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Clinical Characteristics and Direct Medical Cost of Respiratory Syncytial Virus Infection in Children Hospitalized in Suzhou, China

Zhang, Tao PhD*; Zhu, Qiuli Msc*; Zhang, Xuelan MD; Ding, Yunfang MD; Steinhoff, Mark MD; Black, Steven MD; Zhao, Genming PhD*

The Pediatric Infectious Disease Journal: April 2014 - Volume 33 - Issue 4 - p 337–341
doi: 10.1097/INF.0000000000000102
Original Studies

Background: There have been few studies on children hospitalized with respiratory syncytial virus (RSV) published from mainland China. We performed a retrospective review of medical charts to describe the epidemiology, clinical features and direct medical cost of laboratory-proven RSV children hospitalized in Suzhou, China.

Methods: Testing is routine for RSV for children admitted to the respiratory ward at Suzhou University Children’s Hospital. We performed a retrospective study on children with documented RSV infection hospitalized at Suzhou University Children Hospital during 2005–2009 using a structured chart review instrument.

Results: A total of 2721 hospitalized children (15.0% of those tested) were positive by immunofluorescent assay for RSV during 2005–2009, and 64.0% of them were male. Eighty-seven percentage of the RSV-infected children were 2 years old and younger, and 56.6% were ≤6 months of age. The median length of hospital stay was 8 days. Of the RSV-infected children, 92.5% developed pneumonia and 21.8% experienced wheezing. In total, 49 (5.1%) of RSV-positive children were transferred to the ICU. Children ≤6 months old and who had congenital heart disease had higher risk of severe RSV disease. The mean cost of each RSV-related hospitalization was US$571.8 (US$909.6 for children referred to ICU and US$565.4 for those cared for on the wards). Multivariable logistic regression showed that compared with the ≤6 months children, those aged >6 months old had higher hospitalization cost; children with respiratory distress or with chronic lung diseases tended to have higher hospitalization costs than others.

Conclusions: RSV infections and severe RSV diseases mostly occurred in early infancy. The direct medical cost was high relative to family income. Effective strategies of RSV immunization of young children in China may be beneficial in addressing this disease burden.

From the *Department of Epidemiology, School of Public Health, Fudan University, Key Laboratory of Public Health Safety, Ministry of Education, Shanghai; Suzhou University Affiliated Children’s Hospital, Jiangsu Province, People’s Republic of China; and Center for Global Health, Cincinnati Children’s Hospital, Cincinnati, OH.

Accepted for publication September 20, 2013

This research was partly funded by SINO-US collaborative program on Emerging and Re-emerging Infectious Diseases, a grant from the US CDC influenza Branch, a grant from the National Natural Science Foundation of China (81102166) and Shanghai Leading Academic Discipline Project (12GWZX0101). The funders had no role in study design, data collection and analysis, decision to publish or preparation of the article. The authors have no funding or conflicts of interest to disclose.

Address for correspondence: Genming Zhao, PhD, School of Public Health, Fudan University, P.O. Box 289, No.138 Yi Xue Yuan Road, Shanghai 200032, China. E-mail:

© 2014 by Lippincott Williams & Wilkins, Inc.