Impacto clínico y económico de la infección por virus respiratorio sincitial en atención primaria en menores de 5 años

IF 2.6 4区医学 Q2 PEDIATRICS

Anales de pediatria Pub Date : 2026-07-01 Epub Date: 2026-04-11 DOI:10.1016/j.anpedi.2026.504225

Marta Carballal Mariño, María Garcés Sánchez, Ana Cubero Santos, Juan Antonio García Sánchez, Santiago Alfayate Miguélez, César García Vera, Red de Investigación en Pediatría de Atención Primaria (PAPenRED)

{"title":"Impacto clínico y económico de la infección por virus respiratorio sincitial en atención primaria en menores de 5 años","authors":"Marta Carballal Mariño, María Garcés Sánchez, Ana Cubero Santos, Juan Antonio García Sánchez, Santiago Alfayate Miguélez, César García Vera, Red de Investigación en Pediatría de Atención Primaria (PAPenRED)","doi":"10.1016/j.anpedi.2026.504225","DOIUrl":null,"url":null,"abstract":"<div><h3>Introduction and objectives</h3><div>The burden of disease and costs of respiratory syncytial virus (RSV) infections in children under 5 years in pediatric primary care are not well known.</div></div><div><h3>Patients and methods</h3><div>Observational, prospective, and analytical study of children with suspected RSV respiratory infection confirmed by molecular testing. Thirty-seven paediatricians in eight autonomous communities recruited patients aged 0 to 59 months with suspected RSV infection from November 2021 to January 2024. The data were collected on the day of recruitment and at 14 and 30 days. We evaluated direct and indirect health care costs.</div></div><div><h3>Results</h3><div>Of the 517 recruited children, 206 (39.8%) tested positive for RSV (64.5% for type A; 35.4% for type B; and 2.4% for both A and B). There were significant differences in the proportion of children with dyspnea in the RSV-positive group compared to the RSV-negative group (50.0% vs 31.8%; <em>P</em> <.001). In the RSV-positive group, a higher proportion of infants aged less than 12 months, compared to other age groups, visited the emergency department (39.6% versus 22.5%; <em>P</em>  =.004). Inhaled bronchodilators were administered to 58.4%, inhaled corticosteroids to 9.7%, oral corticosteroids to 11.9%, and antibiotics to 18.3%. In the subset of school-aged children, 69.2% missed at least one day of school (median, 8 days; IQR, 5-14). The total cost per episode was €458, with significant differences between infants (€507) and children aged 1 year or older (€419) (mean difference, €88; 95% CI, 76-99; <em>P</em> <.001). The only differences between autonomous communities were in the use of bronchodilators and the frequency of emergency department visits.</div></div><div><h3>Conclusions</h3><div>Infection by RSV in early childhood places a significant clinical, economic and health care resource burden in out-of-hospital settings, which supports the implementation of effective preventive measures.</div></div>","PeriodicalId":7783,"journal":{"name":"Anales de pediatria","volume":"105 1","pages":"Article 504225"},"PeriodicalIF":2.6000,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Anales de pediatria","FirstCategoryId":"3","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S1695403326000949","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2026/4/11 0:00:00","PubModel":"Epub","JCR":"Q2","JCRName":"PEDIATRICS","Score":null,"Total":0}

引用次数: 0

Abstract

Introduction and objectives

The burden of disease and costs of respiratory syncytial virus (RSV) infections in children under 5 years in pediatric primary care are not well known.

Patients and methods

Observational, prospective, and analytical study of children with suspected RSV respiratory infection confirmed by molecular testing. Thirty-seven paediatricians in eight autonomous communities recruited patients aged 0 to 59 months with suspected RSV infection from November 2021 to January 2024. The data were collected on the day of recruitment and at 14 and 30 days. We evaluated direct and indirect health care costs.

Results

Of the 517 recruited children, 206 (39.8%) tested positive for RSV (64.5% for type A; 35.4% for type B; and 2.4% for both A and B). There were significant differences in the proportion of children with dyspnea in the RSV-positive group compared to the RSV-negative group (50.0% vs 31.8%; P < .001). In the RSV-positive group, a higher proportion of infants aged less than 12 months, compared to other age groups, visited the emergency department (39.6% versus 22.5%; P = .010) and required hospital admission (25.0% versus 9.5%; P = .004). Inhaled bronchodilators were administered to 58.4%, inhaled corticosteroids to 9.7%, oral corticosteroids to 11.9%, and antibiotics to 18.3%. In the subset of school-aged children, 69.2% missed at least one day of school (median, 8 days; IQR, 5-14). The total cost per episode was €458, with significant differences between infants (€507) and children aged 1 year or older (€419) (mean difference, €88; 95% CI, 76-99; P < .001). The only differences between autonomous communities were in the use of bronchodilators and the frequency of emergency department visits.

Conclusions

Infection by RSV in early childhood places a significant clinical, economic and health care resource burden in out-of-hospital settings, which supports the implementation of effective preventive measures.

Abstract Image

查看原文本刊更多论文

5岁以下儿童呼吸道合胞病毒感染对初级保健的临床和经济影响

在儿科初级保健中，5岁以下儿童呼吸道合胞病毒（RSV）感染的疾病负担和成本尚不清楚。患者和方法对经分子检测证实的疑似RSV呼吸道感染患儿进行观察性、前瞻性和分析性研究。来自8个自治区的37名儿科医生从2021年11月至2024年1月招募了年龄为0至59个月的疑似RSV感染患者。在招募当天、第14天和第30天采集数据。我们评估了直接和间接的医疗费用。结果在517名招募的儿童中，206名（39.8%）RSV检测阳性（A型64.5%，B型35.4%，A型和B型均为2.4%）。rsv阳性组患儿出现呼吸困难的比例与rsv阴性组比较差异有统计学意义（50.0% vs 31.8%; P < 0.001）。在rsv阳性组中，12个月以下婴儿的急诊科就诊比例（39.6%比22.5%,P = 0.010）和住院比例（25.0%比9.5%,P = 0.004）高于其他年龄组。吸入支气管扩张剂占58.4%，吸入皮质类固醇占9.7%，口服皮质类固醇占11.9%，抗生素占18.3%。在学龄儿童子集中，69.2%至少缺课一天（中位数为8天；IQR为5-14）。每集总费用为458欧元，婴儿（507欧元）和1岁以上儿童（419欧元）之间存在显著差异（平均差异为88欧元；95% CI, 76-99; P < .001）。自治区之间的唯一差异是支气管扩张剂的使用和急诊室就诊的频率。结论幼儿呼吸道合胞病毒感染给院外环境带来了巨大的临床、经济和卫生资源负担，需要采取有效的预防措施。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

求助全文

约1分钟内获得全文求助全文

来源期刊

Anales de pediatria 医学-小儿科

CiteScore

2.10

自引率

4.80%

发文量

155

审稿时长

44 days

期刊介绍： La Asociación Española de Pediatría tiene como uno de sus objetivos principales la difusión de información científica rigurosa y actualizada sobre las distintas áreas de la pediatría. Anales de Pediatría es el Órgano de Expresión Científica de la Asociación y constituye el vehículo a través del cual se comunican los asociados. Publica trabajos originales sobre investigación clínica en pediatría procedentes de España y países latinoamericanos, así como artículos de revisión elaborados por los mejores profesionales de cada especialidad, las comunicaciones del congreso anual y los libros de actas de la Asociación, y guías de actuación elaboradas por las diferentes Sociedades/Secciones Especializadas integradas en la Asociación Española de Pediatría.