Inpatient Burden of Respiratory Syncytial Virus Infection and Influenza in Children Younger Than 5 Years in Japan, 2011–2022: A Database Study

IF 4.3 4区医学 Q1 INFECTIOUS DISEASES

Influenza and Other Respiratory Viruses Pub Date : 2024-11-21 DOI:10.1111/irv.70045

Takeshi Arashiro, Rolf Kramer, Jing Jin, Munehide Kano, Fangyuan Wang, Isao Miyairi

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Abstract

Background

Respiratory syncytial virus (RSV) and influenza virus are major viral etiologies of pediatric lower respiratory tract infection, but comparative data on inpatient burden are lacking.

Methods

Using a large-scale health claims database in Japan, we identified patients under 5 years of age with a confirmed RSV or influenza diagnosis as an outpatient or inpatient between 2011 and 2022. Hospitalization rate, inpatient characteristics, various in-hospital outcomes/complications, and healthcare resource utilization were described.

Results

A total of 176,911 RSV-confirmed outpatients, 153,383 influenza-confirmed outpatients, 90,413 RSV-confirmed hospitalizations, and 11,186 influenza-confirmed hospitalizations were identified. Among outpatients, 24.7% of RSV infection and 2.8% of influenza cases required hospitalization within 1 week. There was no co-morbidities/prematurity for 95.0% of RSV hospitalizations and 96.5% of influenza hospitalizations. Proportions of in-hospital outcomes/complications were (RSV infection vs. influenza): oxygen use 47.6% vs. 14.8%, mechanical ventilation 2.1% vs. 0.7%, pneumonia 33.6% vs. 12.8%, otitis media 7.7% vs. 2.3%, febrile seizure 1.5% vs. 34.4%, encephalitis/encephalopathy 0.1% vs. 0.5%, myocarditis < 0.1% vs. 0.6%, antibiotics prescription 48.0% vs. 24.4%. The mean inpatient stay was 6.1 vs. 4.3 days at direct medical costs of 435,744 vs. 315,809 JPY/patient. These trends held true in age-stratified data. In-hospital death occurred in 31 RSV infection and 6 influenza cases.

Conclusions

Although both infections resulted in substantial burden, RSV infection led to more frequent hospitalizations, worse in-hospital outcomes, longer inpatient stays, higher medical costs, and more frequent antibiotics prescription compared to influenza. Most RSV hospitalizations occurred among healthy term children, emphasizing the need for prevention measures in all children.

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2011-2022 年日本 5 岁以下儿童呼吸道合胞病毒感染和流感的住院负担：一项数据库研究。

背景：呼吸道合胞病毒（RSV呼吸道合胞病毒（RSV）和流感病毒是小儿下呼吸道感染的主要病毒病因，但缺乏有关住院患者负担的比较数据：我们利用日本的大规模健康索赔数据库，确定了 2011 年至 2022 年期间门诊或住院的确诊为 RSV 或流感的 5 岁以下患者。我们对住院率、住院病人特征、各种住院结果/并发症以及医疗资源利用情况进行了描述：结果：共发现 176911 名 RSV 确诊门诊患者、153383 名流感确诊门诊患者、90413 名 RSV 确诊住院患者和 11186 名流感确诊住院患者。在门诊病人中，24.7%的 RSV 感染病例和 2.8% 的流感病例需要在一周内住院治疗。在 95.0% 的 RSV 住院病例和 96.5% 的流感住院病例中，没有并发症/早产儿。住院结果/并发症的比例为（RSV 感染与流感）：使用氧气 47.6% 对 14.8%、机械通气 2.1% 对 0.7%、肺炎 33.6% 对 12.8%、中耳炎 7.7% 对 2.3%、发热性惊厥 1.5% 对 34.4%、脑炎/脑病 0.1% 对 0.5%、心肌炎结论：虽然两种感染都会造成巨大的负担，但与流感相比，RSV 感染导致更频繁的住院治疗、更差的院内预后、更长的住院时间、更高的医疗费用和更频繁的抗生素处方。大多数 RSV 住院病例都发生在健康的足月儿童身上，因此需要对所有儿童采取预防措施。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Influenza and Other Respiratory Viruses 医学-病毒学

CiteScore

7.20

自引率

4.50%

发文量

120

审稿时长

6-12 weeks

期刊介绍： Influenza and Other Respiratory Viruses is the official journal of the International Society of Influenza and Other Respiratory Virus Diseases - an independent scientific professional society - dedicated to promoting the prevention, detection, treatment, and control of influenza and other respiratory virus diseases. Influenza and Other Respiratory Viruses is an Open Access journal. Copyright on any research article published by Influenza and Other Respiratory Viruses is retained by the author(s). Authors grant Wiley a license to publish the article and identify itself as the original publisher. Authors also grant any third party the right to use the article freely as long as its integrity is maintained and its original authors, citation details and publisher are identified.