Impact of Respiratory Viral Codetections on RSV Disease Burden in Young Children in Primary Care

BACKGROUND: Young children with respiratory syncytial virus (RSV) often have viral coinfections. This study assessed the impact of respiratory viral codetections on RSV disease burden in children < 5 years and whether this varies by specific codetected viruses. METHODS: Retrospective analyses were performed using data from the RSV ComNet study prior to implementation of passive immunisation. Children < 5 years with acute respiratory infection (ARI) were eligible for testing for RSV and other viruses (multiplex real-time Polymerase Chain Reaction). Primary care physicians completed a short report on day 1, and parents completed follow-up questionnaires (digital or by phone) on days 14 and 30. Disease burden was measured by healthcare resource utilisation, clinical course, and parental work absence. RESULTS: Of the 2637 children tested, 822 (31%) were RSV-positive, of which 585 (52%) had completed day 1 data. There were 378 (65%) children with RSV monoinfection and 207 (35%) with RSV codetection. Rhinovirus/enterovirus was most frequently codetected (60%). Healthcare resource utilisation, clinical course, and parental work absence did not significantly differ between children with RSV codetection and RSV monoinfection. Hospitalisation rate was 7% (CI: 5%-10%) versus 8% (CI: 5%-13%) and mean duration of illness 11 (CI: 10.6-11.9) versus 12 days (CI: 11.4-13.4), respectively. CONCLUSION: RSV-infections with viral codetections were generally not associated with increased healthcare resource utilisation, symptomatology, or parental work absence in children in primary care, suggesting that viral codetection alongside RSV disease does not impose a greater burden on patients or society. Further research is needed to determine whether specific RSV codetected viruses differentially impact disease burden.