About 22% of acute lower respiratory infections globally, resulting in nearly 100,000 deaths in young children each year, are due to respiratory syncytial virus (RSV) infections. The studies estimated the burden of RSV infections, subsequent hospitalizations and mortality in children in a European country. However, studies determining RSV-related hospitalizations across the EU for children under 5 are lacking. In a newly published study, researchers pooled data from several sources between 2006 and 2018 to estimate hospitalizations due to RSV infections in children under five in 28 European Union countries. They used data from the REspiratory Syncytial virus Consortium in EUrope (RESCEU) project which includes regularly collected data on hospital admissions for six countries: Denmark, Finland, England, Norway, Scotland and the Netherlands. Additionally, they added more data for Spain and France from the literature.
The researchers searched the MEDLINE and EMBASE databases for original articles between January 1, 2019 and November 30, 2021. They also evaluated all articles for eligibility; for example, they checked all eligible articles by retrospective citation chaining. They also assessed the quality of all included studies and calculated an overall score. The study analysis covered 1,372 unique records from the MEDLINE and EMBASE databases and 33 articles identified by back-citation chaining. In addition, it covered two studies reporting RSV-related hospitalization estimates for Spain and France from 1997 to 2011 and 2010 to 2018, respectively. Study analysis revealed that RSV was associated with an average of 245,244 hospital admissions per year. year in children under five, with the majority of cases in children under one year (75%) and one to two years (20.7%).
However, the impact was greatest for infants under two months of age (71.6/1,000 infants). Surprisingly, in the media, RSV infection accounted for 10 out of 1000 children in the EU being hospitalized each year. In fact, RSV is a leading cause of childhood hospitalizations in the EU, especially if hospitalizations related to respiratory infections are reported. These numbers are much lower in countries such as Sweden, Denmark, Italy and Portugal. The countries with the highest number of RSV-related hospitalizations were France, the United Kingdom (UK) and Germany, with 46,027, 39,296 and 34,719 hospitalizations per year in children under five, respectively. The researchers noted that annual RSV-related hospitalization rates varied significantly between EU countries. While the Netherlands had the lowest rates in almost all age groups, Norway had the lowest rates in the three- to four-year age group, and France had the highest rates.
They also noted the highest relative difference in the age range of children aged 12 to 35 months, with rates in France fivefold higher than in the Netherlands. Thus, the survey showed that in children under five years of age, RSV, on average, led to approximately 250,000 respiratory hospitalizations per year in the 28 EU countries covered by this analysis. Of these, 65.4% of hospitalizations in Denmark and 80.7% in Spain occurred, on average, in infants aged zero to 11 months and 94% in Portugal and 97% in Norway in those younger than 23 months. Similar to previous studies, hospitalization related to RSV increased with age characteristics, with infants younger than one year of age bearing the greatest burden, particularly those aged zero to two months. Thus, RSV immunization in the first six months of birth could prove extremely helpful in containing RSV infections among young children.
This, by the way, is the period of the year most at risk for contracting respiratory infections, excluding the presence of the coronavirus and the “Australian” flu virus, which peaked in November and December. In Italy, in fact, RSV infection is seasonal and its peak is precisely January-February, even if last November there was a semi-epidemic of cases. In the most predisposed or fragile subjects (diabetics, heart patients, chronic bronchopaths, dialysis patients, etc.), among other things, it is easy both to contract it and to contract superinfections from Haemophilus and Streptococcus. And it shouldn’t be underestimated for various reasons, both because of the seriousness that can affect children and the elderly, and because the current “dedication” to COVID cases in the converted wards can lengthen the time it takes to approach treatment. And RSV may not have disappeared at all during the two-year period 2020-2021, but simply underestimated or not detected due to the exclusive prevalence of swabs for the coronavirus.
- By Dr. Gianfrancesco Cormaci, PhD, specialist in Clinical Biochemistry.
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Scientific publications
Del Riccio M et al. medRxiv 2023 Feb 10:23285756.
Sahni LC et al. Clin Infect Dis. 2023; 76(3):e1031-e1039.
Vila J et al. J Pediatric Infect Dis Soc. 2023 Feb 6:piad009.
– Degree in Medicine and Surgery in 1998 (MD Degree in 1998) – Specialist in Clinical Biochemistry in 2002 (Clinical Biochemistry residency in 2002) – Doctorate in Neurobiology in 2006 (Neurobiology PhD in 2006) – Stayed in the United States, Baltimore (MD ) as a researcher employed by the National Institute on Drug Abuse (NIDA/NIH) and then at Johns Hopkins University, from 2004 to 2008. – Since 2009 he has been involved in Personalized Medicine. – Emergency medical care in private structures since 2010 – Holder of two patents on the preparation of gluten-free products starting from regular enzymatically neutralized wheat flour (owner of patents concerning the production of gluten-free bakery products, starting from regular wheat flour). – Head of the Research and Development department for CoFood srl (Leader of the R&D for the partnership CoFood srl) – Author of articles on medical and health information on the website www.medicomunicare.it (Medical/health information on website) – Author of ECM FAD courses advertised on the website www.salutesicilia.it