31 research outputs found

    Forest plots of the association of age of child RSV hospitalization on asthma risk in each study (color-coded) included in the systematic review for which we could extract summary statistics.

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    Homaira et al. directly compared the incident rate ratio of asthma hospitalization between RSV hospitalization at <3 months and older age categories (i.e., 3 to <6 months, 6 to <12 months, and 12 to ≤24 months). Age <3 months had the lowest risk of asthma hospitalization (incidence rate ratio: 3 to <6 months vs. <3 months, 1.9 [95% CI: 0.1–3.7]; 6 to <12 months vs. <3 months, 4.4 [95% CI: 2.5–7.8]; 12 to ≤24 months vs. <3 months, 3.8 [95% CI: 2.0–7.2]. Wang et al. described first asthma and wheeze admission rates of age ≤ 5 months and 6–23 months, compared to unintentional accident hospitalization in 6 years or older (per 1000 child-years). Muñoz-Quiles et al. compared odds ratio of childhood asthma between RSV hospitalization in age categories and no previous bronchiolitis.</p

    Patient characteristics.

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    *: The number of participants included in the analysis evaluating the association between age at first RSV infection and child asthma inception. (DOCX)</p

    PRISMA 2020 checklist.

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    Identifying child age of RSV infection associated with increased risk of asthma is important for developing asthma prevention strategies. Our systematic review aimed to comprehensively summarize studies of the association between age of RSV infection and childhood asthma risk. The study protocol was pre-registered, and our study report adhered to the Preferred Reporting Items for Systematic Review and Meta-Analysis (PRISMA). Inclusion criteria were prospective and retrospective cohort studies and case-control studies which assessed the association of age of RSV infection before age 2 years and risk of childhood asthma after age two years. Relevant studies were identified through MEDLINE, Embase, Cochrane and International Clinical Trials Registry Platform (ICTRP) from study inception through May 5, 2023. Studies were evaluated with the Quality In Prognosis Studies (QUIPS) tool. From 149 studies screened, five studies (two prospective cohort studies and three retrospective cohort studies) were included in our systematic review, including 47,603 participants. Available studies only assessed age of severe RSV infection and asthma risk. The included studies used different age categories and outcome definitions, and were rated as having high risk of bias. Two studies had sample sizes of less than 300 and did not provide conclusive results related to age of RSV hospitalization and asthma risk. The other three studies reported RSV hospitalization between age 6 months and 23 months compared with age 0–6 months being associated with a higher odds ratio, hazard ratio, or incidence rate ratio of asthma diagnosis/hospitalization. Due to the heterogeneous epidemiological designs, including exposures and outcome ascertainments of the included studies, we could not perform a meta-analysis, or calculate weighted averages of the effect estimates. Our systematic review highlights a major gap in our knowledge about the relationship between age of RSV infection and asthma risk.</div

    Definition of exposure and outcome in five studies of the association of age of RSV hospitalization during the first 2 years of life and childhood asthma risk.

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    Definition of exposure and outcome in five studies of the association of age of RSV hospitalization during the first 2 years of life and childhood asthma risk.</p

    Study characteristics included in the systematic review of age of RSV hospitalization in the first two years of life and asthma risk after age two years.

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    Study characteristics included in the systematic review of age of RSV hospitalization in the first two years of life and asthma risk after age two years.</p

    Ideal conceptual model of the relationship between age of RSV infection and childhood asthma risk (left panel), and the actual model of RSV hospitalization and childhood asthma risk (right panel) of our systematic review.

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    * RSV = respiratory syncytial virus. Our original conceptual model was ‘age of RSV infection during the first two years of life’, however, there were no studies of the effect of age of RSV infection during the first two years of life on asthma risk, so we included studies which assessed age of RSV hospitalization instead.</p

    Signaling questions for quality assessment.

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    Identifying child age of RSV infection associated with increased risk of asthma is important for developing asthma prevention strategies. Our systematic review aimed to comprehensively summarize studies of the association between age of RSV infection and childhood asthma risk. The study protocol was pre-registered, and our study report adhered to the Preferred Reporting Items for Systematic Review and Meta-Analysis (PRISMA). Inclusion criteria were prospective and retrospective cohort studies and case-control studies which assessed the association of age of RSV infection before age 2 years and risk of childhood asthma after age two years. Relevant studies were identified through MEDLINE, Embase, Cochrane and International Clinical Trials Registry Platform (ICTRP) from study inception through May 5, 2023. Studies were evaluated with the Quality In Prognosis Studies (QUIPS) tool. From 149 studies screened, five studies (two prospective cohort studies and three retrospective cohort studies) were included in our systematic review, including 47,603 participants. Available studies only assessed age of severe RSV infection and asthma risk. The included studies used different age categories and outcome definitions, and were rated as having high risk of bias. Two studies had sample sizes of less than 300 and did not provide conclusive results related to age of RSV hospitalization and asthma risk. The other three studies reported RSV hospitalization between age 6 months and 23 months compared with age 0–6 months being associated with a higher odds ratio, hazard ratio, or incidence rate ratio of asthma diagnosis/hospitalization. Due to the heterogeneous epidemiological designs, including exposures and outcome ascertainments of the included studies, we could not perform a meta-analysis, or calculate weighted averages of the effect estimates. Our systematic review highlights a major gap in our knowledge about the relationship between age of RSV infection and asthma risk.</div
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