EpidStrategies, A Division of ToxStrategies, Rockville, Maryland, USA.
Sanofi, Swiftwater, Pennsylvania, USA.
J Infect Dis. 2022 Aug 15;226(Suppl 2):S195-S212. doi: 10.1093/infdis/jiac201.
The burden and health care utilization (HCU) of respiratory syncytial virus (RSV) in US infants aged <1 year across health care settings are not well characterized.
We systematically reviewed studies of RSV and bronchiolitis published 2000-2021 (data years, 1979-2020). Outcomes included RSV hospitalization (RSVH)/bronchiolitis hospitalization rates, emergency department (ED)/outpatient (OP) visit rates, and intensive care unit (ICU) admissions or mechanical ventilation (MV) use among RSV-/bronchiolitis-hospitalized infants. Study quality was determined using standard tools.
We identified 141 good-/fair-quality studies. Five national studies reported annual average RSVH rates (range, 11.6 per 1000 per year among infants aged 6-11 months in 2006 to 50.1 per 1000 per year among infants aged 0-2 months in 1997). Two national studies provided RSVH rates by primary diagnosis for the entire study period (range, 22.0-22.7 per 1000 in 1997-1999 and 1997-2000, respectively). No national ED/OP data were available. Among 11 nonnational studies, RSVH rates varied due to differences in time, populations (eg, prematurity), and locations. One national study reported that RSVH infants with high-risk comorbidities had 5-times more MV use compared to non-high-risk infants in 1997-2012.
Substantial data variability was observed. Nationally representative studies are needed to elucidate RSV burden and HCU.
在美国，1 岁以下婴儿的呼吸道合胞病毒（RSV）在各医疗保健机构的负担和医疗保健利用（HCU）情况尚未得到充分描述。
我们系统地回顾了 2000 年至 2021 年（数据年份为 1979 年至 2020 年）发表的有关 RSV 和细支气管炎的研究。结果包括 RSV 住院（RSVH）/细支气管炎住院率、急诊（ED）/门诊（OP）就诊率以及 RSV-/细支气管炎住院婴儿的 ICU 入院或机械通气（MV）使用率。使用标准工具评估研究质量。
我们确定了 141 项高质量/良好质量的研究。五项全国性研究报告了每年 RSVH 的平均发生率（2006 年 6-11 月龄婴儿为每 1000 人每年 11.6 例，1997 年 0-2 月龄婴儿为每 1000 人每年 50.1 例）。两项全国性研究提供了整个研究期间 RSVH 的主要诊断率（1997-1999 年和 1997-2000 年分别为每 1000 人每年 22.0-22.7 例）。没有全国性 ED/OP 数据。在 11 项非全国性研究中，由于时间、人群（如早产儿）和地点的不同，RSVH 率存在差异。一项全国性研究报告称，1997-2012 年，患有高危合并症的 RSVH 婴儿使用 MV 的可能性是无高危合并症婴儿的 5 倍。
观察到数据存在很大差异。需要开展具有全国代表性的研究来阐明 RSV 的负担和 HCU。
