Studies on respiratory syncytial virus (RSV)-associated hospital admissions
| Author (year) [ref.]/location | Sample size | Results |
| Hacimustafaoglu et al. (2013) [3] | • The annual incidence of hospitalisation due to RSV+LRTI was 7.8/1000 | |
| Chung et al. (2020) [7] Scotland | 43 514 | • Over the 15-year study period, admission rates for children under 2 years old increased 2.20-fold (95% CI 1.4–3.6-fold) from 17.2 (15.9–18.5) to 37.7 (37.4–38.1) admissions per 1000 children per year • Admissions peaked in infants aged 1 month, and in those born in the 3 months preceding the peak bronchiolitis month – September, October and November |
| Tumba et al. (2020) [14] Brazil | 263 679 | • The incidence of hospitalisation for bronchiolitis increased by 49% over this period (8.5 to 12.7 per 1000 inhabitants per year), between 2013 and 2014, the incidence rate of hospitalisation for acute bronchiolitis decreased by 8% (12.5 to 11.5 per 1000 inhabitants per year) |
| Lewis et al. (2020) [15] England | 3 727 013 | • Bronchiolitis admission rates ranged from 30.9 per 1000 infant-years (95% CI 30.4–31.3) in London to 68.7 per 1000 (95% CI 67.9–69.5) in the North West • Across CCGs: 5.3-fold variation in incidence rates and the epidemic peak ranged from week 49.3 to 52.2 |
| Lewis et al. (2020) [16] England | 3 717 329 | • Bronchiolitis admission rate increased from 47.4 (95% CI 46.8–47.9) to 58.9 per 1000 infant-years (95% CI 58.3–59.5) between 2012 and 2016 |
| Arriola et al. (2020) [18] USA | 1554 | • Adjusted age-specific RSV hospitalisation rates per 100 000 population were 1970 (95% CI 1787–2177), 897 (95% CI 761–1073), 531 (95% CI 459–624) and 358 (95% CI 317–405) for ages 0–2, 3–5, 6–11 and 12–23 months, respectively |
| Glatman-Freedman et al. (2020) [20] Israel | 39 156 | • The hospitalisation load of RSV-related diagnoses was highest in infants <1 year of age (mean yearly rate of 1218.4 per 100 000 infants), rapidly declining in the following years |
| Hardelid et al. (2019) [21] Scotland | 169 726 | • There were 5185 RSV admissions among the 169 726 children in the cohort: 48.6% of admissions occurred before the age of 6 months, and 29.6% after the age of 1 year |
| Reeves et al. (2020) [22] Europe | • Average annual RSV-coded admission rates ranged from 20.5 to 22.3 per 1000 children aged <1 year in Scotland, Finland, Norway and Denmark, whereas in children aged 1–4 years rates ranged from 1.25 to 2.24 per 1000 children • Average annual RSV-coded admission rates ranged from 8.6 to 11.7 per 1000 children aged <1 year in England, the Netherlands and Italy, whereas in children aged 1–4 years rates ranged from 0.2 to 0.3 per 1000 children • Annual average RSV-confirmed admission rates were 21.2 per 1000 children <1 year in Scotland and 21.9 per 1000 children <1 year in Finland. For children aged 1–4 years, RSV-confirmed admission rates were 1.6 per 1000 in Finland and 2.1 per 1000 in Scotland | |
| Svensson et al. (2015) [23] Sweden | 1764 | • The age-specific incidence in infants under 1 year of age was 17.4 per 1000 per year, and the incidence in children aged 1–4 years was 0.6 per 1000 per year • The incidence for all children under 5 years of age was 4.2 per 1000 per year • The risk of being hospitalised for RSV was 17.2 per 1000 live births during the first year of life and 19.6 per 1000 live births before 5 years of age |
| Britton et al. (2020) [25] NSW (Australia) | • Observed mean±se frequency of RSV detections from April to June, 2020, was 94.3±22.8% lower than predicted on the basis of the underlying trend of 2015–2019 data (mean±se absolute reduced frequency per epidemic month (ARF) 99±24; p=0.026) | |
| Reeves et al. (2019) [30] England | 6758 | • Annual average of 20 359 (95% CI 19 236–22 028) RSV-associated admissions in infants in England from mid-2010 to mid-2012 • RSV-associated admissions peaked in infants aged 6 weeks, and those born September to November |
| Glick et al. (2017) [31] USA | 50 157 | • Mean±sd RSV hospitalisation season onset (early November) was 3.3±2.1 weeks before regional activity season onset (early December) • Hospitalisation season offset (early May) was 4.4±2.4 (mean±sd) weeks after activity season offset (mid-April) |
| Thwaites et al. (2020) [43] Scotland | • Between December and January, RSV hospitalisations represented 8.5% of all admissions; this increased to 14.2% between October and March | |
| Buchwald et al. (2020) [44] Mali | 1871 | • The incidence of RSV-associated hospitalisations was 45.6 per 1000 person-years |
| Pelletier et al. (2021) [24] USA | 5 424 688 | • Decrease in the number of RSV hospital admissions beginning in March 2020 compared to years 2010 to 2019 • Admissions in April 2020 (23 798) were 45.4% lower than previous years, 2010–2019 (median=43 550) |
| Benitez-Guerra et al. (2020) [45] Mexico | 294 | • Overall, the hospitalisation rate for RSV-confirmed ARI was 62.6 per 1000 child-years of follow-up |
| Saravanos et al. (2020) [19] Australia | 60 351 | • Under 5s hospitalisation rate was 418 per 100 000 population; under 6 months it was 2224 per 100 000 population; the highest rate was for infants aged 0–2 months (2778 per 100 000 population) |
| Wilder et al. (2021) [26] | 3631 | • Bronchiolitis had fewer median hospitalisations per week in the COVID-19 cohort compared with the pre-COVID-19 cohort: bronchiolitis (1 versus 7; p=0.008) |
| Mendes-da-Silva et al. (2019) [46] Portugal | 80 491 | • The mean admission rate was 26.28 and was higher in the northernmost regions of the country • Admission rate rose by an average of 1.6% per year (3.8% in children younger than 3 months) and the average length of stay was 6.1 days and decreased, to a minimum of 5.5 days in 2014 |
| Rha et al. (2020) [47] USA | 2969 | • RSV-associated hospitalisation rates were 2.9 per 1000 children <5 years old and 14.7 per 1000 children <6 months old; the highest age-specific rate was observed in 1-month-old infants (25.1 per 1000) |
| Li et al. (2021) [48] Global | 1453 | • The median number of RSV-associated ALRI hospitalisations in children younger than 5 years was 8.25 per 1000 (IQR 1.97–48.01), and the median rate of RSV-associated ALRI hospitalisations was 514 (339–866) hospitalisations per 1000 children younger than 5 years |
| Prasad et al. (2019) [49] New Zealand | 71 770 | • The seasonal incidence of RSV-associated ARI hospitalisation without accounting for non-tested children was 3.5 (95% CI 3.3–3.7) per 1000 children or 12.2 (95% CI 11.6–12.9) per 1000 child-years at risk |
| Greenberg et al. (2020) [50] Israel | 374 late preterm and 2948 term infants | • The mean yearly incidences per 1000 children of RSV bronchiolitis hospitalisations of late preterm and term infants were 35.8±13.0 and 19.6±4.1, respectively (p=0.009) • During RSV seasons the mean incidence rate ratio between groups was 1.82 (95% CI 1.60–2.08) |
| Fujiogi et al. (2019) [51] USA | 490 650 | • From 2000 to 2016, the incidence of bronchiolitis hospitalisation decreased from 17.9 to 13.5 per 1000 person-years in US children (25% decrease; p-value trend <0.001) • In contrast, the proportion of bronchiolitis hospitalisations among overall hospitalisations increased from 16% to 18% |
| Kramer et al. (2018) [52] France | 21 930 | • Incidence of RSV-associated hospitalisation in the first year of life per 1000 births was 14.5 (95% CI 13.4–15.6) |
| Reeves et al. (2017) [8] England | • Annual RSV-associated RTI admission rates of 35.1 (95% CI 32.9–38.9) per 1000 children <1 year of age and 5.31 (95% CI 4.5–6.6) per 1000 children 1–4 years of age | |
| Oakley et al. (2017) [53] Australia/New Zealand | 3589 | • ICU admission rates ranged from 4.1% to 9.1% with an average of 5.7%. There was evidence of a difference between sites in the rates of ventilatory support use (p<0.001) • Ventilatory support rates ranged from 2.8 to 5.9% across the sites with an average of 4.5% |
| Cromer et al. (2017) [54] England | • Estimated that RSV is responsible for 12 primary care consultations (95% CI 11.9–12.1) and 0.9 admissions to hospital annually per 100 children younger than 5 years (95% CI 0.89–0.90) • In children younger than 6 months, RSV accounted for more than half of all admissions to hospital for acute respiratory conditions and for >70% of those admissions occurring between October and January | |
| Sanchez-Luna et al. (2016) [55] Spain | 1 328 563 discharges | • The total number of yearly hospital discharges for RSV bronchiolitis (ICD-9 code 466.11) in children under 1 year ranged between 5997 (2005) and 8637 (2012) • The hospitalisation rate (discharges per 1000 children under 1 year) for RSV bronchiolitis increased over the period (from 19 to 24.9) |
| Munoz-Quiles et al. (2016) [56] Spain | 198 223 | • 5390 were hospitalised with the majority of hospitalisations occurring at <6 months of age (incidence rate of 5.2 per 100 children <6 months per year) and 3106 of the hospitalisations were RSV-positive (incidence rate 3.2 per 100 children <6 months per year) |
| Saha et al. (2015) [57] India | 505 | • Annual incidence rates of RSV-associated hospitalisation per 1000 children were highest among infants aged 0–5 months (15.2, 95% CI 8.3–26.8), followed by ages 6–23 months (5.3, 95% CI 3.2–8.7) and lowest among children 24–59 months (0.5, 95% CI 0.1–1.5) |
| Helfrich et al. (2015) [58] | • LPT infants had an absolute hospitalisation rate (AHR) of 2.5%, while term infants had an AHR of 1.3% (p<0.001) • The IDRSV of LPT and term infants was 12.1 and 7.8 per 1000 person-years, respectively | |
| Ochoa et al. (2014) [59] Peru | 335 | • The incidence of RSV respiratory infections that required emergency room management was 103.9 per 1000 child-years, and the incidence of RSV hospitalisations was 116.2 per 1000 child-years (244.9 in infants with a birthweight <1000 g and 88.9 in infants 1000–1500 g; p<0.05) |
| Nasreen et al. (2014) [60] Bangladesh | 12 850 | • RSV was associated with 7.9 SARI hospitalisations per 100 000 person-weeks |
| Murray et al. (2014) [61] | • 7189 hospital admissions with a diagnosis of bronchiolitis, 24.2 admissions per 1000 infants under 1 year (95% CI 23.7–24.8), of which 15% (1050/7189) were born preterm (47.3 bronchiolitis admissions per 1000 preterm infants (95% CI 44.4–50.2)) | |
| Broor et al. (2014) [29] India | 245 | • RSV accounted for the highest virus-associated hospitalisation incidence (34.6 per 10 000, 95% CI 26.3–44.7) and 20% of hospitalisations |
| Emukule et al. (2014) [62] Kenya | • The average annual incidence of RSV-associated SARI hospitalisation per 1000 persons was 5.2 (95% CI 4.0–6.8) among children <5 years • The incidence of RSV-associated medically attended ILI was 24.6 (95% CI 17.0–35.4) among children <5 years and 0.8 (95% CI 0.3–1.9) among persons ≥5 years | |
| Ambrose et al. (2014) [63] USA | 1646 | • Rates of RSV-related MAARI, outpatient lower respiratory tract illness, emergency department visits and hospitalisation (RSVH) during November to March were 25.4, 13.7, 5.9 and 4.9 per 100 infant-seasons, respectively |
| Rowlinson et al. (2013) [64] Egypt | 5342 | • The incidence of RSV-associated hospitalisation and outpatient visits was estimated at 24 and 608 (per 100 000 person-years), respectively • Children aged <1 year experienced the highest incidence of RSV-associated hospitalisations (1745 per 100 000 person-years) |
| Naorat et al. (2013) [65] Thailand | 13 982 | • The incidence of RSV-associated ALRI hospitalisation was 85 cases per 100 000 persons per year • The highest rates occurred among children aged <5 years (981 cases per 100 000 persons per year) and <1 year (1543 cases per 100 000 persons per year) |
| McCracken et al. (2013) [66] Guatemala | 6626 | • The incidence of RSV-associated hospitalisation for ARI was highest among infants aged <6 months (208 cases/10 000 persons per year) • The incidence of RSV-positive clinic visitation for ARI was highest among infants aged 6–23 months (186 cases/10 000 persons per year) |
| Eidelman et al. (2009) [67] Israel | • On average, 147±17 cases of RSV bronchiolitis were admitted annually in the November–March RSV season, representing 7%–9% of admissions and 10%–14% of hospital days • There was a consistent male preponderance of admissions (55–64%) and 15–23% of admissions were patients <1 month old. • In peak months RSV cases accounted for as many as 40% of the hospitalised infants and was the leading cause of over-occupancy (up to 126%) in the paediatric ward during the winter | |
| Hall et al. (2009) [68] USA | 919 | • Overall, RSV was associated with 20% of hospitalisations, 18% of emergency department visits and 15% of office visits for ARIs from November through April • Average annual hospitalisation rates were 17 per 1000 children under 6 months of age and 3 per 1000 children under 5 years of age |
| Tong et al. (2020) [69] USA | 41 610 536 person-years | • The average incidence of all RSV-related healthcare utilisation between 2008 and 2014 was 2.4 per 1000 person-years, with mean incidence for each year of the study ranging from 2.0 to 2.6 per 1000 person-years (RSV-specific rate: 1.5 per 1000 person-years (mean rate for individual years ranging from 1.1 to 1.6 per 1000 person-years)) |
| Kubale et al. (2020) [70] Nicaragua | 833 | • The incidence rate of symptomatic RSV was 248.1 cases per 1000 person-years (95% CI 223.2–275.7) • While infants aged 6–11 months had the highest incidence of symptomatic RSV (361.3/1000 person-years, 95% CI 304.4–428.8), infants <3 months had the highest incidence of severe RSV (RSV-associated hospitalisations and/or severe ALRI) |
| Ueno et al. (2019) [71] Philippines | 3817 | • Incidence rates for children aged 2–23 months were 124.0 and 51.5 per 1000 child-years for total RSV-LRTI and total severe RSV-LRTI, respectively |
LRTI: lower respiratory tract infection; CCG: clinical commissioning group; ALRI: acute lower respiratory infections; RTI: respiratory tract infection; ICU: intensive care unit; ICD-9: International Classification of Diseases, Ninth Revision; LPT: late preterm; IDRSV: incidence density rate for RSV hospitalisation; SARI: severe acute respiratory infection; ILI: influenza-like illness; MAARI: medically attended acute respiratory infection; ARI: acute respiratory infection.