2023年浙江省南部地区住院儿童人呼吸道合胞病毒感染疾病负担研究

Study on the disease burden of hospitalized children with human respiratory syncytial virus infection in southern Zhejiang Province in 2023

目的 了解浙江省南部地区2023年≤5岁儿童人呼吸道合胞病毒(human respiratory syncytial virus,HRSV)感染住院病例的疾病负担。方法 收集2023年1月1日-5月31日,浙江省两家医院实验室检测确诊为HRSV的≤5岁住院儿童的诊疗资料,分析疾病负担以及发生肺炎的影响因素。结果 本次研究共纳入HRSV感染住院病例269例。肺炎病例232例(86.25%)。全部病例的住院费用中位数为4 326.21(IQR:3 281.74~5 599.92)元;住院天数中位数为6 (IQR:4~7) d。0~<1岁儿童病例住院费用(5 429.46元vs. 4 056.96元)和住院天数(6 d vs. 5 d)高于其他年龄组,差异有统计学意义(t=4.852,P<0.01;t=2.618,P=0.010);肺炎组住院费用(4 212.49元vs. 4 052.31元)和住院天数(6 d vs.5 d)高于非肺炎组,差异有统计学意义(t=3.704, P=0.031;t=2.940, P=0.040);混合感染住院费用(4 806.89元vs. 4 051.92元)和住院天数(6 d vs.5 d)高于单一感染,差异有统计学意义(t=3.538,P<0.01;t=4.270, P<0.01)。剖宫产(OR=12.72, 95%CI:5.08~31.90)、低出生体质量(t=-3.074, P=0.002)和入院延迟(t=4.880, P<0.01)为HRSV感染住院儿童发生肺炎的危险因素。结论 2023年浙江省南部地区0~<1岁HRSV感染患儿具有较重的疾病负担,混合感染、剖宫产、出生时低体质量以及入院延迟可引起肺炎疾病负担增加。

Objective To understand the disease burden of hospitalized cases of human respiratory syncytial virus(HRSV)infection in children aged≤5 years in the southern region of Zhejiang Province in 2023.Methods Collect diagnosis and treatment data of≤5-year-old hospitalized children diagnosed with HRSV through laboratory testing in two hospitals in Zhejiang Province from January 1 to May 31,2023,and analyze the disease burden of different population characteristics and risk factors for pneumonia.Results A total of 269 hospitalized cases of HRSV infection were included in this study,with pneumonia cases accounted for 232(86.25%).The median hospitalization cost for all cases was 4326.21[interquartile range(IQR):3281.74-5599.92]yuan,and the median length of hospital stay was 6(IQR:4-7)d.The 0-<1 year group had higher hospitalization costs(5429.46 yuan vs.4056.96 yuan)and longer hospital stays(6 d vs.5 d)compared to other age groups,with statistical significance(t=4.852,P<0.01;t=2.618,P=0.010).Pneumonia cases had higher costs(4212.49 yuan vs.4052.31 yuan)and longer hospital stays(6 d vs.5 d)compared to non-pneumonia cases,with statistical significance(t=3.704,P=0.031;t=2.940,P=0.040),and mixed infections had higher costs(4806.89 yuan vs.4051.92 yuan)and longer hospital stays(6 d vs.5 d)compared to single infections,with statistical significance(t=3.538,P<0.001;t=4.270,P<0.01).Cesarean section(OR=12.72,95%CI:5.08-31.90),low birth weight(t=−3.074,P=0.002),and delayed hospital admission(t=4.880,P<0.01)were risk factors for pneumonia in HRSV-infected hospitalized children.Conclusions Children under one-year-old with HRSV infection in the southern region of Zhejiang Province in 2023 have a heavy disease burden,and mixed infections,cesarean section,low birth weight,and delayed admission were identified as risk factors for increasing the burden of HRSV.