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Review
. 2023 Nov;19(11):1030-1040.
doi: 10.1007/s12519-023-00743-5. Epub 2023 Aug 2.

Clinical manifestations of respiratory syncytial virus infection and the risk of wheezing and recurrent wheezing illness: a systematic review and meta-analysis

Ming-Yue Jiang #  1   2   3 , Yu-Ping Duan #  1   2   3 , Xun-Liang Tong  4 , Qiang-Ru Huang  1   2   3 , Meng-Meng Jia  1   2   3 , Wei-Zhong Yang  5   6   7 , Lu-Zhao Feng  8   9   10
Affiliations
Review

Clinical manifestations of respiratory syncytial virus infection and the risk of wheezing and recurrent wheezing illness: a systematic review and meta-analysis

Ming-Yue Jiang et al. World J Pediatr. 2023 Nov.

Abstract

Background: Respiratory syncytial virus (RSV) infection in infants is a global health priority. We aimed to investigate the common manifestations of RSV infection by age group and human development index (HDI) level and to assess its association with the development of wheezing and recurrent wheezing illness.

Methods: We searched the literature published between January 1, 2010 and June 2, 2022 in seven databases. Outcomes included common manifestations and long-term respiratory outcomes of RSV infection in children. Random- and fixed-effect models were used to estimate the effect size and their 95% confidence intervals. Subgroup analysis was conducted by age and HDI levels. This review was registered in PROSPERO (CRD42022379401).

Results: The meta-analysis included 47 studies. The top five manifestations were cough (92%), nasal congestion (58%), rhinorrhea (53%), shortness of breath (50%), and dyspnea (47%). The clinical symptoms were most severe in infants. In our analysis, compared to very high and high HDI countries, fewer studies in medium HDI countries reported related manifestations, and no study in low HDI countries reported that. The RSV-infected infants were more likely to develop wheezing than the non-infected infants [odds ratio (OR), 3.12; 95% CI, 2.59-3.76] and had a higher risk of developing wheezing illnesses after recovery (OR, 2.60; 95% CI, 2.51-2.70).

Conclusions: Cough and shortness of breath are common manifestations of RSV infection. More attention should be given to infants and areas with low HDI levels. The current findings confirm an association between RSV infection and wheezing or recurrent wheezing illness.

Keywords: Clinical manifestations infants infection; Recurrent wheezing Respiratory syncytial virus infection; Wheezing.

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Conflict of interest statement

No financial or non-financial benefits have been received or will be received from any party related directly or indirectly to the subject of this article.

Figures

Fig. 1
Fig. 1
Flow diagram for the selection of studies. RSV respiratory syncytial virus, CNKI Chinese National Knowledge Infrastructure, VIP Chinese Scientific Journal Database, CBM Chinese Biomedical Literature Database, Wanfang Wanfang Database
Fig. 2
Fig. 2
The associations of RSV-positive and RSV-negative patients with the development of wheezing and recurrent wheezing illness. a Overall impact of RSV infection on the occurrence of wheezing when compared with noninfected children (weights are from mantel-haenszel model); b overall impact of RSV infection in early childhood on subsequent development of recurrent wheeze illness when compared with noninfected children (Weights are from mantel-haenszel model). RSV respiratory syncytial virus CI Confidence interval, MH mantel-haenszel model
See this image and copyright information in PMC

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