Estimation of the Timing and Intensity of Reemergence of Respiratory Syncytial Virus Following the COVID-19 Pandemic in the US.
Estimation of the Timing and Intensity of Reemergence of Respiratory Syncytial Virus Following the COVID-19 Pandemic in the US.
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DOI：
10.1001/jamanetworkopen.2021.41779
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发表时间：
2021-12-01
影响因子：
13.8
通讯作者：
Weinberger DM
中科院分区：
文献类型：
--
作者：
Zheng Z;Pitzer VE;Shapiro ED;Bont LJ;Weinberger DM
2019冠状病毒病大流行后，与呼吸道合胞病毒（RSV）疫情复发的时间和强度相关的因素有哪些？在这项模拟1945万人的模拟建模研究中，外部来源的病毒传入与2021年春夏疫情相关。预计2021年和2022年再次出现的RSV疫情将比典型的RSV季节更加严重，影响更广泛年龄范围的患者。这些发现表明，重新出现的RSV流行的时间和强度可能与通常的RSV季节不同，这取决于缓解措施的持续时间和从其他地区引入病毒的程度。这项模拟建模研究考察了缓解策略、母源性免疫持续时间和外部感染输入与美国COVID-19大流行后再次出现的呼吸道合胞病毒流行的关联。呼吸道合胞病毒（RSV）是幼儿住院的主要原因。由于2019冠状病毒病大流行采取预防措施，RSV于二零二零年基本消失。估计RSV重新出现的时间和强度以及受影响的年龄组对于规划预防性抗体的管理和预测医院能力至关重要。检查不同因素（包括缓解策略、母源性免疫持续时间和外部感染输入）与重新出现的RSV流行动态的相关性。这项模拟建模研究使用数学模型重现了2019冠状病毒病大流行前纽约和加州RSV的年度流行情况。对这些模型进行了修改，以预测2020年至2025年在不同情景下SARS-CoV-2缓解措施的不同严格程度下RSV流行的轨迹。模拟还评估了可能影响RSV流行病再次出现的因素，包括从州外来源引入病毒和婴儿经胎盘获得性免疫力下降。使用拟合到科罗拉多和佛罗里达相似住院数据集的参数的模型分别用于说明两年期RSV流行和全年RSV循环人群中的这些关联。于二零二一年二月至十月进行统计分析。本研究的主要结局定义为整个人群中每月RSV住院的估计数量。次要结局包括5岁以下儿童住院的年龄分布、任何RSV感染的发生率和RSV下呼吸道感染的发生率。在1945万人的模拟人群中，外部来源的病毒传入与2021年春夏疫情的出现有关。2021年春夏疫情强度与随后冬季疫情强度之间存在权衡。在1岁以下儿童中，2021年和2022年RSV季节的RSV住院率估计为每年每100 000名儿童707例，而典型RSV季节为每年每100 000名儿童355例。本次模拟建模研究发现，外来病毒传入与2021年春夏疫情相关。这些发现表明，儿科部门应警惕未来季节的大规模RSV疫情，其强度可能取决于该地区春季和夏季流行的规模。建议在预防管理和医院能力管理方面加强监测。
What are the factors associated with the timing and intensity of reemergent respiratory syncytial virus (RSV) epidemics following the COVID-19 pandemic? In this simulation modeling study of a simulated population of 19.45 million people, virus introduction from external sources was associated with the spring and summer epidemics in 2021. Reemergent RSV epidemics in 2021 and 2022 were projected to be more intense and to affect patients in a broader age range than in typical RSV seasons. These findings suggest that the timing and intensity of reemergent RSV epidemics might be different from the usual RSV season, depending on the duration of mitigation measures and the extent of virus introduction from other regions. This simulation modeling study examines the association of mitigation strategies, duration of maternal-derived immunity, and importation of external infections with reemergent respiratory syncytial virus epidemics following the COVID-19 pandemic in the US. Respiratory syncytial virus (RSV) is a leading cause of hospitalizations in young children. RSV largely disappeared in 2020 owing to precautions taken because of the COVID-19 pandemic. Estimating the timing and intensity of the reemergence of RSV and the age groups affected is crucial for planning for the administration of prophylactic antibodies and anticipating hospital capacity. To examine the association of different factors, including mitigation strategies, duration of maternal-derived immunity, and importation of external infections, with the dynamics of reemergent RSV epidemics. This simulation modeling study used mathematical models to reproduce the annual epidemics of RSV before the COVID-19 pandemic in New York and California. These models were modified to project the trajectory of RSV epidemics from 2020 to 2025 under different scenarios with varying stringency of mitigation measures for SARS-CoV-2. Simulations also evaluated factors likely to affect the reemergence of RSV epidemics, including introduction of the virus from out-of-state sources and decreased transplacentally acquired immunity in infants. Models using parameters fitted to similar inpatient data sets from Colorado and Florida were used to illustrate these associations in populations with biennial RSV epidemics and year-round RSV circulation, respectively. Statistical analysis was performed from February to October 2021. The primary outcome of this study was defined as the estimated number of RSV hospitalizations each month in the entire population. Secondary outcomes included the age distribution of hospitalizations among children less than 5 years of age, incidence of any RSV infection, and incidence of RSV lower respiratory tract infection. Among a simulated population of 19.45 million people, virus introduction from external sources was associated with the emergence of the spring and summer epidemic in 2021. There was a tradeoff between the intensity of the spring and summer epidemic in 2021 and the intensity of the epidemic in the subsequent winter. Among children 1 year of age, the estimated incidence of RSV hospitalizations was 707 per 100 000 children per year in the 2021 and 2022 RSV season, compared with 355 per 100 000 children per year in a typical RSV season. This simulation modeling study found that virus introduction from external sources was associated with the spring and summer epidemics in 2021. These findings suggest that pediatric departments should be alert to large RSV outbreaks in the coming seasons, the intensity of which could depend on the size of the spring and summer epidemic in that location. Enhanced surveillance is recommended for both prophylaxis administration and hospital capacity management.
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DOI：
10.1056/nejmoa0804877
发表时间：
2009-02-05
期刊：
The New England journal of medicine
影响因子：
--
作者：
Hall CB;Weinberg GA;Iwane MK;Blumkin AK;Edwards KM;Staat MA;Auinger P;Griffin MR;Poehling KA;Erdman D;Grijalva CG;Zhu Y;Szilagyi P
通讯作者：
Szilagyi P
影响因子：
4.4
作者：
Cai W;Tolksdorf K;Hirve S;Schuler E;Zhang W;Haas W;Buda S
通讯作者：
Buda S
影响因子：
6.4
作者：
Chu, Helen Y.;Steinhoff, Mark C.;Englund, Janet A.
通讯作者：
Englund, Janet A.
影响因子：
16.6
作者：
Feehan DM;Mahmud AS
通讯作者：
Mahmud AS
影响因子：
3.7
作者：
Hamilton MA;Calzavara A;Emerson SD;Djebli M;Sundaram ME;Chan AK;Kustra R;Baral SD;Mishra S;Kwong JC
通讯作者：
Kwong JC