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. 2023 Jun 8;23(1):385.
doi: 10.1186/s12879-023-08358-x.

Clinical and economic hospital burden of acute respiratory infection (BARI) due to respiratory syncytial virus in Spanish children, 2015-2018

F Martinón-Torres  1   2   3 , M Carmo  4 , L Platero  5 , G Drago  5 , J L López-Belmonte  5 , M Bangert  6 , J Díez-Domingo  7
Affiliations

Clinical and economic hospital burden of acute respiratory infection (BARI) due to respiratory syncytial virus in Spanish children, 2015-2018

F Martinón-Torres et al. BMC Infect Dis. .

Abstract

Respiratory syncytial virus (RSV) is a leading cause of acute lower respiratory infection (ALRI) in children, causing frequent outpatient visits and hospitalizations. Our study aimed to describe the clinical and direct economic burden of ALRI hospitalizations related to RSV in children in Spain and the characteristics of patients and their episodes. In this retrospective study, ALRI hospitalizations in children aged < 5 years for 2015-2018 were reviewed using anonymized administrative public hospital discharge data from Spain. Three case definitions were considered: (a) RSV-specific; (b) RSV-specific and unspecified acute bronchiolitis (RSV-specific and bronchiolitis); and (c) RSV-specific and unspecified ALRI (RSV-specific and ALRI). The study reported a mean of 36,743 yearly admissions potentially due to RSV, resulting in a mean annual cost of €87.1 million. RSV-specific codes accounted for 39.2% of cases, unspecified acute bronchiolitis for 20.1%, and other unspecified ALRI codes for the remaining 40.6%. The mean hospitalization rate per 1,000 children was 55.5 in the first year of life, 16.0 in the second, and 5.4 between 24 and 59 months. A considerable proportion of cases occurred in children under two years old (> 80.4%) and even during the first year of life (> 61.7%). Otherwise healthy children accounted for 92.9% of hospitalizations and 83.3% of costs during the period. Children born preterm accounted for 1.3% of hospitalizations and 5.7% of costs. The findings revealed that RSV still contributes to a high burden on the Spanish health care system. Children under one year of age and otherwise healthy term infants accounted for most of the substantial clinical and economic burden of RSV. Current evidence potentially underestimates the true epidemiology and burden of severe RSV infection; thus, further studies focusing on the outpatient setting are needed.

Keywords: Acute lower respiratory infection; Bronchiolitis; Burden; Children; Epidemiology; Respiratory syncytial virus.

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Conflict of interest statement

Platero L, Drago G, López-Belmonte JL and Bangert M are Sanofi employees and may hold shares and/or stock options in the company. Carmo M is an IQVIA employee. Martinón Torres F and Díez-Domingo J have received fees from Sanofi. F.M-T. received honoraria from GSK group of companies, Pfizer Inc, Sanofi Pasteur, MSD, Seqirus, and Janssen for taking part in advisory boards and expert meetings and for acting as a speaker in congresses outside the scope of the submitted work. FM-T has also acted as principal investigator in randomized controlled trials of the above-mentioned companies as well as Ablynx, Gilead, Regeneron, Roche, Abbott, Novavax, and MedImmune, with honoraria paid to his institution. F.M-T has received support for the present work from the Instituto de Salud Carlos III (Proyecto de Investigación en Salud, Acción Estratégica en Salud): Fondo de Investigación Sanitaria (FIS; PI070069/PI1000540/PI1601569/PI1901090) del plan nacional de I + D + I and ‘fondos FEDER’ and Proyectos GaIN Rescata-Covid_IN845D 2020/23 (GAIN, Xunta de Galicia).

Figures

Fig. 1
Fig. 1
Respiratory syncytial virus-related cases in children < 5 years of age, in Spain, per groups of ICD-9/10 codes, per respiratory syncytial virus case definition and season, 2015–2018. ALRI: Acute lower respiratory infection; RSV: Respiratory syncytial virus
Fig. 2
Fig. 2
Weekly respiratory syncytial virus-related cases in children < 5 years of age between 1 January 2015 and 31st December 2018, in Spain. ALRI: Acute lower respiratory infection; RSV: Respiratory syncytial virus
Fig. 3
Fig. 3
Respiratory syncytial virus-related cases in children < 5 years of age per month of birth between 1 January 2015 and 31st December 2018, per respiratory syncytial virus case definition, Spain. ALRI: Acute lower respiratory infection; RSV: Respiratory syncytial virus
Fig. 4
Fig. 4
Share of relevant risk factors in respiratory syncytial virus hospitalizations per respiratory syncytial virus definition, Spain, 2015–2018. ALRI: Acute lower respiratory infection; RSV: Respiratory syncytial virus
See this image and copyright information in PMC

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