title: Social, economic, and health impact of the respiratory syncytial virus: a systematic search.
abstract: BACKGROUND
  Bronchiolitis caused by the respiratory syncytial virus (RSV) and its related complications are common in infants born prematurely, with severe congenital heart disease, or bronchopulmonary dysplasia, as well as in immunosuppressed infants. There is a rich literature on the different aspects of RSV infection with a focus, for the most part, on specific risk populations. However, there is a need for a systematic global analysis of the impact of RSV infection in terms of use of resources and health impact on both children and adults. With this aim, we performed a systematic search of scientific evidence on the social, economic, and health impact of RSV infection.
  
  
  METHODS
  A systematic search of the following databases was performed: MEDLINE, EMBASE, Spanish Medical Index, MEDES-MEDicina in Spanish, Cochrane Plus Library, and Google without time limits. We selected 421 abstracts based on the 6,598 articles identified. From these abstracts, 4 RSV experts selected the most relevant articles. They selected 65 articles. After reading the full articles, 23 of their references were also selected. Finally, one more article found through a literature information alert system was included.
  
  
  RESULTS
  The information collected was summarized and organized into the following topics: 1. Impact on health (infections and respiratory complications, mid- to long-term lung function decline, recurrent wheezing, asthma, other complications such as otitis and rhino-conjunctivitis, and mortality; 2. Impact on resources (visits to primary care and specialists offices, emergency room visits, hospital admissions, ICU admissions, diagnostic tests, and treatments); 3. Impact on costs (direct and indirect costs); 4. Impact on quality of life; and 5. Strategies to reduce the impact (interventions on social and hygienic factors and prophylactic treatments).
  
  
  CONCLUSIONS
  We concluded that 1. The health impact of RSV infection is relevant and goes beyond the acute episode phase; 2. The health impact of RSV infection on children is much better documented than the impact on adults; 3. Further research is needed on mid- and long-term impact of RSV infection on the adult population, especially those at high-risk; 4. There is a need for interventions aimed at reducing the impact of RSV infection by targeting health education, information, and prophylaxis in high-risk populations.
authors.affiliation: Centre of Public Health Research of Valencia-FISABIO, Valencia, Spain. jdiezdomingo@gmail.com.
authors.forename: Javier
authors.initials: J
authors.lastname: Díez-Domingo
authors.affiliation: Division of Pediatric Respiratory Medicine, Hospital Universitario Donostia-Instituto Biodonostia, San Sebastián, Spain. gonpeya@neumoped.org.|Biomedical Research Centre Network for Respiratory Diseases (CIBERES), San Sebastián, Spain. gonpeya@neumoped.org.|Department of Pediatrics, University of the Basque Country (UPV/EHU), San Sebastián, Spain. gonpeya@neumoped.org.
authors.forename: Eduardo G
authors.initials: EG
authors.lastname: Pérez-Yarza
authors.affiliation: National Center of Microbiology and CIBER of Respiratory Diseases, Instituto de Salud Carlos III, Madrid, Spain. jmelero@isciii.es.
authors.forename: José A
authors.initials: JA
authors.lastname: Melero
authors.affiliation: Neonatology Division, Hospital General Universitario Gregorio Marañón, Madrid, Spain. msluna@salud.madrid.org.
authors.forename: Manuel
authors.initials: M
authors.lastname: Sánchez-Luna
authors.affiliation: Advanced Techniques in Health Services Research, Madrid, Spain. daguilar@taiss.com.
authors.forename: María Dolores
authors.initials: MD
authors.lastname: Aguilar
authors.affiliation: Advanced Techniques in Health Services Research, Madrid, Spain. ablasco@taiss.com.
authors.forename: Antonio Javier
authors.initials: AJ
authors.lastname: Blasco
authors.affiliation: Advanced Techniques in Health Services Research, Madrid, Spain. nalfaro@taiss.com.
authors.forename: Noelia
authors.initials: N
authors.lastname: Alfaro
authors.affiliation: Advanced Techniques in Health Services Research, Madrid, Spain. plazaro@taiss.com.
authors.forename: Pablo
authors.initials: P
authors.lastname: Lázaro
mesh_terms: D001249:Asthma / Q000150:complications; D002675:Child, Preschool; D005260:Female; D014943:Global Health; D017048:Health Care Costs; D006266:Health Education; D006630:Hispanic or Latino; D006760:Hospitalization / Q000191:economics; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D009819:Office Visits / Q000191:economics; D011788:Quality of Life; D018357:Respiratory Syncytial Virus Infections / Q000150:complications / Q000191:economics / Q000517:prevention & control*; D012136:Respiratory Syncytial Viruses / Q000276:immunology