Socioeconomic Impact of RSV Hospitalization

Abstract

Respiratory syncytial virus (RSV) disease is a significant cause of morbidity and socioeconomic burden worldwide among young children. The majority of RSV-associated lower respiratory tract infections (LRTI) and mortality occurs in developing countries and is associated with various sociodemographic risk factors. Independent risk factors for severe RSV disease include age and premature birth. While RSV mortality in developed countries is lower relative to developing countries, high-risk infants with comorbidities experience higher rates of mortality. RSV LRTI is often severe and is associated with hospitalization, increased need for intensive care unit admission and mechanical ventilation, long-term complications, and caregiver stress and loss of work productivity. Overall, these factors translate to higher health care resource utilization and costs and should be factored into the consideration for RSV prophylaxis. Multiple vaccine candidates and long-acting monoclonal antibodies are in various stages of clinical development. Currently, palivizumab is the only approved RSV immunoprophylaxis available for use in specific high-risk pediatric populations. This review will discuss the socioeconomic impact and health care resource utilization of RSV-related hospitalization (RSVH) as well as various sociodemographic risk factors that can be used to identify children at high risk of developing severe RSV disease.

Keywords: Caregiver burden; Cost-effectiveness; Health care utilization; High-risk infants; Immunoprophylaxis; Palivizumab; Quality of life; RSV-related hospitalization; Risk-factor predictive model; Socioeconomic factors.

Fig. 1

a Impact of RSV hospitalization on caregivers persisted following discharge; b Caregiver-reported stress is high and can persist after RSVH [23]. RSV respiratory syncytial virus, RSVH RSV-related hospitalization From Pokrzywinski RM, et al. Clin Pediatr (Phila). 2019;58(8):837–850

Fig. 2

Mean monthly health care cost per infant increases as the gestational age decreases [34]. FT full-term, US$ United States dollars, wGA weeks’ gestational age. Used with permission from McLaurin KK, et al. Pediatric Health Med Ther. 2019;10:21–31 © 2019 Dove Medical Press Limited