Santiago de Compostela (IDIS), Santiago de Compostela, Spain; WHO Collaborating Centre for Vaccine Safety, Santiago de Compostela, Spain; Centro de Investigación Biomédica en Red de Enfermedades Respiratorias, Instituto de Salud Carlos III, Madrid, Spain; Translational Pediatrics and Infectious Diseases, Hospital Clínico Universitario de Santiago (SERGAS), Santiago de Compostela, Spain
| | - Antonio Salas
- Centro de Investigación Biomédica en Red de Enfermedades Respiratorias, Instituto de Salud Carlos III, Madrid, Spain; Genética de Poblaciones en Biomedicina (GenPoB) Research Group, Instituto de Investigación Sanitaria (IDIS), Hospital Clínico Universitario de Santiago (SERGAS), Galicia, Spain; Unidade de Xenética, Instituto de Ciencias Forenses, Facultade de Medicina, Universidade de Santiago de Compostela (USC), Galicia, Spain
| | - Carmen Durán-Parrondo
- Dirección Xeral de Saúde Pública, Consellería de Sanidade, Xunta de Galicia, Galicia, Spain
| | - Federico Martinón-Torres
- Genetics, Vaccines, and Pediatric Infectious Diseases Research Group (GENVIP), Instituto de Investigación Sanitaria de Santiago de Compostela (IDIS), Santiago de Compostela, Spain; WHO Collaborating Centre for Vaccine Safety, Santiago de Compostela, Spain; Centro de Investigación Biomédica en Red de Enfermedades Respiratorias, Instituto de Salud Carlos III, Madrid, Spain; Translational Pediatrics and Infectious Diseases, Hospital Clínico Universitario de Santiago (SERGAS), Santiago de Compostela, Spain.
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11
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Riccò M, Cascio A, Corrado S, Bottazzoli M, Marchesi F, Gili R, Giuri PG, Gori D, Manzoni P. Occurrence of Central Nervous System Complications of Respiratory Syncytial Virus Infections: A Systematic Review with Meta-Analysis. EPIDEMIOLOGIA 2024; 5:421-455. [PMID: 39051211 PMCID: PMC11270441 DOI: 10.3390/epidemiologia5030031] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2024] [Revised: 07/16/2024] [Accepted: 07/16/2024] [Indexed: 07/27/2024] Open
Abstract
An increasing base of evidence suggests that respiratory syncytial virus (RSV) infections may be associated with neurological complications. In accord with the PRISMA statement, we performed a systematic review and meta-analysis on the occurrence of encephalitis and encephalopathy associated with documented RSV infections. PubMed, Embase, and Scopus databases were searched for eligible observational studies published up to 10 April 2024. Raw data included the occurrence of RSV infections among cases of encephalitis and/or encephalopathy and cases of encephalitis and/or encephalopathy among series of RSV infections. Data were pooled in a random effects model. Case reports were also collected, and their data pooled as a cumulative series. Heterogeneity was assessed using the I2 measure, while reporting bias was assessed by means of funnel plots and regression analysis. A total of 15 studies for a total of 7719 RSV infections and 1631 cases of encephalitis were analyzed. Moreover, 27 case reports and case series were retrieved, for a total of 84 individual cases of encephalitis/encephalopathy occurring during a documented RSV infection. A pooled prevalence of 2.20 cases of encephalitis/encephalopathy per 100 RSV cases (I2 = 99%) was calculated, while a prevalence of RSV infections among cases of encephalitis/encephalopathy was estimated to 3.53 per 100 cases for studies on respiratory specimens (I2 = 48%) and 0.37 per cases on central nervous system (CNS) specimens (I2 = 0%). Detection of RSV within the CNS was relatively rare (17.86% of pooled case reports), being associated with male gender (adjusted odds ratio [aOR] 5.021, 95% confidence interval [95%CI] 1.104 to 22.831) and recovery with long-term sequelae (aOR 5.699, 95%CI 1.152; 28.183). Case fatality ratio was estimated to be 0.43 per 100 cases on observational studies and 10.71% in case reports, a difference likely due to publication bias. In summary, RSV represented a not frequent but notable cause of encephalitis/encephalopathy in adults and children. The paucity of available studies not only recommends a cautious appraisal of our results but stresses the clinical significance of future studies on incident cases of encephalitis and/or encephalopathy.
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Affiliation(s)
- Matteo Riccò
- AUSL–IRCCS di Reggio Emilia, Servizio di Prevenzione e Sicurezza Negli Ambienti di Lavoro (SPSAL), Local Health Unit of Reggio Emilia, 42122 Reggio Emilia, Italy
| | - Antonio Cascio
- Infectious and Tropical Diseases Unit, Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties, “G D’Alessandro”, University of Palermo, AOUP P. Giaccone, 90127 Palermo, Italy;
| | - Silvia Corrado
- ASST Rhodense, Dipartimento della donna e Area Materno-Infantile, UOC Pediatria, 20024 Milan, Italy
| | - Marco Bottazzoli
- Department of Otorhinolaryngology, APSS Trento, 38122 Trento, Italy
| | - Federico Marchesi
- Department of Medicine and Surgery, University of Parma, 43126 Parma, Italy
| | - Renata Gili
- Department of Prevention, Turin Local Health Authority, 10125 Torino, Italy
| | | | - Davide Gori
- Department of Biomedical and Neuromotor Sciences, University of Bologna, 40126 Bologna, Italy
| | - Paolo Manzoni
- Department of Public Health and Pediatric Sciences, University of Torino School of Medicine, 10125 Turin, Italy
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12
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De R, Jiang M, Sun Y, Huang S, Zhu R, Guo Q, Zhou Y, Qu D, Cao L, Lu F, Zhao L. A Scoring System to Predict Severe Acute Lower Respiratory Infection in Children Caused by Respiratory Syncytial Virus. Microorganisms 2024; 12:1411. [PMID: 39065180 PMCID: PMC11278654 DOI: 10.3390/microorganisms12071411] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2024] [Revised: 07/04/2024] [Accepted: 07/07/2024] [Indexed: 07/28/2024] Open
Abstract
There were several factors associated with respiratory syncytial virus (RSV) severe acute lower respiratory infection (RSV-sALRI) in infants and young children. It is vital to develop a convenient scoring system to predict RSV-sALRI in children. Pediatric patients with RSV-ALRI from January 2009 to December 2021 were recruited retrospectively. Two-third of them were randomly grouped into the development set and one-third to the validation set. In the development set, risk factors for RSV-sALRI were transferred into the logistic regression analysis, then their receiver operating characteristic (ROC) curves were built to obtain the area under the ROC curve (AUC), and regression coefficients for each predictor were converted to points. Finally, the value of the scoring system was evaluated in the validation set. A total of 1 066 children with RSV-ALRI were recruited, including 710 in the development set and 356 in the validation set. By logistic regression analysis, six factors (younger than 2 years, gestational age <37 weeks, have siblings, birth weight ≤2500 g, artificial/mix feeding, CHD) showed statistical difference and then were scored with points according to the coefficient value (OR) in the development set. In the validation set, the sensitivity of the scoring system was 70.25%, the specificity 85.53%, the positive predictive value 71.43%, the negative predictive value 84.81%, and coincidence rate 0.80. The Kolmogorov-Smirnov test showed the distribution of AUC 0.765 (SE = 0.027; 95% CI = 0.713-0.818; p < 0.001). A simplified scoring system was developed in the study with high prediction value for RSV-sALRI in children.
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Affiliation(s)
- Ri De
- Department of Microbiology and Infectious Disease Center, School of Basic Medical Sciences, Peking University Health Science Center, Beijing 100191, China;
- Laboratory of Virology, Beijing Key Laboratory of Etiology of Viral Disease in Children, Capital Institute of Pediatrics, Beijing 100020, China; (M.J.); (Y.S.); (R.Z.); (Q.G.); (Y.Z.)
| | - Mingli Jiang
- Laboratory of Virology, Beijing Key Laboratory of Etiology of Viral Disease in Children, Capital Institute of Pediatrics, Beijing 100020, China; (M.J.); (Y.S.); (R.Z.); (Q.G.); (Y.Z.)
| | - Yu Sun
- Laboratory of Virology, Beijing Key Laboratory of Etiology of Viral Disease in Children, Capital Institute of Pediatrics, Beijing 100020, China; (M.J.); (Y.S.); (R.Z.); (Q.G.); (Y.Z.)
| | - Siyuan Huang
- Department of Intensive Care Unit, Affiliated Children’s Hospital, Capital Institute of Pediatrics, Beijing 100020, China; (S.H.); (D.Q.)
| | - Runan Zhu
- Laboratory of Virology, Beijing Key Laboratory of Etiology of Viral Disease in Children, Capital Institute of Pediatrics, Beijing 100020, China; (M.J.); (Y.S.); (R.Z.); (Q.G.); (Y.Z.)
| | - Qi Guo
- Laboratory of Virology, Beijing Key Laboratory of Etiology of Viral Disease in Children, Capital Institute of Pediatrics, Beijing 100020, China; (M.J.); (Y.S.); (R.Z.); (Q.G.); (Y.Z.)
| | - Yutong Zhou
- Laboratory of Virology, Beijing Key Laboratory of Etiology of Viral Disease in Children, Capital Institute of Pediatrics, Beijing 100020, China; (M.J.); (Y.S.); (R.Z.); (Q.G.); (Y.Z.)
| | - Dong Qu
- Department of Intensive Care Unit, Affiliated Children’s Hospital, Capital Institute of Pediatrics, Beijing 100020, China; (S.H.); (D.Q.)
| | - Ling Cao
- Department of Respiratory Medicine, Affiliated Children’s Hospital, Capital Institute of Pediatrics, Beijing 100020, China;
| | - Fengmin Lu
- Department of Microbiology and Infectious Disease Center, School of Basic Medical Sciences, Peking University Health Science Center, Beijing 100191, China;
| | - Linqing Zhao
- Laboratory of Virology, Beijing Key Laboratory of Etiology of Viral Disease in Children, Capital Institute of Pediatrics, Beijing 100020, China; (M.J.); (Y.S.); (R.Z.); (Q.G.); (Y.Z.)
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13
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Riccò M, Cascio A, Corrado S, Bottazzoli M, Marchesi F, Gili R, Giuri PG, Gori D, Manzoni P. Impact of Nirsevimab Immunization on Pediatric Hospitalization Rates: A Systematic Review and Meta-Analysis (2024). Vaccines (Basel) 2024; 12:640. [PMID: 38932369 PMCID: PMC11209424 DOI: 10.3390/vaccines12060640] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2024] [Revised: 05/25/2024] [Accepted: 06/06/2024] [Indexed: 06/28/2024] Open
Abstract
A systematic review with a meta-analysis was performed to gather available evidence on the effectiveness of monoclonal antibody nirsevimab in the prevention of lower respiratory tract diseases (LRTDs) due to respiratory syncytial virus (RSV) in children and newborns (CRD42024540669). Studies reporting on real-world experience and randomized controlled trials (RCTs) were searched for in three databases (PubMed, Embase, and Scopus) until 1 May 2024. Our analysis included five RCTs, seven real-world reports, and one official report from the health authorities. Due to the cross-reporting of RCTs and the inclusion of multiple series in a single study, the meta-analysis was performed on 45,238 infants from 19 series. The meta-analysis documented a pooled immunization efficacy of 88.40% (95% confidence interval (95% CI) from 84.70 to 91.21) on the occurrence of hospital admission due to RSV, with moderate heterogeneity (I2 24.3%, 95% CI 0.0 to 56.6). Immunization efficacy decreased with the overall length of the observation time (Spearman's r = -0.546, p = 0.016), and the risk of breakthrough infections was substantially greater in studies with observation times ≥150 days compared to studies lasting <150 days (risk ratio 2.170, 95% CI 1.860 to 2.532). However, the effect of observation time in meta-regression analysis was conflicting (β = 0.001, 95% CI -0.001 to 0.002; p = 0.092). In conclusion, the delivery of nirsevimab was quite effective in preventing hospital admissions due to LRTDs. However, further analyses of the whole RSV season are required before tailoring specific public health interventions.
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Affiliation(s)
- Matteo Riccò
- AUSL–IRCCS di Reggio Emilia, Servizio di Prevenzione e Sicurezza Negli Ambienti di Lavoro (SPSAL), Local Health Unit of Reggio Emilia, 42122 Reggio Emilia, Italy
| | - Antonio Cascio
- Infectious and Tropical Diseases Unit, Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties, “G D’Alessandro”, University of Palermo, AOUP P. Giaccone, 90127 Palermo, Italy;
| | - Silvia Corrado
- ASST Rhodense, Dipartimento Della Donna e Area Materno-Infantile, UOC Pediatria, 20024 Milano, Italy
| | - Marco Bottazzoli
- Department of Otorhinolaryngology, APSS Trento, 38122 Trento, Italy
| | - Federico Marchesi
- Department of Medicine and Surgery, University of Parma, 43126 Parma, Italy;
| | - Renata Gili
- Department of Prevention, Turin Local Health Authority, 10125 Torino, Italy
| | | | - Davide Gori
- Department of Biomedical and Neuromotor Sciences, University of Bologna, 40126 Bologna, Italy;
| | - Paolo Manzoni
- Department of Public Health and Pediatric Sciences, University of Torino School of Medicine, 10125 Turin, Italy;
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14
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Riccò M, Corrado S, Bottazzoli M, Marchesi F, Gili R, Bianchi FP, Frisicale EM, Guicciardi S, Fiacchini D, Tafuri S. RSV Infection in Refugees and Asylum Seekers: A Systematic Review and Meta-Analysis. EPIDEMIOLOGIA 2024; 5:221-249. [PMID: 38920751 PMCID: PMC11202732 DOI: 10.3390/epidemiologia5020016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2024] [Revised: 05/20/2024] [Accepted: 05/23/2024] [Indexed: 06/27/2024] Open
Abstract
Respiratory diseases, including respiratory syncytial virus (RSV) infections, are common reasons for seeking healthcare among refugees and asylum seekers. A systematic review with meta-analysis was designed to appraise all the available evidence on RSV infections among individuals in refugee camps. Three medical databases (PubMed, Embase, and Scopus) as well as the preprint repository medRxiv.org were searched for eligible observational studies, and the collected cases were pooled in a random-effects meta-analysis model. Heterogeneity was assessed using the I2 statistics. Funnel plots and a regression analysis were calculated for analyzing reporting bias. Eventually, six studies were retrieved from three areas (Bangladesh, Thailand, and Kenya), with pooled estimates of 129.704 cases per 1000 samples (95% CI 66.393 to 237.986) for RSV compared to 110.287 per 1000 people for influenza A (95% CI 73.186 to 162.889), 136.398 cases per 1000 people (95% CI 84.510 to 212.741) for human adenovirus (HAdV), 69.553 per 1000 people (95% CI 49.802 to 96.343) for parainfluenzavirus (PIFV), and 60.338 per 1000 people (95% CI 31.933 to 111.109) for human metapneumovirus (hMPV). Using influenza A as a reference group, the risk for a positive specimen was greater for RSV (relative risk [RR] 1.514, 95% CI 1.396 to 1.641) and HAdV (RR 1.984, 95% CI 1.834 to 2.146) and lower for influenza B (RR 0.276, 95% CI: 0.239 to 0.319), PIFV (RR: 0.889, 95% CI 0.806 to 0.981), and hMPV (RR 0.594, 95% CI 0.534 to 0.662). In summary, high rates of RSV infections were documented among individuals sheltered in refugee camps, stressing the importance of specifically designed preventive strategies.
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Affiliation(s)
- Matteo Riccò
- AUSL–IRCCS di Reggio Emilia, Servizio di Prevenzione e Sicurezza Negli Ambienti di Lavoro (SPSAL), Local Health Unit of Reggio Emilia, 42122 Reggio Emilia, Italy
| | - Silvia Corrado
- ASST Rhodense, Dipartimento Della Donna e Area Materno-Infantile, UOC Pediatria, 20024 Garbagnate Milanese, Italy;
| | - Marco Bottazzoli
- Department of Otorhinolaryngology, APSS Trento, 38122 Trento, Italy
| | - Federico Marchesi
- Department of Medicine and Surgery, University of Parma, 43126 Parma, Italy;
| | - Renata Gili
- Department of Prevention, Turin Local Health Authority, Via Silvio Pellico 19, 10125 Turin, Italy
| | | | | | - Stefano Guicciardi
- Health Directorate, Local Health Authority of Bologna, 40127 Bologna, Italy
- Department of Biomedical and Neuromotor Sciences, University of Bologna, 40127 Bologna, Italy
| | - Daniel Fiacchini
- AST Ancona, Prevention Department, UOC Sorveglianza e Prevenzione Malattie Infettive e Cronico Degenerative, 60127 Ancona, Italy
| | - Silvio Tafuri
- Department of Interdisciplinary Medicine, Aldo Moro University of Bari, 70121 Bari, Italy
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15
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Ares-Gómez S, Mallah N, Pardo-Seco J, Malvar-Pintos A, Pérez-Martínez O, Otero-Barrós MT, Súarez-Gaiche N, Santiago-Pérez MI, González-Pérez JM, López-Pérez LR, Rosón B, Alvárez-Gil RM, Ces-Ozores OM, Nartallo-Penas V, Mirás-Carballal S, Rodríguez-Tenreiro C, Rivero-Calle I, Salas A, Durán-Parrondo C, Martinón-Torres F. Short- and mid-term morbidity and primary-care burden due to infant respiratory syncytial virus infection: A Spanish 6-year population-based longitudinal study. Pediatr Allergy Immunol 2024; 35:e14131. [PMID: 38700124 DOI: 10.1111/pai.14131] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/13/2024] [Revised: 04/05/2024] [Accepted: 04/08/2024] [Indexed: 05/05/2024]
Abstract
BACKGROUND The morbidity burden of respiratory syncytial virus (RSV) in infants extends beyond hospitalization. Defining the RSV burden before implementing prophylaxis programs is essential for evaluating any potential impact on short- to mid-term morbidity and the utilization of primary healthcare (PHC) and emergency services (ES). We established this reference data using a population-based cohort approach. METHODS Infants hospitalized for RSV from January 2016 to March 2023 were matched with non-hospitalized ones based on birthdate and sex. We defined the exposure as severe RSV hospitalization. The main study outcomes were as follows: (1) PHC and ES visits for RSV, categorized using the International Classification of Primary Care codes, (2) prescriptions for respiratory airway obstructive disease, and (3) antibacterial prescriptions. Participants were followed up from 30 days before hospitalization for severe RSV until the outcome occurrence or end of the study. Adjusted incidence rate ratios (IRRs) of the outcomes along with their 95% confidence intervals (CI) were estimated using Poisson regression models. Stratified analyses by type of PHC visit (nurse, pediatrician, or pharmacy) and follow-up period were undertaken. We defined mid-term outcomes as those taking place up to 24 months of follow-up period. RESULTS The study included 6626 children (3313 RSV-hospitalized; 3313 non-hospitalized) with a median follow-up of 53.7 months (IQR = 27.9, 69.4). After a 3-month follow-up, severe RSV was associated with a considerable increase in PHC visits for wheezing/asthma (IRR = 4.31, 95% CI: 3.84-4.84), lower respiratory infections (IRR = 4.91, 95% CI: 4.34-5.58), and bronchiolitis (IRR = 4.68, 95% CI: 2.93-7.65). Severe RSV was also associated with more PHC visits for the pediatrician (IRR = 2.00, 95% CI: 1.96-2.05), nurse (IRR = 1.89, 95% CI: 1.75-1.92), hospital emergency (IRR = 2.39, 95% CI: 2.17-2.63), primary healthcare emergency (IRR: 1.54, 95% CI: 1.31-1.82), as well as with important increase in prescriptions for obstructive airway diseases (IRR = 5.98, 95% CI: 5.43-6.60) and antibacterials (IRR = 4.02, 95% CI: 3.38-4.81). All findings remained substantial until 2 years of post-infection. CONCLUSIONS Severe RSV infection in infants significantly increases short- to mid-term respiratory morbidity leading to an escalation in healthcare utilization (PHC/ES attendance) and medication prescriptions for up to 2 years afterward. Our approach could be useful in assessing the impact and cost-effectiveness of RSV prevention programs.
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Affiliation(s)
- Sonia Ares-Gómez
- Genetics, Vaccines and Pediatric Infectious Diseases Research Group (GENVIP), Instituto de Investigación Sanitaria de Santiago (IDIS), Santiago de Compostela, Galicia, Spain
- WHO Collaborating Centre for Vaccine Safety, Santiago de Compostela, Spain
- Centro de Investigación Biomédica en Red de Enfermedades Respiratorias (CIBERES), Instituto de Salud Carlos III, Madrid, Spain
| | - Narmeen Mallah
- Genetics, Vaccines and Pediatric Infectious Diseases Research Group (GENVIP), Instituto de Investigación Sanitaria de Santiago (IDIS), Santiago de Compostela, Galicia, Spain
- WHO Collaborating Centre for Vaccine Safety, Santiago de Compostela, Spain
- Department of Preventive Medicine, University of Santiago de Compostela (USC), Santiago de Compostela, Spain
- Centro de Investigación Biomédica en Red de Epidemiología y Salud Pública (CIBER-ESP), Instituto de Salud Carlos III, Madrid, Spain
| | - Jacobo Pardo-Seco
- Genetics, Vaccines and Pediatric Infectious Diseases Research Group (GENVIP), Instituto de Investigación Sanitaria de Santiago (IDIS), Santiago de Compostela, Galicia, Spain
- WHO Collaborating Centre for Vaccine Safety, Santiago de Compostela, Spain
- Centro de Investigación Biomédica en Red de Enfermedades Respiratorias (CIBERES), Instituto de Salud Carlos III, Madrid, Spain
- Genética de Poblaciones en Biomedicina (GenPoB) Research Group, Instituto de Investigación Sanitaria (IDIS), 15706 Hospital Clínico Universitario de Santiago (SERGAS), Santiago de Compostela, Galicia, Spain
| | - Alberto Malvar-Pintos
- Department of Epidemiology, Dirección Xeral de Saude Pública, Consellería de Sanidade, Xunta de Galicia, Santiago de Compostela, Galicia, Spain
| | - Olaia Pérez-Martínez
- Department of Epidemiology, Dirección Xeral de Saude Pública, Consellería de Sanidade, Xunta de Galicia, Santiago de Compostela, Galicia, Spain
| | - María-Teresa Otero-Barrós
- Department of Epidemiology, Dirección Xeral de Saude Pública, Consellería de Sanidade, Xunta de Galicia, Santiago de Compostela, Galicia, Spain
| | - Nuria Súarez-Gaiche
- Department of Epidemiology, Dirección Xeral de Saude Pública, Consellería de Sanidade, Xunta de Galicia, Santiago de Compostela, Galicia, Spain
| | - Maria-Isolina Santiago-Pérez
- Department of Epidemiology, Dirección Xeral de Saude Pública, Consellería de Sanidade, Xunta de Galicia, Santiago de Compostela, Galicia, Spain
| | - Juan-Manuel González-Pérez
- Subdirección de Sistemas y Tecnologías de la Información, Consellería de Sanidade, Xunta de Galicia, Santiago de Compostela, Galicia, Spain
| | - Luis-Ricardo López-Pérez
- Subdirección de Sistemas y Tecnologías de la Información, Consellería de Sanidade, Xunta de Galicia, Santiago de Compostela, Galicia, Spain
| | - Benigno Rosón
- Subdirección de Sistemas y Tecnologías de la Información, Consellería de Sanidade, Xunta de Galicia, Santiago de Compostela, Galicia, Spain
| | - Rosa-María Alvárez-Gil
- Deparment of Communicable Diseases, Dirección Xeral de Saude Pública, Consellería de Sanidade, Xunta de Galicia, Santiago de Compostela, Galicia, Spain
| | - Olga-María Ces-Ozores
- Deparment of Communicable Diseases, Dirección Xeral de Saude Pública, Consellería de Sanidade, Xunta de Galicia, Santiago de Compostela, Galicia, Spain
| | - Victoria Nartallo-Penas
- Deparment of Communicable Diseases, Dirección Xeral de Saude Pública, Consellería de Sanidade, Xunta de Galicia, Santiago de Compostela, Galicia, Spain
| | - Susana Mirás-Carballal
- Deparment of Communicable Diseases, Dirección Xeral de Saude Pública, Consellería de Sanidade, Xunta de Galicia, Santiago de Compostela, Galicia, Spain
| | - Carmen Rodríguez-Tenreiro
- Genetics, Vaccines and Pediatric Infectious Diseases Research Group (GENVIP), Instituto de Investigación Sanitaria de Santiago (IDIS), Santiago de Compostela, Galicia, Spain
- WHO Collaborating Centre for Vaccine Safety, Santiago de Compostela, Spain
- Centro de Investigación Biomédica en Red de Enfermedades Respiratorias (CIBERES), Instituto de Salud Carlos III, Madrid, Spain
| | - Irene Rivero-Calle
- Genetics, Vaccines and Pediatric Infectious Diseases Research Group (GENVIP), Instituto de Investigación Sanitaria de Santiago (IDIS), Santiago de Compostela, Galicia, Spain
- WHO Collaborating Centre for Vaccine Safety, Santiago de Compostela, Spain
- Centro de Investigación Biomédica en Red de Enfermedades Respiratorias (CIBERES), Instituto de Salud Carlos III, Madrid, Spain
- Translational Pediatrics and Infectious Diseases, Hospital Clínico Universitario and University of Santiago de Compostela (USC), Santiago de Compostela, Spain
| | - Antonio Salas
- Genetics, Vaccines and Pediatric Infectious Diseases Research Group (GENVIP), Instituto de Investigación Sanitaria de Santiago (IDIS), Santiago de Compostela, Galicia, Spain
- Centro de Investigación Biomédica en Red de Enfermedades Respiratorias (CIBERES), Instituto de Salud Carlos III, Madrid, Spain
- Genética de Poblaciones en Biomedicina (GenPoB) Research Group, Instituto de Investigación Sanitaria (IDIS), 15706 Hospital Clínico Universitario de Santiago (SERGAS), Santiago de Compostela, Galicia, Spain
- Unidade de Xenética, Instituto de Ciencias Forenses, Facultade de Medicina, Universidade de Santiago de Compostela (USC), Santiago de Compostela, Galicia, Spain
| | - Carmen Durán-Parrondo
- Dirección Xeral de Saude Pública, Consellería de Sanidade, Xunta de Galicia, Santiago de Compostela, Galicia, Spain
| | - Federico Martinón-Torres
- Genetics, Vaccines and Pediatric Infectious Diseases Research Group (GENVIP), Instituto de Investigación Sanitaria de Santiago (IDIS), Santiago de Compostela, Galicia, Spain
- WHO Collaborating Centre for Vaccine Safety, Santiago de Compostela, Spain
- Centro de Investigación Biomédica en Red de Enfermedades Respiratorias (CIBERES), Instituto de Salud Carlos III, Madrid, Spain
- Translational Pediatrics and Infectious Diseases, Hospital Clínico Universitario and University of Santiago de Compostela (USC), Santiago de Compostela, Spain
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Mazela J, Jackowska T, Czech M, Helwich E, Martyn O, Aleksiejuk P, Smaga A, Glazewska J, Wysocki J. Epidemiology of Respiratory Syncytial Virus Hospitalizations in Poland: An Analysis from 2015 to 2023 Covering the Entire Polish Population of Children Aged under Five Years. Viruses 2024; 16:704. [PMID: 38793586 PMCID: PMC11126078 DOI: 10.3390/v16050704] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2024] [Revised: 04/26/2024] [Accepted: 04/27/2024] [Indexed: 05/26/2024] Open
Abstract
BACKGROUND Respiratory syncytial virus (RSV) is an important cause of childhood hospitalizations. The aim of the study was to estimate the rates of RSV-related hospitalizations in children aged less than 5 years in Poland. METHODS This retrospective observational cohort study was based on data obtained from the National Health Fund in Poland regarding all acute respiratory tract infections and RSV-coded admissions of children (age < 5 years) to public hospitals between July 2015 and June 2023. Patients were stratified based on the following age groups: 0-1 month, 2-3 months, 4-6 months, 7-12 months, 13-24 months, and 25-60 months. RESULTS The number of RSV-related hospitalizations increased every season, both before and through the ending phase of the coronavirus disease 2019 (COVID-19) pandemic. The COVID-19 pandemic was associated with a shift in the seasonality pattern of RSV infection. Hospitalization rates per 1000 inhabitants were the highest for children aged 0-12 months, reaching 47.3 in the 2022/23 season. Within this group, the highest hospitalization rate was observed for children aged 2-3 months-94.9 in the 2022/23 season. During the ending phase of the COVID-19 pandemic, the observed increase in admission rates was 2-, 4-, and 5-fold the pre-COVID rate for children aged <12 months, 12-24 months, and 25-60 months, respectively. CONCLUSIONS In Poland, RSV infections cause a significant burden in hospitalized children aged less than 5 years. RSV-related hospitalizations were most frequent in children aged less than 1 year. The COVID-19 pandemic was associated with a shift in the seasonality pattern of RSV infections. After the pandemic, more RSV-related hospitalizations were observed in older children (aged 13 months and older) vs. the pre-pandemic phase.
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Affiliation(s)
- Jan Mazela
- Department of Neonatology, Poznan University of Medical Sciences in Poznan, 60-535 Poznan, Poland
| | - Teresa Jackowska
- Department of Pediatrics, Centre of Postgraduate Medical Education, 01-813 Warsaw, Poland;
| | - Marcin Czech
- Department of Pharmacoeconomics, Hospital Infection Control Team, Institute of Mother and Child, 01-211 Warsaw, Poland;
| | - Ewa Helwich
- Institute of Mother and Child, 01-211 Warsaw, Poland;
| | - Oliver Martyn
- Sanofi A/S, Vaccines Medical Affairs, DK-2100 København, Denmark;
| | - Pawel Aleksiejuk
- Sanofi Sp. z o.o., Vaccines Medical Affairs, 01-211 Warsaw, Poland
| | - Anna Smaga
- PEX Sp. z o.o., 02-796 Warsaw, Poland; (A.S.); (J.G.)
- National Institute of Public Health NIH—National Research Institute, 00-791 Warsaw, Poland
| | | | - Jacek Wysocki
- Department of Preventive Medicine, Poznan University of Medical Sciences at Poznan, 61-701 Poznan, Poland;
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17
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Pandolfi E, Loconsole D, Chironna M, van Summeren J, Paget J, Raponi M, Russo L, Campagna I, Croci I, Concato C, Perno CF, Tozzi AE, Linardos G, Bartolucci V, Ciampini S, Muda AO, De Angelis L, Ciofi Degli Atti ML, Rizzo C. Pre-COVID-19-pandemic RSV epidemiology and clinical burden in pediatric primary care in Italy: a comparative analysis across two regions for the 2019/2020 season. BMC Infect Dis 2024; 24:388. [PMID: 38605310 PMCID: PMC11007985 DOI: 10.1186/s12879-024-09229-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2023] [Accepted: 03/15/2024] [Indexed: 04/13/2024] Open
Abstract
BACKGROUND Respiratory syncytial virus (RSV) infection in children under 5 years have a significant clinical burden, also in primary care settings. This study investigates the epidemiology and burden of RSV in Italian children during the 2019/20 pre-pandemic winter season. METHODS A prospective cohort study was conducted in two Italian regions. Children with Acute Respiratory Infection (ARI) visiting pediatricians were eligible. Nasopharyngeal swabs were collected and analyzed via multiplex PCR for RSV detection. A follow-up questionnaire after 14 days assessed disease burden, encompassing healthcare utilization and illness duration. Statistical analyses, including regression models, explored associations between variables such as RSV subtype and regional variations. RESULTS Of 293 children with ARI, 41% (119) tested positive for RSV. Median illness duration for RSV-positive cases was 7 days; 6% required hospitalization (median stay: 7 days). Medication was prescribed to 95% (110/116) of RSV cases, with 31% (34/116) receiving antibiotics. RSV subtype B and regional factors predicted increased healthcare utilization. Children with shortness of breath experienced a 36% longer illness duration. CONCLUSIONS This study highlights a significant clinical burden and healthcare utilization associated with RSV in pre-pandemic Italian primary care settings. Identified predictors, including RSV subtype and symptomatology, indicate the need for targeted interventions and resource allocation strategies. RSV epidemiology can guide public health strategies for the implementation of preventive measures.
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Affiliation(s)
- Elisabetta Pandolfi
- Predictive and Preventive Medicine Research Unit, Bambino Gesù Children's Hospital IRCCS, Rome, Italy
| | - Daniela Loconsole
- Department of Interdisciplinary Medicine, University of Bari, Bari, Italy
| | - Maria Chironna
- Department of Interdisciplinary Medicine, University of Bari, Bari, Italy
| | | | - John Paget
- Nivel, Netherlands Institute for Health Services Research, Utrecht, The Netherlands
| | | | - Luisa Russo
- Division of Metabolism, Bambino Gesù Children's Hospital IRCCS, Rome, Italy
| | - Ilaria Campagna
- Predictive and Preventive Medicine Research Unit, Bambino Gesù Children's Hospital IRCCS, Rome, Italy
| | - Ileana Croci
- Predictive and Preventive Medicine Research Unit, Bambino Gesù Children's Hospital IRCCS, Rome, Italy
| | - Carlo Concato
- Virology Unit, Laboratory Department, Bambino Gesù Children's Hospital IRCCS, Rome, Italy
| | - Carlo Federico Perno
- Virology Unit, Laboratory Department, Bambino Gesù Children's Hospital IRCCS, Rome, Italy
| | - Alberto Eugenio Tozzi
- Predictive and Preventive Medicine Research Unit, Bambino Gesù Children's Hospital IRCCS, Rome, Italy
| | - Giulia Linardos
- Virology Unit, Laboratory Department, Bambino Gesù Children's Hospital IRCCS, Rome, Italy
| | - Veronica Bartolucci
- Predictive and Preventive Medicine Research Unit, Bambino Gesù Children's Hospital IRCCS, Rome, Italy
| | - Sara Ciampini
- Local Health Unit, Public Health Service, Rome, Italy
| | - Andrea Onetti Muda
- Department of Laboratories, Bambino Gesù Children's Hospital IRCCS, Rome, Italy
| | - Luigi De Angelis
- Department of Translational Research and New Technologies in Medicine and Surgery, University of Pisa, Pisa, Italy.
| | | | - Caterina Rizzo
- Department of Translational Research and New Technologies in Medicine and Surgery, University of Pisa, Pisa, Italy
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18
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Paget J, Chaves SS, Li Y, Nair H, Spreeuwenberg P. Revisiting influenza-hospitalisation estimates from the Burden of Influenza and Respiratory Syncytial Virus Disease (BIRD) project using different extrapolation methods. J Glob Health 2024; 14:03017. [PMID: 38574354 PMCID: PMC10994668 DOI: 10.7189/jogh.14.03017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/06/2024] Open
Affiliation(s)
| | - Sandra S Chaves
- Foundation for Influenza Epidemiology, Fondation de France, Paris, France
| | - You Li
- University of Edinburgh, Edinburgh, UK
- Nanjing Medical University, Nanjing, China
| | - Harish Nair
- University of Edinburgh, Edinburgh, UK
- Nanjing Medical University, Nanjing, China
- School of Public Health, University of the Witwatersrand, Johannesburg, South Africa
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19
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Scarpaci M, Bracaloni S, Esposito E, De Angelis L, Baglivo F, Casini B, Panatto D, Ogliastro M, Loconsole D, Chironna M, Pariani E, Pellegrinelli L, Pandolfi E, Croci I, Rizzo C. RSV Disease Burden in Primary Care in Italy: A Multi-Region Pediatric Study, Winter Season 2022-2023. Influenza Other Respir Viruses 2024; 18:e13282. [PMID: 38622776 PMCID: PMC11018906 DOI: 10.1111/irv.13282] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2023] [Revised: 02/05/2024] [Accepted: 03/11/2024] [Indexed: 04/17/2024] Open
Abstract
INTRODUCTION Human respiratory syncytial virus (RSV) is one of the most frequent causes of respiratory infections in children under 5 years of age, but its socioeconomic impact and burden in primary care settings is still little studied. METHODS During the 2022/2023 winter season, 55 pediatricians from five Italian regions participated in our community-based study. They collected a nasal swab for RSV molecular test from 650 patients under the age of 5 with acute respiratory infections (ARIs) and performed a baseline questionnaire. The clinical and socioeconomic burden of RSV disease in primary care was evaluated by two follow-up questionnaires completed by the parents of positive children on Days 14 and 30. RESULTS RSV laboratory-confirmed cases were 37.8% of the total recruited ARI cases, with RSV subtype B accounting for the majority (65.4%) of RSV-positive swabs. RSV-positive children were younger than RSV-negative ones (median 12.5 vs. 16.5 months). The mean duration of symptoms for all children infected by RSV was 11.47 ± 6.27 days. We did not observe substantial differences in clinical severity between the two RSV subtypes, but RSV-A positive patients required more additional pediatric examinations than RSV-B cases. The socioeconomic impact of RSV infection was considerable, causing 53% of children to be absent from school, 46% of parents to lose working days, and 25% of families to incur extra costs. CONCLUSIONS Our findings describe a baseline of the RSV disease burden in primary care in Italy before the introduction of upcoming immunization strategies.
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Affiliation(s)
- Michela Scarpaci
- Department of Translational Research and New Technologies in Medicine and SurgeryUniversity of PisaPisaItaly
| | - Sara Bracaloni
- Department of Translational Research and New Technologies in Medicine and SurgeryUniversity of PisaPisaItaly
| | - Enrica Esposito
- Department of Translational Research and New Technologies in Medicine and SurgeryUniversity of PisaPisaItaly
| | - Luigi De Angelis
- Department of Translational Research and New Technologies in Medicine and SurgeryUniversity of PisaPisaItaly
| | - Francesco Baglivo
- Department of Translational Research and New Technologies in Medicine and SurgeryUniversity of PisaPisaItaly
| | - Beatrice Casini
- Department of Translational Research and New Technologies in Medicine and SurgeryUniversity of PisaPisaItaly
| | | | | | - Daniela Loconsole
- Hygiene Section, Department of Interdisciplinary MedicineUniversity of Bari “A. Moro”BariItaly
| | - Maria Chironna
- Hygiene Section, Department of Interdisciplinary MedicineUniversity of Bari “A. Moro”BariItaly
| | - Elena Pariani
- Department of Biomedical Sciences for HealthUniversity of MilanMilanItaly
| | | | - Elisabetta Pandolfi
- Predictive and Preventive Medicine Research UnitBambino Gesù Children's Hospital, IRCCSRomeItaly
| | - Ileana Croci
- Predictive and Preventive Medicine Research UnitBambino Gesù Children's Hospital, IRCCSRomeItaly
| | - Caterina Rizzo
- Department of Translational Research and New Technologies in Medicine and SurgeryUniversity of PisaPisaItaly
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20
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Homaira N. Will nirsevimab be the holy grail for prevention of respiratory syncytial virus lower respiratory tract infections in infants? Transl Pediatr 2024; 13:525-529. [PMID: 38590379 PMCID: PMC10998989 DOI: 10.21037/tp-23-534] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/30/2023] [Accepted: 12/29/2023] [Indexed: 04/10/2024] Open
Affiliation(s)
- Nusrat Homaira
- Discipline of Paediatrics and Child Health, School of Clinical Medicine, Faculty of Medicine, UNSW Sydney, Randwick, NSW, Australia
- Respiratory Department, Sydney Children’s Hospital, Randwick, NSW, Australia
- James P. Grant School of Public Health, BRAC University, Dhaka, Bangladesh
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21
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van der Velden K, van Summeren J, Caini S, Nair H, Dückers M, Meijer A. William John Paget PhD. J Infect Dis 2024; 229:S1-S3. [PMID: 38064690 DOI: 10.1093/infdis/jiad554] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/02/2024] Open
Affiliation(s)
- Koos van der Velden
- Department of Primary and Community Care, Radboud University, Medical Centre, Nijmegen, the Netherlands
| | | | - Saverio Caini
- Nivel-Netherlands Institute for Health Services Research, Utrecht, the Netherlands
| | - Harish Nair
- Centre for Global Health, Usher Institute, University of Edinburgh, Edinburgh, United Kingdom
| | - Michel Dückers
- Nivel-Netherlands Institute for Health Services Research, Utrecht, the Netherlands
- Faculty of Behavioural and Social Sciences, University of Groningen, Groningen, the Netherlands
| | - Adam Meijer
- Centre for Infectious Disease Control (CIb), National Institute for Public Health and the Environment (RIVM), Bilthoven, the Netherlands
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22
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Osei-Yeboah R, Johannesen CK, Egeskov-Cavling AM, Chen J, Lehtonen T, Fornes AU, Paget J, Fischer TK, Wang X, Nair H, Campbell H. Respiratory Syncytial Virus-Associated Hospitalization in Adults With Comorbidities in 2 European Countries: A Modeling Study. J Infect Dis 2024; 229:S70-S77. [PMID: 37970679 DOI: 10.1093/infdis/jiad510] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2023] [Revised: 11/07/2023] [Accepted: 11/11/2023] [Indexed: 11/17/2023] Open
Abstract
BACKGROUND Individuals with comorbidities are at increased risk of severe respiratory syncytial virus (RSV) infection. We estimated RSV-associated respiratory hospitalization among adults aged ≥45 years with comorbidities in Denmark and Scotland. METHODS By analyzing national hospital and virologic data, we estimated annual RSV-associated hospitalizations by 7 selected comorbidities and ages between 2010 and 2018. We estimated rate ratios of RSV-associated hospitalization for adults with comorbidity than the overall population. RESULTS In Denmark, annual RSV-associated hospitalization rates per 1000 adults ranged from 3.1 for asthma to 19.4 for chronic kidney disease (CKD). In Scotland, rates ranged from 2.4 for chronic liver disease to 9.0 for chronic obstructive pulmonary disease (COPD). In both countries, we found a 2- to 4-fold increased risk of RSV hospitalization for adults with COPD, ischemic heart disease, stroke, and diabetes; a 1.5- to 3-fold increased risk for asthma; and a 3- to 7-fold increased risk for CKD. RSV hospitalization rates among adults aged 45 to 64 years with COPD, asthma, ischemic heart disease, or CKD were higher than the overall population. CONCLUSIONS This study provides important evidence for identifying risk groups and assisting health authorities in RSV vaccination policy making.
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Affiliation(s)
- Richard Osei-Yeboah
- Centre for Global Health, Usher Institute, University of Edinburgh, United Kingdom
| | - Caroline Klint Johannesen
- Department of Virology and Microbiological Special Diagnostics, Statens Serum Institut, Copenhagen, Denmark
| | - Amanda Marie Egeskov-Cavling
- Department of Clinical Research, Nordsjaellands Hospital Hilleroed, and Department of Public Health, University of Copenhagen, Denmark
| | - Junru Chen
- School of Public Health, Nanjing Medical University, China
| | - Toni Lehtonen
- Department of Health Security, Finnish Institute for Health and Welfare, Helsinki
| | - Arantxa Urchueguía Fornes
- Vaccine Research Department, Foundation for the Promotion of Health and Biomedical Research in the Valencian Region, Valencia, Spain
| | - John Paget
- Department of Primary Care, Netherlands Institute for Health Services Research, Utrecht
| | - Thea K Fischer
- Department of Virology and Microbiological Special Diagnostics, Statens Serum Institut, Copenhagen, Denmark
| | - Xin Wang
- Centre for Global Health, Usher Institute, University of Edinburgh, United Kingdom
- School of Public Health, Nanjing Medical University, China
| | - Harish Nair
- Centre for Global Health, Usher Institute, University of Edinburgh, United Kingdom
| | - Harry Campbell
- Centre for Global Health, Usher Institute, University of Edinburgh, United Kingdom
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23
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Osei-Yeboah R, Zhu F, Wang X, Nair H, Campbell H. Respiratory Syncytial Virus-Associated Hospital Admissions by Deprivation Levels Among Children and Adults in Scotland. J Infect Dis 2024; 229:S61-S69. [PMID: 37797317 DOI: 10.1093/infdis/jiad428] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2023] [Revised: 09/12/2023] [Accepted: 09/26/2023] [Indexed: 10/07/2023] Open
Abstract
BACKGROUND Socioeconomic deprivation may predispose individuals to respiratory tract infections. We estimated RSV-associated hospitalizations by socioeconomic deprivation in Scotland. METHODS Using national routine health care records and virological surveillance from 2010 to 2016, we used a time-series linear regression model and a direct measurement based on ICD-10 coded diagnoses to estimate RSV-associated hospitalizations by Scottish Index of Multiple Deprivation (SIMD) quintile and age in comparison to influenza-associated hospitalizations. RESULTS We estimated an annual average rate per 1000 people of 0.76 (95% CI: 0.43-0.90) in the least deprived group to 1.51 (1.03-1.79) for the most deprived group using model-based approach. The rate ratio (RR) was 1.96 (1.23-3.25), 1.60 (1.0-2.66), 1.35 (0.85-2.25), and 1.12 (0.7-1.85) in the 1st to 4th quintile versus the least deprived group. The pattern of RSV-associated hospitalization rates variation with SIMD was most pronounced in children 0-2y. The ICD-10 approach provided much lower rates than the model-based approach but yielded similar RR estimates between SIMD. Influenza-associated hospitalization rate generally increased with higher deprivation levels among individuals 1y+. CONCLUSIONS Higher RSV and influenza hospitalization rates are related to higher deprivation levels. Differences between deprivation levels are most pronounced in infants and young children for RSV, and are more apparent among individuals 1y+ for influenza.
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Affiliation(s)
- Richard Osei-Yeboah
- Centre for Global Health, Usher Institute, University of Edinburgh, Edinburgh, United Kingdom
| | - Fuyu Zhu
- School of Public Health, Nanjing Medical University, Nanjing, Jiangsu, China
| | - Xin Wang
- Centre for Global Health, Usher Institute, University of Edinburgh, Edinburgh, United Kingdom
- School of Public Health, Nanjing Medical University, Nanjing, Jiangsu, China
| | - Harish Nair
- Centre for Global Health, Usher Institute, University of Edinburgh, Edinburgh, United Kingdom
| | - Harry Campbell
- Centre for Global Health, Usher Institute, University of Edinburgh, Edinburgh, United Kingdom
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24
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Congedo G, Lombardi GS, Zjalic D, Di Russo M, La Gatta E, Regazzi L, Indolfi G, Staiano A, Cadeddu C. Knowledge, attitudes and behaviours of a sample of Italian paediatricians towards RSV and its preventive strategies: a cross-sectional study. Ital J Pediatr 2024; 50:35. [PMID: 38424627 PMCID: PMC10905893 DOI: 10.1186/s13052-024-01593-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/31/2023] [Accepted: 01/07/2024] [Indexed: 03/02/2024] Open
Abstract
BACKGROUND Respiratory Syncytial Virus (RSV) infection mainly affects newborns, infants and young children aged < 2 years. Since an RSV vaccine is in the European Medicines Agency's waitlist validation, nowadays the prevention only includes passive immunization with monoclonal antibodies (mAb). In the present study we aimed at investigating Italian paediatricians' knowledge, attitudes and behaviours towards RSV and its prevention. METHODS From February to May 2023, an anonymous online questionnaire, with answers based on the Likert scale, was administered to a sample of Italian paediatricians' members of the Italian Society of Paediatrics. Descriptive and inferential statistical analyses were performed using STATA 17. RESULTS The paediatricians who answered the questionnaire were 507, mostly women (70.6%), aged 30-45 (33.1%), employed in hospitals in 66.6% of cases. The 10.8% of respondents reported that RSV is transmitted only among children younger than 2 years of age and 80.33% of participants that school-age children are not at risk of developing severe forms of RSV disease. The 25% of participants thought that active immunization is currently available to prevent RSV infection and 35.7% that does not exist passive immunization to prevent RSV for infants and newborns aged < 2 years. The 97.5% of physicians managed bronchiolitis cases and 65.6% of participants did not prescribe the administration of mAb. Higher age, seniority and RSV knowledge score were found to be associated with having a higher mAb knowledge score (p < 0.001) and having a higher RSV knowledge was associated with a higher mAb knowledge score (p < 0.001). The logistic regression model found that the odds of a positive attitude towards mAB knowledge score increased by over 3 times (OR 3.23, 95% CI [1.41, 7.40], p = 0.006) for being female and the odds of a positive attitude towards mAB knowledge score increased by almost 10 times (OR 9.73, 95% CI [3.06, 30.89], p < 0.001) for a one-unit increase in RSV knowledge score. CONCLUSIONS Paediatricians' limited knowledge or awareness could represent a barrier to the implementation of preventive strategies against RSV infection. Strategies to improve paediatricians' education on RSV prevention are, therefore, crucial.
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Affiliation(s)
- Giulia Congedo
- Department of Life Science and Public Health, Section of Hygiene, Università Cattolica del Sacro Cuore, Roma, Italy.
| | - Gaia Surya Lombardi
- Department of Life Science and Public Health, Section of Hygiene, Università Cattolica del Sacro Cuore, Roma, Italy
| | - Doris Zjalic
- Department of Life Science and Public Health, Section of Hygiene, Università Cattolica del Sacro Cuore, Roma, Italy
| | - Mattia Di Russo
- Department of Life Science and Public Health, Section of Hygiene, Università Cattolica del Sacro Cuore, Roma, Italy
| | - Emanuele La Gatta
- Department of Life Science and Public Health, Section of Hygiene, Università Cattolica del Sacro Cuore, Roma, Italy
| | - Luca Regazzi
- Department of Life Science and Public Health, Section of Hygiene, Università Cattolica del Sacro Cuore, Roma, Italy
| | - Giuseppe Indolfi
- Department Neurofarba, Università degli Studi di Firenze, Firenze, Italy
- Meyer Children's Hospital, IRCCS, Firenze, Italy
| | - Annamaria Staiano
- Department of Translational Medical Science, Section of Pediatrics, Università degli studi di Napoli "Federico II", Napoli, Italy
| | - Chiara Cadeddu
- Department of Life Science and Public Health, Section of Hygiene, Università Cattolica del Sacro Cuore, Roma, Italy
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25
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Bechini A, Salvati C, Bonito B, Del Riccio M, Stancanelli E, Bruschi M, Ionita G, Iamarino JA, Bentivegna D, Buscemi P, Ciardi G, Cosma C, Stacchini L, Conticello C, Bega M, Paoli S, Schirripa A, Bertizzolo L, Muzii B, Azzi MV, Parisi S, Trippi F, Bonanni P, Boccalini S. Costs and healthcare utilisation due to respiratory syncytial virus disease in paediatric patients in Italy: a systematic review. Public Health 2024; 227:103-111. [PMID: 38154422 DOI: 10.1016/j.puhe.2023.11.039] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2023] [Revised: 11/21/2023] [Accepted: 11/28/2023] [Indexed: 12/30/2023]
Abstract
OBJECTIVES Respiratory syncytial virus (RSV) is a frequent cause of acute lower respiratory infection in children, imposing a substantial economic burden on healthcare systems. This systematic review aimed to assess the economic burden and healthcare utilisation of RSV in children aged 0-59 months in Italy. STUDY DESIGN Systematic review. METHODS A systematic search of PubMed, Embase, Scopus, and the International HTA Database, including studies published in English or Italian, was conducted between January 2000 and July 2022. Inclusion criteria required studies to be conducted in Italy and provide data on the economic costs and healthcare resource utilisation related to RSV infections. RESULTS Out of 20,845 records screened, 18 articles met the inclusion criteria. Only one study provided comprehensive data on RSV disease costs, including hospitalisation, diagnostic tests, and medical procedures for infants with RSV-bronchiolitis. The mean cost per inpatient was higher for RSV-positive children (€5753.43 ± €2041.62) than that for RSV-negative children. Additionally, five studies reported a median length of hospital stay of 5 days for RSV-infected children, and four studies indicated a higher frequency of intensive care unit admissions for RSV-infected children than for those with other viral infections. CONCLUSIONS This is the first systematic review to examine the economic burden and healthcare utilisation of RSV in children aged 0-59 months in Italy. While limited data were available, the findings underscore the urgency to conduct further research and gather additional evidence on the costs and healthcare resource utilisation associated with RSV infections. Such efforts are essential for informing the development of effective prevention strategies for paediatric RSV infections in Italy.
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Affiliation(s)
- Angela Bechini
- Department of Health Sciences, University of Florence, Florence 50134, Italy
| | - Cristina Salvati
- Department of Health Sciences, University of Florence, Florence 50134, Italy
| | - Benedetta Bonito
- Department of Health Sciences, University of Florence, Florence 50134, Italy
| | - Marco Del Riccio
- Department of Health Sciences, University of Florence, Florence 50134, Italy.
| | - Enrica Stancanelli
- Medical Specialization School of Hygiene and Preventive Medicine, University of Florence, Florence 50134, Italy
| | - Mario Bruschi
- Medical Specialization School of Hygiene and Preventive Medicine, University of Florence, Florence 50134, Italy
| | - Giulia Ionita
- Medical Specialization School of Hygiene and Preventive Medicine, University of Florence, Florence 50134, Italy
| | - Johanna Alexandra Iamarino
- Medical Specialization School of Hygiene and Preventive Medicine, University of Florence, Florence 50134, Italy
| | - Davide Bentivegna
- Medical Specialization School of Hygiene and Preventive Medicine, University of Florence, Florence 50134, Italy
| | - Primo Buscemi
- Medical Specialization School of Hygiene and Preventive Medicine, University of Florence, Florence 50134, Italy
| | - Giulia Ciardi
- Medical Specialization School of Hygiene and Preventive Medicine, University of Florence, Florence 50134, Italy
| | - Claudia Cosma
- Medical Specialization School of Hygiene and Preventive Medicine, University of Florence, Florence 50134, Italy
| | - Lorenzo Stacchini
- Medical Specialization School of Hygiene and Preventive Medicine, University of Florence, Florence 50134, Italy
| | - Cristiana Conticello
- Medical Specialization School of Hygiene and Preventive Medicine, University of Florence, Florence 50134, Italy
| | - Manjola Bega
- Medical Specialization School of Hygiene and Preventive Medicine, University of Florence, Florence 50134, Italy
| | - Sonia Paoli
- Medical Specialization School of Hygiene and Preventive Medicine, University of Florence, Florence 50134, Italy
| | - Annamaria Schirripa
- Medical Specialization School of Hygiene and Preventive Medicine, University of Florence, Florence 50134, Italy
| | | | | | | | | | | | - Paolo Bonanni
- Department of Health Sciences, University of Florence, Florence 50134, Italy
| | - Sara Boccalini
- Department of Health Sciences, University of Florence, Florence 50134, Italy
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26
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Riccò M, Baldassarre A, Corrado S, Bottazzoli M, Marchesi F. Respiratory Syncytial Virus, Influenza and SARS-CoV-2 in Homeless People from Urban Shelters: A Systematic Review and Meta-Analysis (2023). EPIDEMIOLOGIA 2024; 5:41-79. [PMID: 38390917 PMCID: PMC10885116 DOI: 10.3390/epidemiologia5010004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2023] [Revised: 01/20/2024] [Accepted: 01/23/2024] [Indexed: 02/24/2024] Open
Abstract
Homeless people (HP) are disproportionally affected by respiratory disorders, including pneumococcal and mycobacterial infections. On the contrary, more limited evidence has been previously gathered on influenza and severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), and very little is known about the occurrence of human respiratory syncytial virus (RSV), a common cause of respiratory tract infections among children and the elderly. The present systematic review was designed to collect available evidence about RSV, influenza and SARS-CoV-2 infections in HP, focusing on those from urban homeless shelters. Three medical databases (PubMed, Embase and Scopus) and the preprint repository medRxiv.org were therefore searched for eligible observational studies published up to 30 December 2023, and the collected cases were pooled in a random-effects model. Heterogeneity was assessed using the I2 statistics. Reporting bias was assessed by funnel plots and a regression analysis. Overall, 31 studies were retrieved, and of them, 17 reported on the point prevalence of respiratory pathogens, with pooled estimates of 4.91 cases per 1000 HP (95%CI: 2.46 to 9.80) for RSV, 3.47 per 1000 HP for influenza and 40.21 cases per 1000 HP (95%CI: 14.66 to 105.55) for SARS-CoV-2. Incidence estimates were calculated from 12 studies, and SARS-CoV-2 was characterized by the highest occurrence (9.58 diagnoses per 1000 persons-months, 95%CI: 3.00 to 16.16), followed by influenza (6.07, 95%CI: 0.00 to 15.06) and RSV (1.71, 95%CI: 0.00 to 4.13). Only four studies reported on the outcome of viral infections in HP: the assessed pathogens were associated with a high likelihood of hospitalization, while high rates of recurrence and eventual deaths were reported in cases of RSV infections. In summary, RSV, influenza and SARS-CoV-2 infections were documented in HP from urban shelters, and their potential outcomes stress the importance of specifically tailored preventive strategies.
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Affiliation(s)
- Matteo Riccò
- AUSL-IRCCS di Reggio Emilia, Servizio di Prevenzione e Sicurezza Negli Ambienti di Lavoro (SPSAL), Local Health Unit of Reggio Emilia, 42122 Reggio Emilia, Italy
| | - Antonio Baldassarre
- Department of Experimental and Clinical Medicine, University of Florence, 50134 Florence, Italy
| | - Silvia Corrado
- ASST Rhodense, Dipartimento della Donna e Area Materno-Infantile, UOC Pediatria, 20024 Milan, Italy
| | - Marco Bottazzoli
- Department of Otorhinolaryngology, APSS Trento, 38122 Trento, Italy
| | - Federico Marchesi
- Department of Medicine and Surgery, University of Parma, 43126 Parma, Italy
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27
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Räikkönen K, Gissler M, Kajantie E, Tapiainen T. Antenatal corticosteroid treatment and infectious diseases in children: a nationwide observational study. THE LANCET REGIONAL HEALTH. EUROPE 2023; 35:100750. [PMID: 37860637 PMCID: PMC10583166 DOI: 10.1016/j.lanepe.2023.100750] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/07/2023] [Revised: 09/21/2023] [Accepted: 09/26/2023] [Indexed: 10/21/2023]
Abstract
Background Antenatal Corticosteroid Treatment (ACT) improves the outcome of preterm infants, but may influence immune system development and risk of immune-related diseases. We investigated whether ACT is associated with infectious diseases in children born at term (≥37 gestational weeks), and very-to-moderate (<34 gestational weeks), and late (34-36 completed gestational weeks) preterm. Methods All singleton live births in Finland between 01/01/2006 and 31/12/2021, were followed-up until 31/12/2021. Exposure was maternal ACT. Primary outcomes were numbers of inpatient treatment days, episodes, and specialized care outpatient visits with any infectious disease diagnoses between ages 0 and 4 years. We considered mother- and child-related covariates, and conducted term-born co-sibling comparisons. Findings Data comprised 855,234 children. Of the 20,858 (2.4%) treatment-exposed children, 5981 (28.2%) were very-to-moderate preterm-born, 5809 (27.9%) late preterm-born, and 9069 (43.5%) term-born. Of the 271,767 term-born co-sibling pairs, 5010 (1.8%) were treatment-exposure-discordant, and 266,522 (98.1%) nonexposure-concordant. Among the term- and late preterm-born, treatment-exposed children had more inpatient treatment days than nonexposed children (term: 0.87 vs. 0.56 day/y, adjusted mean difference [aMD] 0.19, 95% CI 0.17-0.28; late preterm: 1.35 vs. 1.00 days/y, aMD 0.31,0.13-0.31), more inpatient treatment episodes (term: 0.43 vs. 0.33 episodes/y, aMD 0.06, 0.06-0.11; late preterm: 0.55 vs. 0.48 episodes/y, aMD 0.12, 0.06-0.18), and specialized care treatment visits (term: 1.46 vs. 0.95 visits/y, aMD 0.38; 0.34-0.43; late preterm: 1.63 vs. 1.28 visits/y, aMD 0.22, 0.12-0.32). Treatment-exposed and nonexposed very-to-moderate preterm-born children were similar in these outcomes, though they had less inpatient treatment days and episodes at 3-4 years. Differences remained in term-born co-sibling comparisons. Interpretation These findings reinforce previous suggestions for careful consideration of risks and benefits of ACT. Funding Academy of Finland, HiLIFE Fellows-Programme.
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Affiliation(s)
- Katri Räikkönen
- Department of Psychology and Logopedics, Faculty of Medicine, University of Helsinki, Helsinki, Finland
- Department of Obstetrics and Gynecology, Helsinki University Hospital, University of Helsinki, Helsinki, Finland
| | - Mika Gissler
- Department of Knowledge Brokers, THL Finnish Institute for Health and Welfare, Helsinki, Finland
- Research Centre for Child Psychiatry, University of Turku, Turku, Finland
- Department of Molecular Medicine and Surgery, Karolinska Institutet and Academic Primary Health Care Centre, Region Stockholm, Stockholm, Sweden
| | - Eero Kajantie
- Research Unit of Clinical Medicine, University of Oulu, Oulu, Finland
- Department of Public Health Solutions, THL Finnish Institute for Health and Welfare, Helsinki and Oulu, Finland
- Department of Clinical and Molecular Medicine, Norwegian University of Science and Technology, Trondheim, Norway
- Children's Hospital, Helsinki University Hospital, University of Helsinki, Helsinki, Finland
| | - Terhi Tapiainen
- Research Unit of Clinical Medicine, University of Oulu, Oulu, Finland
- Department of Pediatrics and Adolescent Medicine, Medical Research Center, Oulu University Hospital, Oulu, Finland
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28
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Osei-Yeboah R, Spreeuwenberg P, Del Riccio M, Fischer TK, Egeskov-Cavling AM, Bøås H, van Boven M, Wang X, Lehtonen T, Bangert M, Campbell H, Paget J. Estimation of the Number of Respiratory Syncytial Virus-Associated Hospitalizations in Adults in the European Union. J Infect Dis 2023; 228:1539-1548. [PMID: 37246742 PMCID: PMC10681866 DOI: 10.1093/infdis/jiad189] [Citation(s) in RCA: 20] [Impact Index Per Article: 20.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2023] [Revised: 05/16/2023] [Accepted: 05/25/2023] [Indexed: 05/30/2023] Open
Abstract
BACKGROUND Respiratory syncytial virus (RSV) is a major cause of lower respiratory tract infections in adults that can result in hospitalizations. Estimating RSV-associated hospitalization is critical for planning RSV-related healthcare across Europe. METHODS We gathered RSV-associated hospitalization estimates from the RSV Consortium in Europe (RESCEU) for adults in Denmark, England, Finland, Norway, Netherlands, and Scotland from 2006 to 2017. We extrapolated these estimates to 28 European Union (EU) countries using nearest-neighbor matching, multiple imputations, and 2 sets of 10 indicators. RESULTS On average, 158 229 (95% confidence interval [CI], 140 865-175 592) RSV-associated hospitalizations occur annually among adults in the EU (≥18 years); 92% of these hospitalizations occur in adults ≥65 years. Among 75-84 years, the annual average is estimated at 74 519 (95% CI, 69 923-79 115) at a rate of 2.24 (95% CI, 2.10-2.38) per 1000. Among ≥85 years, the annual average is estimated at 37 904 (95% CI, 32 444-43 363) at a rate of 2.99 (95% CI, 2.56-3.42). CONCLUSIONS Our estimates of RSV-associated hospitalizations in adults are the first analysis integrating available data to provide the disease burden across the EU. Importantly, for a condition considered in the past to be primarily a disease of young children, the average annual hospitalization estimate in adults was lower but of a similar magnitude to the estimate in young children (0-4 years): 158 229 (95% CI, 140 865-175 592) versus 245 244 (95% CI, 224 688-265 799).
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Affiliation(s)
- Richard Osei-Yeboah
- Centre for Global Health, Usher Institute, University of Edinburgh, United Kingdom
| | - Peter Spreeuwenberg
- Netherlands Institute for Health Services Research, Utrecht, The Netherlands
| | - Marco Del Riccio
- Netherlands Institute for Health Services Research, Utrecht, The Netherlands
- Postgraduate Medical School in Public Health, University of Florence, Italy
| | - Thea K Fischer
- Department of Virus and Microbiological Special Diagnostics, Statens Serum Institut, Copenhagen, Denmark
- Department of Clinical Research, Nordsjaellands Hospital, Hilleroed and Public Health, University of Copenhagen, Denmark
| | - Amanda Marie Egeskov-Cavling
- Department of Virus and Microbiological Special Diagnostics, Statens Serum Institut, Copenhagen, Denmark
- Department of Clinical Research, Nordsjaellands Hospital, Hilleroed and Public Health, University of Copenhagen, Denmark
| | - Håkon Bøås
- Department of Infection Control and Vaccines, Norwegian Institute of Public Health, Oslo
| | - Michiel van Boven
- Centre for Infectious Disease Control, National Institute for Public Health and the Environment, Bilthoven
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht University, The Netherlands
| | - Xin Wang
- School of Public Health, Nanjing Medical University, China
| | - Toni Lehtonen
- Department of Health Security, Finnish Institute for Health and Welfare, Helsinki
| | | | - Harry Campbell
- Centre for Global Health, Usher Institute, University of Edinburgh, United Kingdom
| | - John Paget
- Netherlands Institute for Health Services Research, Utrecht, The Netherlands
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