Presentation (CTI)

OBJECTIVES: Respiratory syncytial virus (RSV) is a leading cause of respiratory tract infection in children. While infants are at high risk, RSV remains a considerable health problem beyond infancy. This study aimed to describe RSV and subsequent wheezing burden in toddlers aged 6 to 24 months and their parents.
METHODS: An international cross-sectional survey conducted in the US, UK, Spain and Italy from February to April 2023 enrolled 1032 parents of children under 6 years old. Parents were assigned to the reference group (children never diagnosed with bronchiolitis/RSV, n=600) or to the RSV group (children diagnosed with bronchiolitis/tested RSV-positive between 6 and 24 months, n=432). Multivariable logistic regressions were used to assess the association between RSV and wheezing.
RESULTS: The mean age at RSV diagnosis was 14.6 months and 40% of RSV-infected toddlers were hospitalized. Wheezing odds were 4.2 (95%CI 3.2-5.6, p<0.001) higher in the RSV group than in the reference group. Wheezing-related healthcare visits were significantly more frequent in the RSV group (p<0.05 for all healthcare professionals visited). All types of wheezing-related costs (prescribed, routine, and over-the-counter medications, laboratory analysis and transportation) were reported as significantly higher by RSV-parents (p<0.05 for all). The impact of these costs was moderate to strong for 43% of parents in the RSV group vs 16% in the reference group (p<0.001). Wheezing impact on professional life was reported as moderate to severe by 49% of parents in the RSV group vs 31% in the reference group (p=0.004). Among RSV-parents, 80% missed at least one day of work due to wheezing against 50% in the reference group (p<0.001).
CONCLUSIONS: Wheezing represents a considerable burden for toddlers and their families and appears to be more frequent and more impactful in children with RSV history, affecting notably parents’ finances and professional lives.