Estimate trends and quantify change from RSV burden on healthcare systems

When the medical system is overloaded, such as during a pandemic, respiratory syncytial virus Quantified long-term temporal and spatial trends estimated using hospitalization data, according to a study published in (RSV) The forefront of pediatrics.

RSV most often causes mild respiratory tract infections, but can be more severe in children under 2 years of age. RSV infection is best expected seasonally, being most frequent in late fall, winter, and early spring. However, the COVID-19 pandemic changed the seasonality of RSV. This study aimed to quantify how the COVID-19 pandemic affected her RSV infection in children at the Texas state and county level.

Texas hospital discharge records and the Texas Public Use Data File (PUDF) from Q1 2006 to Q4 2021 were used in this study. Discharge diagnosis, length of stay, patient age, patient status at end of service, and patient county were used as variables. All hospital discharge diagnoses were included in the dataset and the analysis focused on her RSV-related hospitalization in children aged 5 years and younger.

Cumulative quarterly hospitalization rates for children aged 4 years and younger were calculated from monthly RSV-related hospitalization rates reported from 2018 to 2022 on the RSV Hospitalization Surveillance Network (RSV-NET). Children were divided into three groups based on the PUDF dataset, age 1–28 days, age 29–365 days, and age 1–4 years.

The study included 158,920 RSV-related hospitalizations from 2006 to 2021, with most hospitalizations in children <5 years of age (89%). Breaking this down further, from 2006 to 2019, her children aged 29–365 days had the highest hospitalization rates (65%) and those aged 1–28 days had the lowest rates (8%). . Patients aged 1-28 days (57%) and 1-4 years (40%) had the highest hospitalization rates.

The seasonal pattern of hospitalizations was consistent between 2006 and 2019. He had the highest number of cases in 2010, 2011, and 2019, and all years from 2006 to 2019, with a general downward trend in the number of cases in the first quarter and all other years. was up in the quarter.

Compared to linear regression models that estimated RSV hospitalizations in 2020 and 2021 minus the impact of COVID-19, hospitalizations were lower in the 2020 season, with a stronger peak in the third quarter of 2021. The outbreak peaked 1.5 times higher than expected, and instead of Q4 2020, he occurred in Q3 2021, almost a year later than expected. The number of cases in the second quarter of 2021 (n = 1223) was also 2.6 times higher than in the normal season, and he was 5 times higher given the seasonal shift. Hospitalization rates trended downward over time in the first quarter, but trended upward in all other quarters.

RSV-related hospitalizations were 1.9-fold and 9.5-fold higher at the state and county levels from 2018 to 2021 compared to those reported in the RSV-NET data. The difference is greater in 2020 and 2021, with county-level average rates 43 times higher than RSV-NET and state hospitalization rates 5 times higher than reported in RSV-NET.

Length of stay followed a seasonal trend from 2006 to 2019 with longer length of stay in Q2 and Q3. However, this has been impacted by the pandemic, with stays up to 6.5 times longer than expected in Q4 2020 (29.3 days vs. 4.5 days). The lapse rate was 2.28 times (0.39%) higher in 2020 compared to the 2006-2019 average (0.17%).

Rural counties had the highest hospitalization rates in Texas in the second quarter of 2020, with three urban counties reporting cases during the pandemic. Re-emergence of RSV was found to follow typical onset, but with higher and more widespread distribution. During the COVID-19 pandemic, no cases of RSV were found in rural areas along the southwestern border, but were reported prior to the second quarter of 2020.

Potential limitations to these study results include what researchers used International Classification of Diseases, 9th revision, and 10th Revision, Clinical Amendment Code for diagnosing RSV that may have misrepresented hospital burden. This study did not examine risk factors for co-infection and RSV hospitalization. Also, in 2021 he has not tested lack of exposure to the virus as the reason for the atypical peak of RSV.

The researchers concluded that observing RSV-related hospitalizations is an important way to assess the burden of RSV infection in children’s hospitals. Observing how the COVID-19 pandemic changed her RSV hospitalization reveals the role the pandemic played in the seasonality of RSV and the lengthening of hospital stays.

reference

Uwak I, Johnson N, Mustapha T, et al. Using records from 2006 to 2021, we quantify changes in respiratory syncytial virus-associated hospitalizations in Texas children during the COVID-19 pandemic. front pediatricsPublished online March 13, 2023 doi: 10.3389/fped.2023.1124316