Defining the Burden of Disease of RSV in the European Union: estimates of RSV-associated hospitalisations in children under 5 years of age. A systematic review and modelling study.

BACKGROUND: No overall estimate of RSV-associated hospitalisations in children under 5 years has been published for the European Union (EU). We aimed to estimate the RSV hospitalisation burden in children under 5 years in EU countries and Norway, by age group.

METHODS: We collated national RSV-associated hospitalisation estimates calculated using linear regression models via the RESCEU project for Denmark, England, Finland, Norway, the Netherlands and Scotland during 2006-2018. Additional estimates were obtained from a systematic review. Using the multiple imputation and nearest neighbour matching methods, we estimated overall RSV-associated hospitalisations and rates in the EU.

RESULTS: Additional estimates for only two countries (France and Spain) were found in the literature. In the EU, an average of 245,244 (95%CI 224,688-265,799) yearly hospital admissions with a respiratory infection per year were associated with RSV in children under the age of 5, with most cases occurring among children aged less than 1 year (75%). Infants aged less than 2 months represented the most affected group (71.6 per 1,000 children; 66.6-76.6).

CONCLUSION: Our findings will help support decisions regarding prevention efforts and represent an important benchmark to understand changes in the RSV burden following the introduction of RSV immunisation programs in Europe.