Systematic review and meta-analysis of the prevalence of common respiratory viruses in children < 2 years with bronchiolitis in the pre-COVID-19 pandemic era

  1. Sebastien Kenmoe
  2. Cyprien Kengne-Nde
  3. Jean Thierry Ebogo-Belobo
  4. Donatien Serge Mbaga
  5. Abdou Fatawou Modiyinji
  6. Richard Njouom

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Abstract

The advent of genome amplification assays has allowed description of new respiratory viruses and to reconsider the role played by certain respiratory viruses in bronchiolitis. This systematic review and meta-analysis was initiated to clarify the prevalence of respiratory viruses in children with bronchiolitis in the pre-COVID-19 pandemic era.

Methods

We performed an electronic search through Pubmed and Global Index Medicus databases. We included observational studies reporting the detection rate of common respiratory viruses in children with bronchiolitis using molecular assays. Data was extracted and the quality of the included articles was assessed. We conducted sensitivity, subgroups, publication bias, and heterogeneity analyses using a random effect model.

Results

The final meta-analysis included 51 studies. Human respiratory syncytial virus (HRSV) was largely the most commonly detected virus 59.2%; 95% CI [54.7; 63.6]). The second predominant virus was Rhinovirus (RV) 19.3%; 95% CI [16.7; 22.0]) followed by Human bocavirus (HBoV) 8.2%; 95% CI [5.7; 11.2]). Other reported viruses included Human Adenovirus (HAdV) 6.1%; 95% CI [4.4; 8.0]), Human Metapneumovirus (HMPV) 5.4%; 95% CI [4.4; 6.4]), Human Parainfluenzavirus (HPIV) 5.4%; 95% CI [3.8; 7.3]), Influenza 3.2%; 95% CI [2.2; 4.3], Human Coronavirus (HCoV) 2.9%; 95% CI [2.0; 4.0]), and Enterovirus (EV) 2.9%; 95% CI [1.6; 4.5]). HRSV was the predominant virus involved in multiple detection and most codetections were HRSV + RV 7.1%, 95% CI [4.6; 9.9]) and HRSV + HBoV 4.5%, 95% CI [2.4; 7.3]).

Conclusions

The present study has shown that HRSV is the main cause of bronchiolitis in children, we also have Rhinovirus, and Bocavirus which also play a significant role. Data on the role played by SARS-CoV-2 in children with acute bronchiolitis is needed.

Review registration

PROSPERO, CRD42018116067 .

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  1. Version published to 10.1371/journal.pone.0242302
  2. ScreenIT

    SciScore for 10.1101/2020.08.28.20183681: (What is this?)

    Please note, not all rigor criteria are appropriate for all manuscripts.

    Table 1: Rigor

    Institutional Review Board Statementnot detected.
    Randomizationnot detected.
    Blindingnot detected.
    Power Analysisnot detected.
    Sex as a biological variableThe information gathered included: the name of the author, the year of publication, the design of the study, the country, the WHO regions, the sampling method, the period of the study, the definition of bronchiolitis, the exclusion criteria, the sample type, the viral detection assay, age range, mean or median age, percentage of male gender, number of samples tested for each virus, number of positives for each virus, and the data of the evaluation of the study quality.

    Table 2: Resources

    Software and Algorithms
    SentencesResources
    The search strategy applied in Pubmed is available in S2 Table.
    Pubmed
    suggested: (PubMed, RRID:SCR_004846)

    Results from OddPub: We did not detect open data. We also did not detect open code. Researchers are encouraged to share open data when possible (see Nature blog).

    Results from LimitationRecognizer: We detected the following sentences addressing limitations in the study:
    A second limitation in our study is that we did not consider multiple other factors that could further explain the variability in the prevalence of viruses in bronchiolitis such as comorbidities, anti-HRSV prophylaxis and the number of virus types sought in studies for multi-species such as mild HCoV and HPIV. It is also known that bronchiolitis case definitions show great variability in terms of age limit and constellation of clinical symptoms according to geographic area and time that we did not consider in this study.79,123 Beyond these limitations, this systematic review and meta-analysis reports the prevalence recorded over two decades of a large panel of common respiratory viruses currently involved in bronchiolitis. We report the data obtained in almost all WHO regions from the PCR that currently represent the most commonly used assays in diagnosing respiratory viruses, which is another major asset of this work. We also have conducted multiple sensitivity analyses that further strengthen the robustness of our results on multiple important aspects such as children hospitalization, age range, and design and quality of studies. The results of this systematic review and meta-analysis further underline the strong majority of HRSV in children with bronchiolitis. This work also highlights the importance of RV and the newly described HMPV and HBoV in children with bronchiolitis. The HRSV + RV and HRSV + HBoV co-detections were the most frequent in children with bronchiolitis. ...

    Results from TrialIdentifier: No clinical trial numbers were referenced.

    Results from Barzooka: We did not find any issues relating to the usage of bar graphs.

    Results from JetFighter: We did not find any issues relating to colormaps.

    Results from rtransparent:
    • Thank you for including a conflict of interest statement. Authors are encouraged to include this statement when submitting to a journal.
    • Thank you for including a funding statement. Authors are encouraged to include this statement when submitting to a journal.
    • No protocol registration statement was detected.

    About SciScore

    SciScore is an automated tool that is designed to assist expert reviewers by finding and presenting formulaic information scattered throughout a paper in a standard, easy to digest format. SciScore checks for the presence and correctness of RRIDs (research resource identifiers), and for rigor criteria such as sex and investigator blinding. For details on the theoretical underpinning of rigor criteria and the tools shown here, including references cited, please follow this link.

  3. Version published to 10.1101/2020.08.28.20183681v1 on medRxiv