Costello J, Colosia A, Kato K, Bertzos K, McQuarrie K. Systematic literature review of the signs and symptoms of respiratory syncytial virus in young children. Poster presented at the International Society for Influenza and other Respiratory Virus Diseases (ISIRV) 2022 Conference; September 26, 2022. Belfast, United Kingdom.

BACKGROUND: Respiratory syncytial virus (RSV) is the most frequent cause of lower respiratory tract infection in young children and a leading cause of hospitalization. Very young children cannot reliably report their RSV symptoms, so clinicians rely on caregivers to identify signs and symptoms of RSV. A systematic literature review (SLR) was conducted to document caregiver-reported RSV signs and symptoms (CG-RSV S&S) and clinician-reported RSV signs and symptoms (Clin-RSV S&S) in children of different age groups and treatment settings (hospital and community).

METHODS: Two researchers independently reviewed published articles from 2011 to 2021 from electronic database searches (MEDLINE, MEDLINE In-Process, Embase, PsycINFO, and Cochrane Library), conference abstracts from the past 3 years, and bibliographies of relevant SLRs to identify CG- and Clin-RSV S&S in children <5 years old. Another outcome of interest included hospital length of stay (LOS)

RESULTS: In total, 37 studies were reviewed, including those presenting CG-RSV S&S (n=6), Clin-RSV S&S (n=25), and hospital LOS (n=13). Studies differed by age group, treatment setting, and geographical location. The RSV S&S commonly reported (in ≥40% of children) by both caregivers and clinicians across age groups and treatment settings were nasal discharge/congestion, cough, shortness of breath, fever, and feeding abnormalities. Caregivers also commonly reported vomiting (hospital setting only) and clinicians also commonly reported wheezing. There were no clear patterns of CG-RSV S&S by age or setting. Clinicians reported fever more frequently with increased age in hospitalized children. Median hospital LOS (9 studies) was 4-5 days regardless of age group but varied by country.

CONCLUSION: The most commonly reported RSV S&S were consistent across caregivers and clinicians (nasal discharge/congestion, cough, shortness of breath, fever, feeding abnormalities). Clinicians also commonly reported wheezing; caregivers possibly reported this symptom differently (e.g., as breathing difficulty). No notable differences by age were found for CG- and Clin-reported RSV S&S in the community setting; for hospitalized patients, clinicians reported higher frequency of fever with increased age.

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