Expert consensus on the diagnosis, treatment, and prevention of respiratory syncytial virus infections in children

doi:10.1007/s12519-023-00777-9

Review

. 2024 Jan;20(1):11-25.

doi: 10.1007/s12519-023-00777-9. Epub 2023 Dec 8.

Expert consensus on the diagnosis, treatment, and prevention of respiratory syncytial virus infections in children

Xian-Li Zhang¹, Xi Zhang², Wang Hua¹, Zheng-De Xie³, Han-Min Liu⁴, Hai-Lin Zhang⁵, Bi-Quan Chen⁶, Yuan Chen⁷, Xin Sun⁸, Yi Xu⁹, Sai-Nan Shu¹⁰, Shun-Ying Zhao¹¹, Yun-Xiao Shang¹², Ling Cao¹³, Yan-Hui Jia¹, Luo-Na Lin¹, Jiong Li¹⁴, Chuang-Li Hao¹⁵, Xiao-Yan Dong¹⁶, Dao-Jiong Lin¹⁷, Hong-Mei Xu¹⁸, De-Yu Zhao¹⁹, Mei Zeng²⁰, Zhi-Min Chen²¹, Li-Su Huang²²

Affiliations

¹ Department of Infectious Disease, Children's Hospital, Zhejiang University School of Medicine, 3333 Binsheng Road, Binjiang District, Hangzhou, 310052, China.
² Clinical Research Unit, Xin Hua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China.
³ Beijing Pediatric Research Institute, Beijing Children's Hospital, Capital Medical University, Beijing, China.
⁴ Department of Pediatric Pulmonology, West China Second University Hospital, Sichuan University, Chengdu, China.
⁵ Department of Pediatric Pulmonology, the Second Affiliated Hospital & Yuying Children's Hospital, Wenzhou Medical University, Wenzhou, China.
⁶ Department of Infectious Disease, Anhui Provincial Children's Hospital, Hefei, China.
⁷ Department of Pediatrics, the Second Hospital of Hebei Medical University, Shijiazhuang, China.
⁸ Department of Pediatrics, Xijing Hospital, the Fourth Military Medical University, Xi'an, China.
⁹ Department of Infectious Disease, Guangzhou Women and Children's Medicine Center, Guangzhou Medicine University, Guangzhou, China.
¹⁰ Department of Pediatrics, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
¹¹ Department of Respiratory Disease, Beijing Children's Hospital, Capital Medical University, Beijing, China.
¹² Department of Pediatric Respiratory, Shengjing Hospital of China Medical University, Shenyang, China.
¹³ Respiratory Department, Children's Hospital Affiliated to Capital Institute of Pediatrics, Beijing, China.
¹⁴ Department of Clinical Epidemiology, Aarhus University, Aarhus, Denmark.
¹⁵ Department of Respirology, Children's Hospital of Soochow University, Suzhou, China.
¹⁶ Department of Respiratory, Children's Hospital of Shanghai, Children's Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China.
¹⁷ Department of Infectious Disease, Hainan Women and Children's Medical Center, Haikou, China.
¹⁸ Department of Infectious Disease, Children's Hospital of Chongqing Medical University, Chongqing, China.
¹⁹ Department of Respiratory, Children's Hospital of Nanjing Medical University, Nanjing, China.
²⁰ Department of Infectious Diseases, Children's Hospital of Fudan University, 399 Wanyuan Road, Minhang District, Shanghai, 201102, China. zengmeigao@aliyun.com.
²¹ Department of Respiratory Diseases, Children's Hospital, Zhejiang University School of Medicine, 3333 Binsheng Road, Binjiang District, Hangzhou, 310052, China. zmchen@zju.edu.cn.
²² Department of Infectious Disease, Children's Hospital, Zhejiang University School of Medicine, 3333 Binsheng Road, Binjiang District, Hangzhou, 310052, China. lisuhuang@zju.edu.cn.

PMID: 38064012
PMCID: PMC10828005
DOI: 10.1007/s12519-023-00777-9

Review

Expert consensus on the diagnosis, treatment, and prevention of respiratory syncytial virus infections in children

Xian-Li Zhang et al. World J Pediatr. 2024 Jan.

. 2024 Jan;20(1):11-25.

doi: 10.1007/s12519-023-00777-9. Epub 2023 Dec 8.

Authors

Affiliations

¹ Department of Infectious Disease, Children's Hospital, Zhejiang University School of Medicine, 3333 Binsheng Road, Binjiang District, Hangzhou, 310052, China.
² Clinical Research Unit, Xin Hua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China.
³ Beijing Pediatric Research Institute, Beijing Children's Hospital, Capital Medical University, Beijing, China.
⁴ Department of Pediatric Pulmonology, West China Second University Hospital, Sichuan University, Chengdu, China.
⁵ Department of Pediatric Pulmonology, the Second Affiliated Hospital & Yuying Children's Hospital, Wenzhou Medical University, Wenzhou, China.
⁶ Department of Infectious Disease, Anhui Provincial Children's Hospital, Hefei, China.
⁷ Department of Pediatrics, the Second Hospital of Hebei Medical University, Shijiazhuang, China.
⁸ Department of Pediatrics, Xijing Hospital, the Fourth Military Medical University, Xi'an, China.
⁹ Department of Infectious Disease, Guangzhou Women and Children's Medicine Center, Guangzhou Medicine University, Guangzhou, China.
¹⁰ Department of Pediatrics, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
¹¹ Department of Respiratory Disease, Beijing Children's Hospital, Capital Medical University, Beijing, China.
¹² Department of Pediatric Respiratory, Shengjing Hospital of China Medical University, Shenyang, China.
¹³ Respiratory Department, Children's Hospital Affiliated to Capital Institute of Pediatrics, Beijing, China.
¹⁴ Department of Clinical Epidemiology, Aarhus University, Aarhus, Denmark.
¹⁵ Department of Respirology, Children's Hospital of Soochow University, Suzhou, China.
¹⁶ Department of Respiratory, Children's Hospital of Shanghai, Children's Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China.
¹⁷ Department of Infectious Disease, Hainan Women and Children's Medical Center, Haikou, China.
¹⁸ Department of Infectious Disease, Children's Hospital of Chongqing Medical University, Chongqing, China.
¹⁹ Department of Respiratory, Children's Hospital of Nanjing Medical University, Nanjing, China.
²⁰ Department of Infectious Diseases, Children's Hospital of Fudan University, 399 Wanyuan Road, Minhang District, Shanghai, 201102, China. zengmeigao@aliyun.com.
²¹ Department of Respiratory Diseases, Children's Hospital, Zhejiang University School of Medicine, 3333 Binsheng Road, Binjiang District, Hangzhou, 310052, China. zmchen@zju.edu.cn.
²² Department of Infectious Disease, Children's Hospital, Zhejiang University School of Medicine, 3333 Binsheng Road, Binjiang District, Hangzhou, 310052, China. lisuhuang@zju.edu.cn.

PMID: 38064012
PMCID: PMC10828005
DOI: 10.1007/s12519-023-00777-9

Erratum in

Correction to: Expert consensus on the diagnosis, treatment, and prevention of respiratory syncytial virus infections in children.
Zhang XL, Zhang X, Hua W, Xie ZD, Liu HM, Zhang HL, Chen BQ, Chen Y, Sun X, Xu Y, Shu SN, Zhao SY, Shang YX, Cao L, Jia YH, Lin LN, Li J, Hao CL, Dong XY, Lin DJ, Xu HM, Zhao DY, Zeng M, Chen ZM, Huang LS. Zhang XL, et al. World J Pediatr. 2024 Feb 25. doi: 10.1007/s12519-023-00792-w. Online ahead of print. World J Pediatr. 2024. PMID: 38402517 No abstract available.

Abstract

Background: Respiratory syncytial virus (RSV) is the leading global cause of respiratory infections and is responsible for about 3 million hospitalizations and more than 100,000 deaths annually in children younger than 5 years, representing a major global healthcare burden. There is a great unmet need for new agents and universal strategies to prevent RSV infections in early life. A multidisciplinary consensus development group comprising experts in epidemiology, infectious diseases, respiratory medicine, and methodology aims to develop the current consensus to address clinical issues of RSV infections in children.

Data sources: The evidence searches and reviews were conducted using electronic databases, including PubMed, Embase, Web of Science, and the Cochrane Library, using variations in terms for "respiratory syncytial virus", "RSV", "lower respiratory tract infection", "bronchiolitis", "acute", "viral pneumonia", "neonatal", "infant" "children", and "pediatric".

Results: Evidence-based recommendations regarding diagnosis, treatment, and prevention were proposed with a high degree of consensus. Although supportive care remains the cornerstone for the management of RSV infections, new monoclonal antibodies, vaccines, drug therapies, and viral surveillance techniques are being rolled out.

Conclusions: This consensus, based on international and national scientific evidence, reinforces the current recommendations and integrates the recent advances for optimal care and prevention of RSV infections. Further improvements in the management of RSV infections will require generating the highest quality of evidence through rigorously designed studies that possess little bias and sufficient capacity to identify clinically meaningful end points.

Keywords: Consensus prevention; Respiratory syncytial virus; Treatment.

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Conflict of interest statement

Author Zhi-Min Chen is a member of the Editorial Board for World Journal of Pediatrics. The paper was handled by the other Editor and has undergone a rigorous peer review process. Author Zhi-Min Chen was not involved in the journal's review of, or decisions related to, this manuscript. Other authors have no conflict of interest to disclose. No financial or nonfinancial benefits have been received or will be received from any party related directly or indirectly to the subject of this article.

References

1. 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. The Lancet. 2022;399:2047–2064. doi: 10.1016/S0140-6736(22)00478-0. - DOI - PMC - PubMed
1. Shi T, McAllister DA, O’Brien KL, Simoes EAF, Madhi SA, Gessner BD, et al. Global, regional, and national disease burden estimates of acute lower respiratory infections due to respiratory syncytial virus in young children in 2015: a systematic review and modelling study. The Lancet. 2017;390:946–958. doi: 10.1016/S0140-6736(17)30938-8. - DOI - PMC - PubMed
1. Bardsley M, Morbey RA, Hughes HE, Beck CR, Watson CH, Zhao H, et al. Epidemiology of respiratory syncytial virus in children younger than 5 years in England during the COVID-19 pandemic, measured by laboratory, clinical, and syndromic surveillance: a retrospective observational study. Lancet Infect Dis. 2023;23:56–66. doi: 10.1016/S1473-3099(22)00525-4. - DOI - PMC - PubMed
1. Williams TC, Sinha I, Barr IG, Zambon M. Transmission of paediatric respiratory syncytial virus and influenza in the wake of the COVID-19 pandemic. Euro Surveill Bull Eur Sur Mal Transm Eur Commun Dis Bull. 2021;26:2100186. - PMC - PubMed
1. Agha R, Avner JR. Delayed seasonal RSV surge observed during the COVID-19 pandemic. Pediatrics. 2021;148:e2021052089. doi: 10.1542/peds.2021-052089. - DOI - PubMed

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[1] 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. The Lancet. 2022;399:2047–2064. doi: 10.1016/S0140-6736(22)00478-0. - DOI - PMC - PubMed

[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. The Lancet. 2022;399:2047–2064. doi: 10.1016/S0140-6736(22)00478-0. - DOI - PMC - PubMed

[3] Shi T, McAllister DA, O’Brien KL, Simoes EAF, Madhi SA, Gessner BD, et al. Global, regional, and national disease burden estimates of acute lower respiratory infections due to respiratory syncytial virus in young children in 2015: a systematic review and modelling study. The Lancet. 2017;390:946–958. doi: 10.1016/S0140-6736(17)30938-8. - DOI - PMC - PubMed

[4] Shi T, McAllister DA, O’Brien KL, Simoes EAF, Madhi SA, Gessner BD, et al. Global, regional, and national disease burden estimates of acute lower respiratory infections due to respiratory syncytial virus in young children in 2015: a systematic review and modelling study. The Lancet. 2017;390:946–958. doi: 10.1016/S0140-6736(17)30938-8. - DOI - PMC - PubMed

[5] Bardsley M, Morbey RA, Hughes HE, Beck CR, Watson CH, Zhao H, et al. Epidemiology of respiratory syncytial virus in children younger than 5 years in England during the COVID-19 pandemic, measured by laboratory, clinical, and syndromic surveillance: a retrospective observational study. Lancet Infect Dis. 2023;23:56–66. doi: 10.1016/S1473-3099(22)00525-4. - DOI - PMC - PubMed

[6] Bardsley M, Morbey RA, Hughes HE, Beck CR, Watson CH, Zhao H, et al. Epidemiology of respiratory syncytial virus in children younger than 5 years in England during the COVID-19 pandemic, measured by laboratory, clinical, and syndromic surveillance: a retrospective observational study. Lancet Infect Dis. 2023;23:56–66. doi: 10.1016/S1473-3099(22)00525-4. - DOI - PMC - PubMed

[7] Williams TC, Sinha I, Barr IG, Zambon M. Transmission of paediatric respiratory syncytial virus and influenza in the wake of the COVID-19 pandemic. Euro Surveill Bull Eur Sur Mal Transm Eur Commun Dis Bull. 2021;26:2100186. - PMC - PubMed

[8] Williams TC, Sinha I, Barr IG, Zambon M. Transmission of paediatric respiratory syncytial virus and influenza in the wake of the COVID-19 pandemic. Euro Surveill Bull Eur Sur Mal Transm Eur Commun Dis Bull. 2021;26:2100186. - PMC - PubMed

[9] Agha R, Avner JR. Delayed seasonal RSV surge observed during the COVID-19 pandemic. Pediatrics. 2021;148:e2021052089. doi: 10.1542/peds.2021-052089. - DOI - PubMed

[10] Agha R, Avner JR. Delayed seasonal RSV surge observed during the COVID-19 pandemic. Pediatrics. 2021;148:e2021052089. doi: 10.1542/peds.2021-052089. - DOI - PubMed

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Expert consensus on the diagnosis, treatment, and prevention of respiratory syncytial virus infections in children

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Expert consensus on the diagnosis, treatment, and prevention of respiratory syncytial virus infections in children

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