Department of Health Services, Policy and Practice, Brown University School of Public Health, Providence, Rhode Island, USA.
Department of Epidemiology, Brown University School of Public Health, Providence, Rhode Island, USA.
J Infect Dis. 2022 Aug 15;226(Suppl 2):S164-S174. doi: 10.1093/infdis/jiac185.
Respiratory syncytial virus (RSV) is a leading cause of infant hospitalization in the United States. Preterm infants and those with select comorbidities are at highest risk of RSV-related complications. However, morbidity due to RSV infection is not confined to high-risk infants. We estimated the burden of medically attended (MA) RSV-associated lower respiratory tract infection (LRTI) among infants in the United States.
We analyzed commercial (MarketScan Commercial [MSC], Optum Clinformatics [OC]), and Medicaid (MarketScan Medicaid [MSM]) insurance claims data for infants born between April 2016 and February 2020. Using both specific and sensitive definitions of MA RSV LRTI, we estimated the burden of MA RSV LRTI during infants' first RSV season, stratified by gestational age, comorbidity status, and highest level of medical care associated with the MA RSV LRTI diagnosis.
According to the specific definition 75.0% (MSC), 78.6% (MSM), and 79.6% (OC) of MA RSV LRTI events during infants' first RSV season occurred among term infants without known comorbidities.
Term infants without known comorbidities account for up to 80% of the MA RSV LRTI burden in the United States during infants' first RSV season. Future prevention efforts should consider all infants.
呼吸道合胞病毒(RSV)是导致美国婴儿住院的主要原因。早产儿和患有特定合并症的婴儿是 RSV 相关并发症的高危人群。然而,与 RSV 感染相关的发病率并不仅限于高危婴儿。我们估计了美国婴儿因 RSV 感染而需要医疗(MA)的下呼吸道感染(LRTI)的负担。
我们分析了 2016 年 4 月至 2020 年 2 月期间出生的婴儿的商业(市场扫描商业[MSC]、Optum Clinformatics [OC])和医疗补助(市场扫描医疗补助[MSM])保险索赔数据。使用 MA RSV LRTI 的特定和敏感定义,我们根据胎龄、合并症状况以及与 MA RSV LRTI 诊断相关的最高医疗水平,分层估计了婴儿第一个 RSV 季节中 MA RSV LRTI 的负担。
根据特定的定义,75.0%(MSC)、78.6%(MSM)和 79.6%(OC)的婴儿第一个 RSV 季节的 MA RSV LRTI 事件发生在无已知合并症的足月婴儿中。
无已知合并症的足月婴儿在婴儿第一个 RSV 季节中占美国 MA RSV LRTI 负担的 80%。未来的预防工作应考虑所有婴儿。