Clinical manifestations of respiratory syncytial virus infection and the risk of wheezing and recurrent wheezing illness: a systematic review and meta-analysis

• Published in: World journal of pediatrics : WJP Vol. 19; no. 11; pp. 1030 - 1040
• Main Authors: Jiang, Ming-Yue, Duan, Yu-Ping, Tong, Xun-Liang, Huang, Qiang-Ru, Jia, Meng-Meng, Yang, Wei-Zhong, Feng, Lu-Zhao
• Format: Journal Article
• Language: English
• Published: Singapore Springer Nature Singapore 01.11.2023; School of Population Medicine and Public Health,Chinese Academy of Medical Sciences and Peking Union Medical College,#9 Dong Dan San Tiao,Dongcheng District,Beijing 100730,China; State Key Laboratory of Respiratory Health and Multimorbidity,Chinese Academy of Medical Sciences and Peking Union Medical College,Beijing,China; Key Laboratory of Pathogen Infection Prevention and Control(Peking Union Medical College),Ministry of Education,Beijing,China%Department of pulmonary and critical care medicine,Beijing Hospital/National Gerontology Center/Institute of Gerontology,Chinese Academy of Medical Sciences,Beijing 100730,China
• Subjects: Critical Care Medicine; Imaging; Intensive; Maternal and Child Health; Medicine; Medicine & Public Health; Pediatric Surgery; Pediatrics; Radiology; Surgery; Systematic Review; Recurrent wheezing Respiratory syncytial virus infection; Wheezing; Clinical manifestations infants infection
• ISSN: 1708-8569; 1867-0687
• DOI: 10.1007/s12519-023-00743-5

Background Respiratory syncytial virus (RSV) infection in infants is a global health priority. We aimed to investigate the common manifestations of RSV infection by age group and human development index (HDI) level and to assess its association with the development of wheezing and recurrent wheezing illness. Methods We searched the literature published between January 1, 2010 and June 2, 2022 in seven databases. Outcomes included common manifestations and long-term respiratory outcomes of RSV infection in children. Random- and fixed-effect models were used to estimate the effect size and their 95% confidence intervals. Subgroup analysis was conducted by age and HDI levels. This review was registered in PROSPERO (CRD42022379401). Results The meta-analysis included 47 studies. The top five manifestations were cough (92%), nasal congestion (58%), rhinorrhea (53%), shortness of breath (50%), and dyspnea (47%). The clinical symptoms were most severe in infants. In our analysis, compared to very high and high HDI countries, fewer studies in medium HDI countries reported related manifestations, and no study in low HDI countries reported that. The RSV-infected infants were more likely to develop wheezing than the non-infected infants [odds ratio (OR), 3.12; 95% CI, 2.59–3.76] and had a higher risk of developing wheezing illnesses after recovery (OR, 2.60; 95% CI, 2.51–2.70). Conclusions Cough and shortness of breath are common manifestations of RSV infection. More attention should be given to infants and areas with low HDI levels. The current findings confirm an association between RSV infection and wheezing or recurrent wheezing illness.