Loss of Health-related Quality of Life Among Hospitalized Children With Respiratory Syncytial Virus and Their Caregivers

BACKGROUND: Respiratory syncytial virus (RSV) is recognized as a major cause of wintertime illness in children. Two forms of immunization to protect infants against severe infection have recently been approved. Information on the effects of infections on health-related quality of life (HRQoL) supports well-informed policy decisions. However, validated HRQoL instruments for infants and young children are lacking. We estimated the short-term impact on HRQoL of RSV infection on children, using a new pediatric instrument, and their caregivers. METHODS: Children ≤36 months of age admitted to a tertiary pediatric hospital with laboratory-confirmed RSV infection were recruited during the 2023/2024 season. HRQoL loss was assessed prospectively using an experimental multiattribute utility tool (EQ-TIPS V2.0) for children and the established EQ-5D-5L for their primary caregivers, from presentation to recovery, allowing the calculation of quality-adjusted life years (QALY) lost. RESULTS: Among 103 families recruited, 97 completed at least 3 questionnaires during the study period. The main domains affected in children were "eating" and "pain" and for primary caregivers, "anxiety/depression" and undertaking "usual activities." The median RSV-associated HRQoL loss for children was 4.7 days [interquartile range (IQR): 4.6-5.1] [12.9 QALY/1000 children (IQR: 12.4-14.1)] and for primary caregivers was 3.1 days (IQR 3.0-3.3) [8.4 QALY/1000 caregivers (IQR: 8.3-9.0)]. CONCLUSIONS: The short-term impact of RSV infection on HRQoL is substantial both for children and their caregivers. Using a HRQoL tool specifically designed for young children delivers higher estimates of loss than previously reported. This study provides important additional information to guide immunization policy recommendations.