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.

中文翻译：

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呼吸道合胞病毒感染的临床表现以及喘息和复发性喘息疾病的风险：系统评价和荟萃分析

背景

婴儿呼吸道合胞病毒（RSV）感染是全球健康的一个优先事项。我们的目的是按年龄组和人类发育指数 (HDI) 水平调查 RSV 感染的常见表现，并评估其与喘息和复发性喘息疾病的关系。

方法

我们检索了七个数据库中2010年1月1日至2022年6月2日期间发表的文献。结果包括儿童 RSV 感染的常见表现和长期呼吸道结果。使用随机和固定效应模型来估计效应大小及其 95% 置信区间。按年龄和 HDI 水平进行亚组分析。该评论已在 PROSPERO 中注册 (CRD42022379401)。

结果

荟萃分析包括 47 项研究。前五位的表现是咳嗽（92%）、鼻塞（58%）、鼻漏（53%）、气短（50%）、呼吸困难（47%）。婴儿的临床症状最为严重。在我们的分析中，与人类发展指数极高和高的国家相比，中等人类发展指数国家报告相关表现的研究较少，而低人类发展指数国家则没有研究报告这一情况。感染 RSV 的婴儿比未感染的婴儿更容易出现喘息 [比值比 (OR), 3.12；95% CI, 2.59–3.76] 并且康复后患喘息疾病的风险较高（OR, 2.60；95% CI, 2.51–2.70）。

结论

咳嗽和呼吸急促是 RSV 感染的常见表现。应更多关注婴儿和 HDI 水平较低的地区。目前的研究结果证实 RSV 感染与喘息或复发性喘息疾病之间存在关联。