Journal Article

Comparison of health care resource utilization among preterm and term infants hospitalized with Human Respiratory Syncytial Virus infections: A systematic review and meta-analysis of retrospective cohort studies

Kengne-Nde, Cyprien, Kenmoe, Sebastien, Modiyinji, Abdou Fatawou, Njouom, Richard, La Rosa, Giuseppina

2020

Overview

Data on the variation in the medical resource utilization rate of Human Respiratory Syncytial Virus (HRSV) infected children by gestational age have recently been made available. This review aimed to determine whether prematurity is independently associated with the use of medical resources in hospitalized children for HRSV infections. We conducted this systematic review on cohort studies published on the medical resources use in preterm and full-term patients hospitalized for confirmed HRSV infections. We searched PubMed, Embase, and Global Index medicus for eligible studies. The standardized mean difference (SMD) and Risk Ratio (RR) with their 95% confidence intervals (95% CI) were estimated as summary statistics with random effects meta-analysis. The overall results were adjusted to the common confounders by stratified analyses. A total of 14 articles (20 studies) were included. Compared to full-term, preterm hospitalized with HRSV infections had more frequent intensive care unit admission (RR = 2.6, 95% CI = 1.9-3.5), increased length of stay in hospital (SMD = 0.6, 95% CI = 0.5-0.8) and intensive care unit (SMD = 0.6, 95% CI = 0.4-0.8) and increased case fatality rate (RR = 6.9, 95% CI = 2.0-23.8). Mechanical ventilation utilization was more frequent in preterm children ≤ 2 years (RR = 15.5, 95% CI = 8.9-26.4) and those who did not receive prophylaxis against HRSV (RR = 15.9, 95% CI = 9.1-27.9)] than in full-term children. No differences were identified in the frequency of emergency department visits, oxygen utilization, and the age at the first HRSV episode between preterm and full-term infants. Regardless of gestational age, preterm infants hospitalized for HRSV infections, especially those ≤ 2 years, have an increased frequency of use of health resources and poor outcomes compared to full-term infants. HRSV vaccine development programs for pregnant women should be accelerated. Review registration PROSPERO, CRD42019124375.

• Publisher: Public Library of Science,Public Library of Science (PLoS)
• Subject: Age / Analysis / Bias / Birth weight / Child Health Services - statistics & numerical data / Children / Citation management software / Classification / Clinical trials / Cohort analysis / Confidence intervals / Cross infection / Delivery of Health Care - statistics & numerical data / Disease prevention / Emergency medical care / Emergency medical services / Gestational Age / Health aspects / Health care / Hospital patients / Hospitalization - statistics & numerical data / Humans / Infant / Infant, Premature / Infant, Premature, Diseases - therapy / Infant, Premature, Diseases - virology / Infants / Infections / Laboratories / Mechanical ventilation / Medical care utilization / Medicine and Health Sciences / Meta-analysis / Multiple births / Oxygen / Palivizumab / Patient Acceptance of Health Care - statistics & numerical data / Pediatrics / People and Places / Physical Sciences / Pregnancy / Pregnant women / Premature birth / Premature infants / Prophylaxis / Research and Analysis Methods / Resource utilization / Resources utilization / Respiratory syncytial virus / Respiratory Syncytial Virus Infections - therapy / Respiratory Syncytial Virus Infections - virology / Respiratory Syncytial Virus, Human - isolation & purification / Retrospective Studies / Statistical analysis / Studies / Systematic review / Utilization / Vaccine development / Vaccines / Ventilation / Virology / Virus diseases / Viruses