Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Meta-Analysis
. 2024 Mar 5;19(3):e0297608.
doi: 10.1371/journal.pone.0297608. eCollection 2024.

Epidemiology and burden of respiratory syncytial virus in Italian adults: A systematic review and meta-analysis

Alexander Domnich  1 , Giovanna Elisa Calabrò  2
Affiliations
Meta-Analysis

Epidemiology and burden of respiratory syncytial virus in Italian adults: A systematic review and meta-analysis

Alexander Domnich et al. PLoS One. .

Abstract

Objective: Respiratory syncytial virus (RSV) is a common respiratory pathogen not only in children, but also in adults. In view of a recent authorization of adult RSV vaccines in Italy, our research question was to quantify the epidemiology and burden of RSV in Italian adults.

Methods: Observational studies on the epidemiology and clinical burden of laboratory-confirmed or record-coded RSV infection in Italian adults of any age were eligible. Studies with no separate data for Italian adults, modeling and other secondary publications were excluded. A literature search was performed in MEDLINE, Biological Abstracts, Global Health, Scopus and Web of Science on 22 November 2023. Critical appraisal was performed by means of a Joanna Briggs Institute checklist. Random-effects (RE) meta-analysis was performed to obtain pooled estimates and the observed heterogeneity was investigated by subgroup and meta-regression analyses. The protocol was prospectively registered (doi.org/10.17504/protocols.io.5qpvo32odv4o/v1).

Results: Thirty-five studies were identified, most of which had at least one possible quality concern. RSV seasonal attack rates ranged from 0.8 ‰ in community-dwelling older adults to 10.9% in hematological outpatients. In the RE model, 4.5% (95% CI: 3.2-5.9%) of respiratory samples tested positive for RSV. This positivity prevalence was higher in older adults (4.4%) than in working-age adults (3.5%) and in outpatient (4.9%) than inpatient (2.9%) settings. According to the meta-regression, study location and sample size were also significant predictors of RSV detection frequency. The pooled estimate of in-hospital mortality was as high as 7.2% (95% CI: 4.7-10.3%). Data on other indicators of the diseases burden, such as complication and hospitalization rates, were unavailable.

Conclusion: RSV poses a measurable burden on Italian adults, especially those of older age and with some co-morbidities. However, several data on the natural history of RSV disease are missing and should be established by future large-scale studies.

PubMed Disclaimer

Conflict of interest statement

Alexander Domnich and Giovanna Elisa Calabrò, the only authors of the manuscript, declare no competing interests. This does not alter our adherence to PLOS ONE policies on sharing data and materials.

Figures

Fig 1
Fig 1. PRISMA flow diagram of the study selection process.
Fig 2
Fig 2. Forest plot of the random-effects model on RSV positivity prevalence among Italian adults of any age, by setting.
Fig 3
Fig 3. Forest plot of the random-effects model on RSV positivity prevalence among Italian working-age and older adults, by setting.
See this image and copyright information in PMC

References

    1. McLaughlin JM, Khan F, Begier E, Swerdlow DL, Jodar L, Falsey AR. Rates of medically attended RSV among US adults: A systematic review and meta-analysis. Open Forum Infect Dis. 2022;9(7):ofac300. doi: 10.1093/ofid/ofac300 - DOI - PMC - PubMed
    1. Rafferty E, Paulden M, Buchan SA, Robinson JL, Bettinger JA, Kumar M, et al.. Evaluating the individual healthcare costs and burden of disease associated with RSV across age groups. Pharmacoeconomics. 2022;40(6):633–645. doi: 10.1007/s40273-022-01142-w - DOI - PMC - PubMed
    1. Osei-Yeboah R, Spreeuwenberg P, Del Riccio M, Fischer TK, Egeskov-Cavling AM, Bøås H, et al.. Estimation of the number of RSV-associated hospitalisations in adults in the European Union. J Infect Dis. 2023;228(11):1539–1548. doi: 10.1093/infdis/jiad189 - DOI - PMC - PubMed
    1. Du Y, Yan R, Wu X, Zhang X, Chen C, Jiang D, et al.. Global burden and trends of respiratory syncytial virus infection across different age groups from 1990 to 2019: A systematic analysis of the Global Burden of Disease 2019 Study. Int J Infect Dis. 2023;135:70–76. doi: 10.1016/j.ijid.2023.08.008 - DOI - PubMed
    1. Shi T, Denouel A, Tietjen AK, Campbell I, Moran E, Li X, et al.. Global disease burden estimates of respiratory syncytial virus-associated acute respiratory infection in older adults in 2015: A systematic review and meta-analysis. J Infect Dis. 2020;222(Suppl 7):S577–S583. doi: 10.1093/infdis/jiz059 - DOI - PubMed

MeSH terms