Li Taoyu, Fang Heping, Liu Xiangyu, Deng Yu, Zang Na, Xie Jun, Xie Xiaohong, Luo Zhengxiu, Luo Jian, Liu Yulin, Fu Zhou, Ren Luo, Liu Enmei
Department of Respiratory Medicine, Children's Hospital of Chongqing Medical University, National Clinical Research Center for Child Health and Disorders, Ministry of Education Key Laboratory of Child Development and Disorders, Chongqing Key Laboratory of Child Rare Diseases in Infection and Immunity, Chongqing 400015, China.
Pediatric Research Institute, Children's Hospital of Chongqing Medical University, Chongqing 401122, China.
Chin Med J Pulm Crit Care Med. 2024 Sep 19;2(3):182-187. doi: 10.1016/j.pccm.2024.08.006. eCollection 2024 Sep.
Respiratory syncytial virus (RSV) is a leading cause of lower respiratory tract infection (LRTI). However, few comprehensive descriptions of the disease burden, medical resource utilization (MRU), and costs of RSV are available for China. This study aimed to provide the basis for the development of RSV prevention strategies by analyzing the burden of RSV among inpatients with lower respiratory tract infection under 5 years of age.
We conducted a retrospective hospital-based study from June 2009 to May 2019 in Chongqing. Inpatients with LRTI were tested for eight viruses. We analyzed the RSV disease burden, MRU, and direct hospitalization costs by using non-parametric Mann‒Whitney test, Chi-squared test or Fisher's exact test and logistic regression.
A total of 6991 children under 5 years of age with LRTI were included in this study. The overall RSV-positive rate was 34.5% (2410/6991). Prior to admission, 81.9% (1973/2410) of these RSV-positive cases were otherwise healthy. Compared with children aged 24-59 months, the odds ratio (OR) and 95% confidence interval (CI) for RSV infection were 2.509 (2.139-2.945), 1.882 (1.549-2.222), and 1.479 (1.240-1.765) for those aged 1-5 months, 6-11 months, and 12-23 months, respectively. The proportions of patients treated with invasive ventilation and continuous positive airway pressure (CPAP) were significantly higher among RSV-positive cases (1.1% [27/2410] and 3.9% [93/2410]) than RSV-negative cases (0.9% [43/4581] and 2.7% [124/4581]) ( = 0.023). Compared with RSV-negative cases, RSV-positive cases had significantly longer hospital length of stay (6 [5, 8] days 6 [5, 8] days, < 0.001) and higher hospitalization costs (963.0 [757.9, 1298.5] USD 935.6 [719.7, 1296.3] USD, = 0.022).
Most RSV infections occurred during early childhood and among individuals in the otherwise healthy group. Younger age was associated with a higher RSV-positive rate. Effective prevention measures are needed in the earliest stages to reduce the RSV burden.
呼吸道合胞病毒（RSV）是下呼吸道感染（LRTI）的主要病因。然而，关于中国RSV疾病负担、医疗资源利用（MRU）及成本的全面描述较少。本研究旨在通过分析5岁以下下呼吸道感染住院患者中RSV的负担，为制定RSV预防策略提供依据。
我们于2009年6月至2019年5月在重庆进行了一项基于医院的回顾性研究。对LRTI住院患者进行了8种病毒检测。我们使用非参数曼-惠特尼检验、卡方检验或费舍尔精确检验以及逻辑回归分析了RSV疾病负担、MRU和直接住院成本。
本研究共纳入6991例5岁以下LRTI儿童。RSV总体阳性率为34.5%（2410/6991）。入院前，这些RSV阳性病例中81.9%（1973/2410）此前身体健康。与24 - 59月龄儿童相比，1 - 5月龄、6 - 11月龄和12 - 23月龄儿童RSV感染的比值比（OR）及95%置信区间（CI）分别为2.509（2.139 - 2.945）、1.882（1.549 - 2.222）和1.479（1.240 - 1.765）。RSV阳性病例中接受有创通气和持续气道正压通气（CPAP）治疗的患者比例（分别为1.1%[27/2410]和3.9%[93/2410]）显著高于RSV阴性病例（分别为0.9%[43/4581]和2.7%[124/4581]）（P = 0.023）。与RSV阴性病例相比，RSV阳性病例的住院时间显著更长（6[5, 8]天对6[5, 8]天，P < 0.001），住院成本更高（963.0[757.9, 1298.5]美元对935.6[719.7, 1296.3]美元，P = 0.022）。
大多数RSV感染发生在幼儿期及此前身体健康的人群中。年龄越小，RSV阳性率越高。需要在最早阶段采取有效预防措施以减轻RSV负担。
