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Burden of Hospitalized Respiratory Syncytial Virus in Children in Sweden: A Population-based Case-cohort Study
Sven Arne Silfverdal1, Malin Ryd Rinder2,3, Oliver Martyn4
1From the Department of Clinical Sciences, Pediatrics, Umeå University, Umeå, Sweden.
Insights
Respiratory syncytial virus (RSV) significantly burdens young children, causing numerous hospitalizations. New prophylactic measures are recommended to reduce this impact on otherwise healthy infants.
Area of Science:
- Pediatrics
- Infectious Diseases
- Public Health
Background:
- Respiratory syncytial virus (RSV) is a primary cause of acute respiratory infections and hospitalizations in young children.
- Prophylaxis for RSV is now available, making disease burden assessment crucial for evaluating new interventions.
- Understanding RSV's impact on healthy children is vital for public health strategies.
Purpose of the Study:
- To assess the disease burden of RSV hospitalizations in children under 60 months in Sweden.
- To analyze patient characteristics, incidence rates, healthcare utilization, costs, and mortality associated with RSV.
- To evaluate the impact of RSV on otherwise healthy children and inform prophylactic strategies.
Main Methods:
- A case-cohort study utilizing Swedish national registers from 2006 to 2022.
- Inclusion of 31,907 hospitalized RSV cases and 95,697 age-matched controls under 60 months.
- Analysis of patient demographics, incidence, short- and long-term healthcare resource use, costs, and mortality.
Main Results:
- RSV incidence varied from 203.3 to 708.4 per 100,000, peaking in infants aged 1-2 months.
- RSV accounted for 27% of all pediatric respiratory infection hospitalizations.
- RSV cases incurred significant healthcare costs (€27 million in 2021-2022) and higher outpatient visit rates (61.8% within 30 days) compared to controls.
Conclusions:
- RSV hospitalization places a substantial burden on young, often healthy, Swedish children.
- Findings underscore the need for widespread prophylactic immunization for all infants.
- Prophylactic strategies are essential to mitigate the significant public health impact of RSV in pediatric populations.
Background:
Respiratory syncytial virus (RSV) is a leading cause of acute respiratory infection and hospitalization in young children. Despite its significant burden, prophylaxis for all young children has only recently become available. Understanding the disease burden among this population is critical to evaluate the potential impact of new prophylactic options.
Methods:
This case-cohort study used data from the Swedish national registers. However, 31,907 hospitalized RSV cases <60 months old and 95,697 age-matched comparators were included from 2006 to 2022. The study investigated patient characteristics, incidence, short- and long-term healthcare resource use, associated costs, mortality and associations with high-risk conditions.
Results:
Most cases (84.4%) were born at full-term and were otherwise healthy. RSV incidence ranged from 203.3 per 100,000 (2006-007) to 708.4 per 100,000 (2021-2022), with the highest rates in children 1-<2 months of age. RSV accounted for 27.0% of all hospitalized acute respiratory infection cases. In the 30 days following index, 61.8% of RSV cases had an outpatient care visit, compared to 12.0% of comparators, and short-term care costs for cases totaled €27 million in 2021-2022. In the 12 months following index, 87.6% of RSV cases had an outpatient care visit, while 47.1% of comparators did. Mortality among RSV cases was low (30-day Kaplan-Meier survival: 1.00, 95% CI: 1.00-1.00).
Conclusions:
RSV hospitalization imposes a significant burden on young children in Sweden, most of whom are otherwise healthy. These findings support the adoption of prophylactic immunization strategies targeting all infants to mitigate this burden.
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