A1 Refereed original research article in a scientific journal
The burden of respiratory syncytial virus in healthy term-born infants in Europe: a prospective birth cohort study
Authors: Wildenbeest Joanne G, Billard Marie-Noëlle, Zuurbier Roy P, Korsten Koos, Langedijk Annefleur C, van de Ven Peter M, Snape Matthew D, Drysdale Simon B, Pollard Andrew J, Robinson Hannah, Heikkinen Terho, Cunningham Steve, O'Neill Thomas, Rizkalla Bishoy, Dacosta-Urbieta Ana, Martinón-Torres Federico, van Houten Marlies A, Bont Louis J, RESCEU Investigators
Publisher: Elsevier
Publication year: 2023
Journal: The Lancet Respiratory Medicine
Journal name in source: The Lancet. Respiratory medicine
Journal acronym: Lancet Respir Med
Volume: 11
Issue: 4
First page : 341
Last page: 353
ISSN: 2213-2600
eISSN: 2213-2619
DOI: https://doi.org/10.1016/S2213-2600(22)00414-3(external)
Web address : https://www.sciencedirect.com/science/article/pii/S2213260022004143?via%3Dihub(external)
Self-archived copy’s web address: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9764871/(external)
Background
Respiratory syncytial virus (RSV) is a major cause of hospitalisation in infants. The burden of RSV infection in healthy term infants has not yet been established. Accurate health-care burden data in healthy infants are necessary to determine RSV immunisation policy when RSV immunisation becomes available.
Methods
We performed a multicentre, prospective, observational birth cohort study in healthy term-born infants (≥37 weeks of gestation) in five sites located in different European countries to determine the health-care burden of RSV. The incidence of RSV-associated hospitalisations in the first year of life was determined by parental questionnaires and hospital chart reviews. We performed active RSV surveillance in a nested cohort to determine the incidence of medically attended RSV infections. The study is registered with ClinicalTrials.gov, NCT03627572.
Findings
In total, 9154 infants born between July 1, 2017, and April 1, 2020, were followed up during the first year of life and 993 participated in the nested active surveillance cohort. The incidence of RSV-associated hospitalisations in the total cohort was 1·8% (95% CI 1·6–2·1). There were eight paediatric intensive care unit admissions, corresponding to 5·5% of 145 RSV-associated hospitalisations and 0·09% of the total cohort. Incidence of RSV infection in the active surveillance cohort confirmed by any diagnostic assay was 26·2% (24·0–28·6) and that of medically attended RSV infection was 14·1% (12·3–16·0).
Interpretation
RSV-associated acute respiratory infection causes substantial morbidity, leading to the hospitalisation of one in every 56 healthy term-born infants in high-income settings. Immunisation of pregnant women or healthy term-born infants during their first winter season could have a major effect on the health-care burden caused by RSV infections.
