Center for Infectious Diseases Research, American University of Beirut, Beirut, Lebanon; Division of Pediatric Infectious Diseases, Department of Pediatrics and Adolescent Medicine, American University of Beirut Medical Center, Beirut, Lebanon.
Center for Infectious Diseases Research, American University of Beirut, Beirut, Lebanon.
Vaccine. 2021 Jun 29;39(29):3803-3813. doi: 10.1016/j.vaccine.2021.05.076. Epub 2021 Jun 4.
Respiratory Syncytial Virus (RSV) is a common respiratory virus that generally causes a mild illness in children and adults or severe symptoms with complications in infants and the elderly, particularly in the presence of underlying comorbidities. While epidemiological data about this virus are available globally, data from the Middle East and North Africa (MENA) region are still scarce. For this reason, we conducted a systematic review to determine the burden of RSV disease in the MENA region by searching the available literature up until September 2018. A total of 1242 studies were retrieved of which 90 were included in the review. Most of the included studies were conducted in subjects aged 0-18 years with the majority being in children below 3 years of age, while only 2 studies included exclusively adults above 18 years of age. RSV infection rates varied greatly between different studies on hospitalized subjects and ranged between 4% and 82%, while the range was smaller in studies on outpatient subjects (between 6% and 36%). When calculating the RSV infection rates in the hospitalized subjects with different inclusion criteria, we found that it was 19%, 70%, and 33% among subjects admitted with Acute Respiratory Infections (ARIs), Acute Lower Respiratory Infections (ALRIs), and bronchiolitis, respectively. RSV infections were most common during the winter season. With regards to complications, intensive care unit admissions ranged between 1% and 15%, while the need for mechanical ventilation ranged between 1% and 10%. The overall RSV related mortality rate across all age groups in studies included in our review was 1.9%. This review identifies several limitations in the existing data and under-representation of the adult population. Future studies should be providing more evidence on the RSV burden in adults and children with comorbidities in order to better assess the potential impact of future preventive strategies in the MENA region.
呼吸道合胞病毒（RSV）是一种常见的呼吸道病毒，通常在儿童和成人中引起轻度疾病，或在婴儿和老年人中引起严重症状并伴有并发症，尤其是在存在潜在合并症的情况下。虽然全球都有关于这种病毒的流行病学数据，但中东和北非（MENA）地区的数据仍然很少。因此，我们进行了一项系统评价，通过搜索截至 2018 年 9 月的现有文献，确定 MENA 地区 RSV 疾病的负担。共检索到 1242 项研究，其中 90 项研究纳入了本综述。纳入的研究大多针对 0-18 岁的人群，其中大部分为 3 岁以下的儿童，只有 2 项研究仅纳入 18 岁以上的成年人。在对住院患者进行的不同研究中，RSV 感染率差异很大，范围在 4%-82%之间，而在对门诊患者进行的研究中，范围较小（6%-36%）。当计算不同纳入标准的住院患者的 RSV 感染率时，我们发现因急性呼吸道感染（ARI）、急性下呼吸道感染（ALRI）和细支气管炎而住院的患者中 RSV 感染率分别为 19%、70%和 33%。RSV 感染最常见于冬季。在并发症方面，重症监护病房的入住率在 1%-15%之间，需要机械通气的比例在 1%-10%之间。在本综述纳入的研究中，所有年龄段的 RSV 相关死亡率为 1.9%。本综述确定了现有数据中的一些局限性和成人人群代表性不足。未来的研究应该提供更多关于合并症的儿童和成人中 RSV 负担的证据，以便更好地评估未来预防策略在 MENA 地区的潜在影响。
