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.
