TY - JOUR
T1 - The role of viral co-infections in the severity of acute respiratory infections among children infected with respiratory syncytial virus (RSV):
T2 - a systematic review and meta-analysis
AU - Li, You
AU - Pillai, Pallavi
AU - Miyake, Fuyu
AU - Nair, Harish
PY - 2020/6/11
Y1 - 2020/6/11
N2 - Background
Respiratory syncytial virus (RSV) is the predominant viral cause of childhood pneumonia. Little is known about the role of viral-coinfections in the clinical severity in children infected with RSV.
Methods
We conducted a systematic literature review of publications comparing the clinical severity between RSV mono-infection and RSV co-infection with other viruses in children under five years (<5y). Clinical severity was measured using the following six clinical outcomes: hospitalisation, length of hospital stay, use of supplemental oxygen, intensive care unit (ICU) admission, mechanical ventilation and deaths. We summarised the findings by clinical outcome and conducted random-effect meta-analyses, where applicable, to quantitatively synthesize the association between RSV mono-infection/RSV co-infection and the clinical severity.
Results
Overall, no differences in the clinical severity were found between RSV mono-infection and RSV co-infection with any viruses, except for the RSV-human metapneumovirus (hMPV) co-infection. RSV-hMPV coinfection was found to be associated with a higher risk of ICU admission (odds ratio [OR]: 7.2, 95% confidence interval [CI]: 2.1–25.1; OR after removal of the most influential study: 3.7, 95% CI: 1.1–12.3). We also observed a trend from three studies that RSV-hMPV coinfections were likely to be associated with longer hospital stay.
Conclusion
Our findings suggest that RSV-hMPV coinfections might be associated with increased risk for ICU admission in children <5y compared with RSV mono-infection but such association does not imply causation. Our findings do not support the association between RSV coinfections with other viruses and clinical severity but further large-scale investigations are needed to confirm the findings.
AB - Background
Respiratory syncytial virus (RSV) is the predominant viral cause of childhood pneumonia. Little is known about the role of viral-coinfections in the clinical severity in children infected with RSV.
Methods
We conducted a systematic literature review of publications comparing the clinical severity between RSV mono-infection and RSV co-infection with other viruses in children under five years (<5y). Clinical severity was measured using the following six clinical outcomes: hospitalisation, length of hospital stay, use of supplemental oxygen, intensive care unit (ICU) admission, mechanical ventilation and deaths. We summarised the findings by clinical outcome and conducted random-effect meta-analyses, where applicable, to quantitatively synthesize the association between RSV mono-infection/RSV co-infection and the clinical severity.
Results
Overall, no differences in the clinical severity were found between RSV mono-infection and RSV co-infection with any viruses, except for the RSV-human metapneumovirus (hMPV) co-infection. RSV-hMPV coinfection was found to be associated with a higher risk of ICU admission (odds ratio [OR]: 7.2, 95% confidence interval [CI]: 2.1–25.1; OR after removal of the most influential study: 3.7, 95% CI: 1.1–12.3). We also observed a trend from three studies that RSV-hMPV coinfections were likely to be associated with longer hospital stay.
Conclusion
Our findings suggest that RSV-hMPV coinfections might be associated with increased risk for ICU admission in children <5y compared with RSV mono-infection but such association does not imply causation. Our findings do not support the association between RSV coinfections with other viruses and clinical severity but further large-scale investigations are needed to confirm the findings.
U2 - 10.7189/jogh.10.010426
DO - 10.7189/jogh.10.010426
M3 - Article
SN - 2047-2978
VL - 10
SP - 010426
JO - Journal of Global Health
JF - Journal of Global Health
IS - 1
ER -