1887
Research Open Access
Like 0

Abstract

Background

Respiratory syncytial virus (RSV) is a leading cause of acute respiratory infections and hospitalisations in infants (age < 1 year) and young children. Little is known on RSV epidemiology and related inpatient healthcare resource use (HCRU) in Switzerland.

Aim

To explore RSV-related hospitalisations, inpatient HCRU and medical costs in all age groups, and risk factors for infant hospitalisations in Switzerland.

Methods

We used national hospital registry data from 2003 to 2021 identifying RSV cases with ICD-10-GM codes, and described demographic characteristics, HCRU and associated medical costs of RSV inpatients. The effect of risk factors on infant hospitalisation was estimated with logistic regression.

Results

We observed a general increase and biannual pattern in RSV hospitalisations between 2003/04 and 2018/19, with 3,575 hospitalisations in 2018/19 and 2,487 in 2019/20 before numbers declined in 2020/21 (n = 902). Around two thirds of all hospitalisations occurred in infants. Mean (median) age was 118 (85) days in hospitalised infants and 74 (77) years in hospitalised adult patients (> 18 years); 7.2% of cases required intensive care unit stay. Mean inpatient medical costs were estimated at EUR 8,046. Most (90.8%) hospitalised infants with RSV were born after 35 weeks of gestation without bronchopulmonary dysplasia or congenital heart disease. Low birth weight, gestational age and congenital disorders were associated with a higher risk for hospitalisation.

Conclusions

RSV leads to a substantial number of hospitalisations and peaks in hospital capacity utilisation. Measures to protect all infants from an RSV hospitalisation are essential in addressing this public health challenge.

Loading

Article metrics loading...

/content/10.2807/1560-7917.ES.2024.29.39.2400119
2024-09-26
2024-10-06
http://instance.metastore.ingenta.com/content/10.2807/1560-7917.ES.2024.29.39.2400119
Loading
Loading full text...

Full text loading...

/deliver/fulltext/eurosurveillance/29/39/eurosurv-29-39-4.html?itemId=/content/10.2807/1560-7917.ES.2024.29.39.2400119&mimeType=html&fmt=ahah

References

  1. Bont L, Checchia PA, Fauroux B, Figueras-Aloy J, Manzoni P, Paes B, et al. Defining the epidemiology and burden of severe respiratory syncytial virus infection among infants and children in western countries. Infect Dis Ther. 2016;5(3):271-98.  https://doi.org/10.1007/s40121-016-0123-0  PMID: 27480325 
  2. Li Y, Wang X, Blau DM, Caballero MT, Feikin DR, Gill CJ, et al. Global, regional, and national disease burden estimates of acute lower respiratory infections due to respiratory syncytial virus in children younger than 5 years in 2019: a systematic analysis. Lancet. 2022;399(10340):2047-64.  https://doi.org/10.1016/S0140-6736(22)00478-0  PMID: 35598608 
  3. Cilla G, Sarasua A, Montes M, Arostegui N, Vicente D, Pérez-Yarza E, et al. Risk factors for hospitalization due to respiratory syncytial virus infection among infants in the Basque Country, Spain. Epidemiol Infect. 2006;134(3):506-13.  https://doi.org/10.1017/S0950268805005571  PMID: 16638164 
  4. Shi T, Balsells E, Wastnedge E, Singleton R, Rasmussen ZA, Zar HJ, et al. Risk factors for respiratory syncytial virus associated with acute lower respiratory infection in children under five years: Systematic review and meta-analysis. J Glob Health. 2015;5(2):020416.  https://doi.org/10.7189/jogh.05.020416  PMID: 26682048 
  5. Murray J, Bottle A, Sharland M, Modi N, Aylin P, Majeed A, et al. Risk factors for hospital admission with RSV bronchiolitis in England: a population-based birth cohort study. PLoS One. 2014;9(2):e89186.  https://doi.org/10.1371/journal.pone.0089186  PMID: 24586581 
  6. Cai W, Buda S, Schuler E, Hirve S, Zhang W, Haas W. Risk factors for hospitalized respiratory syncytial virus disease and its severe outcomes. Influenza Other Respir Viruses. 2020;14(6):658-70.  https://doi.org/10.1111/irv.12729  PMID: 32064773 
  7. Hall CB, Weinberg GA, Iwane MK, Blumkin AK, Edwards KM, Staat MA, et al. The burden of respiratory syncytial virus infection in young children. N Engl J Med. 2009;360(6):588-98.  https://doi.org/10.1056/NEJMoa0804877  PMID: 19196675 
  8. Rha B, Curns AT, Lively JY, Campbell AP, Englund JA, Boom JA, et al. Respiratory syncytial virus–associated hospitalizations among young children: 2015-2016. Pediatrics. 2020;146(1):e20193611.  https://doi.org/10.1542/peds.2019-3611  PMID: 32546583 
  9. Wildenbeest JG, Billard M-N, Zuurbier RP, Korsten K, Langedijk AC, van de Ven PM, et al. The burden of respiratory syncytial virus in healthy term-born infants in Europe: a prospective birth cohort study. Lancet Respir Med. 2023;11(4):341-53.  https://doi.org/10.1016/S2213-2600(22)00414-3  PMID: 36372082 
  10. von Hammerstein AL, Aebi C, Barbey F, Berger C, Buettcher M, Casaulta C, et al. Interseasonal RSV infections in Switzerland - rapid establishment of a clinician-led national reporting system (RSV EpiCH). Swiss Med Wkly. 2021;151(3536):w30057.  https://doi.org/10.4414/SMW.2021.w30057  PMID: 34499459 
  11. Berger TM, Aebi C, Duppenthaler A, Stocker M, Swiss Pediatric Surveillance Unit. Prospective population-based study of RSV-related intermediate care and intensive care unit admissions in Switzerland over a 4-year period (2001-2005). Infection. 2009;37(2):109-16.  https://doi.org/10.1007/s15010-008-8130-z  PMID: 19412586 
  12. Duppenthaler A, Gorgievski-Hrisoho M, Frey U, Aebi C. Two-year periodicity of respiratory syncytial virus epidemics in Switzerland. Infection. 2003;31(2):75-80.  https://doi.org/10.1007/s15010-002-3124-8  PMID: 12682811 
  13. van Summeren J, Meijer A, Aspelund G, Casalegno JS, Erna G, Hoang U, et al. Low levels of respiratory syncytial virus activity in Europe during the 2020/21 season: what can we expect in the coming summer and autumn/winter? Euro Surveill. 2021;26(29):2100639.  https://doi.org/10.2807/1560-7917.ES.2021.26.29.2100639  PMID: 34296672 
  14. Van Brusselen D, De Troeyer K, Ter Haar E, Vander Auwera A, Poschet K, Van Nuijs S, et al. Bronchiolitis in COVID-19 times: a nearly absent disease? Eur J Pediatr. 2021;180(6):1969-73.  https://doi.org/10.1007/s00431-021-03968-6  PMID: 33517482 
  15. Casalegno J-S, Ploin D, Cantais A, Masson E, Bard E, Valette M, et al. Characteristics of the delayed respiratory syncytial virus epidemic, 2020/2021, Rhône Loire, France. Euro Surveill. 2021;26(29):2100630.  https://doi.org/10.2807/1560-7917.ES.2021.26.29.2100630  PMID: 34296674 
  16. Swiss Federal Statistical Office (FSO). Medizinische Statistik der Krankenhäuser. [Hospital inpatient registry]. Neuchâtel: FSO; 2022. German. Available from: https://www.bfs.admin.ch/bfs/de/home/statistiken/gesundheit/erhebungen/ms.html
  17. Bundesinstitut für Arzneimittel und Medizinprodukte (BfArM). ICD-10-GM Version 2021, Systematisches Verzeichnis, Internationale statistische Klassifikation der Krankheiten und verwandter Gesundheitsprobleme, 10. Revision. [ICD-10-GM International Statistical Classification of Diseases and Related Health Problems, German Modification]. Köln: BfArM; 2020. German. Available from: https://www.bfarm.de/DE/Kodiersysteme/Klassifikationen/ICD/ICD-10-GM/_node.html
  18. Swiss Federal Statistical Office (FSO). Population and Household Statistics (STATPOP). Neuchâtel: FSO; 2022. Available from: https://www.bfs.admin.ch/bfs/de/home/statistiken/bevoelkerung/stand-entwicklung/bevoelkerung.html
  19. Swiss Federal Statistical Office (FSO). Vital Statistics (BEVNAT). Neuchâtel: FSO; 2022. Available from: https://www.bfs.admin.ch/bfs/en/home/statistics/population/surveys/bevnat.html
  20. Bandeira T, Carmo M, Lopes H, Gomes C, Martins M, Guzman C, et al. Burden and severity of children’s hospitalizations by respiratory syncytial virus in Portugal, 2015-2018. Influenza Other Respir Viruses. 2023;17(1):e13066.  https://doi.org/10.1111/irv.13066  PMID: 36377322 
  21. Mendes-da-Silva A, Gonçalves-Pinho M, Freitas A, Azevedo I. Trends in hospitalization for acute bronchiolitis in Portugal: 2000-2015. Pulmonology. 2019;25(3):154-61.  https://doi.org/10.1016/j.pulmoe.2018.05.002  PMID: 29898876 
  22. SwissDRG AG. DRG catalogue (Fallpauschalenkatalog). 2012-2022. Bern: SwissDRG AG. [Accessed: 9 Sep 2024]. Available from: https://www.swissdrg.org/de/akutsomatik/swissdrg-system-1202023/fallpauschalenkatalog
  23. Kanton Zürich - Gesundheitsdirektion. Übersicht über die Tarife 2012 bis 2022 für stationäre Behandlungen in den Spitälern und Geburtshäusern mit Standort im Kanton Zürich gemäss Zürcher Spitallisten. [Overview of tariffs 2012 to 2022 for inpatient treatment in hospitals and birthing centres located in the Canton of Zurich according to Zurich hospital lists]. Zurich: Gesundheitsdirektion Kanton Zürich; 2022. German. Available from: https://www.zh.ch/content/dam/zhweb/bilder-dokumente/themen/gesundheit/gesundheitsversorgung/spitaeler_kliniken/spitalfinanzierung/spitaltarife/2021/20211222_uebersicht_stat_tarife_2012_2022_V07.pdf
  24. Swiss National Bank. Foreign exchange rates – Year. Zurich: SNB. [Accessed: 9 Sep 2024]. Available from: https://data.snb.ch/en/topics/ziredev/cube/devkua?fromDate=2013&toDate=2022&dimSel=D1(EUR1)
  25. Gil-Prieto R, Gonzalez-Escalada A, Marín-García P, Gallardo-Pino C, Gil-de-Miguel A. Respiratory syncytial virus bronchiolitis in children up to 5 years of age in Spain: epidemiology and comorbidities: an observational study. Medicine (Baltimore). 2015;94(21):e831.  https://doi.org/10.1097/MD.0000000000000831  PMID: 26020386 
  26. Weigl JA, Puppe W, Schmitt H-J. Seasonality of respiratory syncytial virus-positive hospitalizations in children in Kiel, Germany, over a 7-year period. Infection. 2002;30(4):186-92.  https://doi.org/10.1007/s15010-002-2159-1  PMID: 12236558 
  27. Terletskaia-Ladwig E, Enders G, Schalasta G, Enders M. Defining the timing of respiratory syncytial virus (RSV) outbreaks: an epidemiological study. BMC Infect Dis. 2005;5(1):20.  https://doi.org/10.1186/1471-2334-5-20  PMID: 15801975 
  28. Jepsen MT, Trebbien R, Emborg HD, Krause TG, Schønning K, Voldstedlund M, et al. Incidence and seasonality of respiratory syncytial virus hospitalisations in young children in Denmark, 2010 to 2015. Euro Surveill. 2018;23(3):17-00163.  https://doi.org/10.2807/1560-7917.ES.2018.23.3.17-00163  PMID: 29386093 
  29. Niekler P, Goettler D, Liese JG, Streng A. Hospitalizations due to respiratory syncytial virus (RSV) infections in Germany: a nationwide clinical and direct cost data analysis (2010-2019). Infection. 2023;1-10.  https://doi.org/10.1007/s15010-023-02122-8  PMID: 37973718 
  30. World Health Organization (WHO). Global Health Expenditure Database. Geneva: WHO. [Accessed: 14 May 2024]. Available from: https://apps.who.int/nha/database
  31. Clopper BR, Zhou Y, Tannis A, Staat MA, Rice M, Boom JA, et al. Medical costs of RSV-associated hospitalizations and emergency department visits in children aged< 5 years: observational findings from the new vaccine surveillance network (NVSN), 2016-2019. J Pediatr. 2024;271:114045.  https://doi.org/10.1016/j.jpeds.2024.114045  PMID: 38561048 
  32. Liese JG, Grill E, Fischer B, Roeckl-Wiedmann I, Carr D, Belohradsky BH, et al. , Munich RSV Study Group. Incidence and risk factors of respiratory syncytial virus-related hospitalizations in premature infants in Germany. Eur J Pediatr. 2003;162(4):230-6.  https://doi.org/10.1007/s00431-002-1105-7  PMID: 12647195 
  33. Hak SF, Venekamp RP, Wildenbeest JG, Bont LJ. Outpatient respiratory syncytial virus infections and novel preventive interventions. Curr Opin Pediatr. 2024;36(2):171-81.  https://doi.org/10.1097/MOP.0000000000001323  PMID: 38085019 
  34. Wroblewski D, Brust-Sisti LA, Bridgeman M, Bridgeman MB. Vaccines for respiratory syncytial virus prevention in older adults. Ann Pharmacother. 2024;10600280241241049.  https://doi.org/10.1177/10600280241241049  PMID: 38563554 
  35. Pecenka C, Sparrow E, Feikin DR, Srikantiah P, Mimi Darko D, Karikari-Boateng E, et al. Respiratory syncytial virus vaccination and immunoprophylaxis: realising the potential for protection of young children. Lancet. 2024. Forthcoming.  https://doi.org/10.1016/S0140-6736(24)01699-4 
  36. Moline HL, Tannis A, Toepfer AP, Williams JV, Boom JA, Englund JA, et al. Early estimate of nirsevimab effectiveness for prevention of respiratory syncytial virus-associated hospitalization among infants entering their first respiratory syncytial virus season - new vaccine surveillance network, October 2023-February 2024. MMWR Morb Mortal Wkly Rep. 2024;73(9):209-14.  https://doi.org/10.15585/mmwr.mm7309a4  PMID: 38457312 
  37. López-Lacort M, Muñoz-Quiles C, Mira-Iglesias A, López-Labrador FX, Mengual-Chuliá B, Fernández-García C, et al. Early estimates of nirsevimab immunoprophylaxis effectiveness against hospital admission for respiratory syncytial virus lower respiratory tract infections in infants, Spain, October 2023 to January 2024. Euro Surveill. 2024;29(6):2400046.  https://doi.org/10.2807/1560-7917.ES.2024.29.6.2400046  PMID: 38333937 
  38. Ares-Gómez S, Mallah N, Santiago-Pérez MI, Pardo-Seco J, Pérez-Martínez O, Otero-Barrós MT, et al. Effectiveness and impact of universal prophylaxis with nirsevimab in infants against hospitalisation for respiratory syncytial virus in Galicia, Spain: initial results of a population-based longitudinal study. Lancet Infect Dis. 2024;24(8):817-28.  https://doi.org/10.1016/S1473-3099(24)00215-9  PMID: 38701823 
  39. Nirsevimab expert working group. Consensus statement/recommendation on the prevention of respiratory syncytial virus (RSV) infections with the monoclonal antibody Nirsevimab (Beyfortus). 2024. Available from: https://www.bag.admin.ch/dam/bag/de/dokumente/mt/i-und-b/richtlinien-empfehlungen/empfehlungen-spezifische-erreger-krankheiten/rsv/rsv-consensus-statement-nirsevimab.pdf.download.pdf
  40. Agyeman P, Barazzone C, Hammer J, Heininger U, Nadal D, Pfammatter J-P, et al. Konsensus Statement zur Prävention von Respiratory Syncytial Virus (RSV)-Infektionen mit dem humanisierten monoklonalen Antikörper Palivizumab (Synagis). (Consensus statement on the prevention of Respiratory syncytial virus (RSV) infections with the humanized monoclonal antibody palivizumab (Synagis)). Paediatrica.2017;28(2):13-5. German.  https://doi.org/10.5167/uzh-138831 
/content/10.2807/1560-7917.ES.2024.29.39.2400119
Loading

Data & Media loading...

Supplementary data

Submit comment
Close
Comment moderation successfully completed
This is a required field
Please enter a valid email address
Approval was a Success
Invalid data
An Error Occurred
Approval was partially successful, following selected items could not be processed due to error