Xie Zhengde, Qin Qiang, Shen Kunling, Fang Cheng, Li Yang, Deng Tong
Key Laboratory of Major Diseases in Children, Ministry of Education, National Clinical Research Center for Respiratory Diseases, Beijing Key Laboratory of Pediatric Respiratory Infection Diseases, Infection and Virology Laboratory, Beijing Pediatric Research Institute, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing, China.
Key Laboratory of Major Diseases in Children, Ministry of Education, National Clinical Research Center for Respiratory Diseases, Respiratory Department, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing, China.
Transl Pediatr. 2020 Aug;9(4):496-506. doi: 10.21037/tp-20-148.
Respiratory syncytial virus (RSV), which is associated with acute lower respiratory tract infection (ALRTI), is highly common among children. The burden of RSV varies between countries. In China, the actual burden remains unclear. Thus, this meta-analysis aimed to quantify the positive rate of ALRTI-related RSV infections among Chinese children in recent years.
The PubMed, Web of Science, China National Knowledge Infrastructure (CNKI), WanFang, and Chinese BioMedical (CBM) databases were searched to identify relevant cross-sectional studies published between January 1, 2015 and December 31, 2018. Subsequently, a meta-analysis was performed using R software.
A total of 18 studies involving 66,799 ALRTI cases were finally included in the meta-analysis. Among those ALRTIs cases, the overall positive rate of RSV infection was 16.0% (95% CI: 12.9-19.6%). The rate was significantly higher in children <3 years (19.5%, 95% CI 13.3-27.6%) compared to those ≥3 years (5.6%, 95% CI: 2.3-13.2%; P<0.01). Moreover, stratified analysis revealed that RSV infection was most frequent in children <6 months (31.1%, 95% CI: 21.0-43.5%). The positive detection rate of RSV infection was significantly associated with season (P<0.01), with winter having the highest detection rate (29.0%, 95% CI: 21.3-38.2%), followed by autumn (20.9%, 95% CI: 10.5-37.3%), and summer having the lowest rate (6.4%, 95% CI: 2.3-16.9%). The rate of RSV infection was highest and lowest in November (49.4%, 95% CI: 29.0-70.0%) and June (1.3%, 95% CI: 0.6-2.8%), respectively. When stratified according to geographical region, RSV infections peaked in winter (South: 24.8%, 95% CI: 12.9-42.3%; North: 36.3%, 95% CI: 30.8-42.1%), followed by autumn (South: 13.9%, 95% CI: 6.5-27.4%; North: 32.7%, 95% CI: 20.2-48.3%).
In conclusion, our meta-analysis showed that among Chinese children with ALRTI, 16.0% had RSV infection. RSV infection frequently occurred in children under the age of 3 years, especially in those under 6 months. The rate of RSV infections was highest in winter, followed by autumn.
呼吸道合胞病毒（RSV）与急性下呼吸道感染（ALRTI）相关，在儿童中极为常见。RSV的负担在不同国家有所不同。在中国，实际负担仍不明确。因此，本荟萃分析旨在量化近年来中国儿童中与ALRTI相关的RSV感染阳性率。
检索PubMed、Web of Science、中国知网（CNKI）、万方和中国生物医学文献数据库（CBM），以识别2015年1月1日至2018年12月31日期间发表的相关横断面研究。随后，使用R软件进行荟萃分析。
共有18项研究涉及66,799例ALRTI病例最终纳入荟萃分析。在这些ALRTI病例中，RSV感染的总体阳性率为16.0%（95%CI：12.9 - 19.6%）。与≥3岁的儿童（5.6%，95%CI：2.3 - 13.2%；P<0.01）相比，<3岁儿童的感染率显著更高（19.5%，95%CI 13.3 - 27.6%）。此外，分层分析显示，RSV感染在<6个月的儿童中最为常见（31.1%，95%CI：21.0 - 43.5%）。RSV感染的阳性检出率与季节显著相关（P<0.01），冬季检出率最高（29.0%，95%CI：21.3 - 38.2%），其次是秋季（20.9%，95%CI：10.5 - 37.3%），夏季最低（6.4%，95%CI：2.3 - 16.9%）。RSV感染率在11月最高（49.4%，95%CI：29.0 - 70.0%），6月最低（1.3%，95%CI：0.6 - 2.8%）。按地理区域分层时，RSV感染在冬季达到峰值（南方：24.8%，95%CI：12.9 - 42.3%；北方：36.3%，95%CI：30.8 - 42.1%），其次是秋季（南方：13.9%，95%CI：6.5 - 27.4%；北方：32.7%，95%CI：20.2 - 48.3%）。
总之，我们的荟萃分析表明在中国患有ALRTI的儿童中，16.0%感染了RSV。RSV感染常见于3岁以下儿童，尤其是6个月以下的儿童。RSV感染率在冬季最高，其次是秋季。
