Parent's perception of respiratory syncytial virus and subsequent wheezing burden: A multi-country cross-sectional survey

Background: Respiratory Syncytial Virus (RSV) is the leading cause of hospitalization in infants. RSV bronchiolitis is associated with an increased risk of subsequent wheezing. We aimed to document the parents' perception of the link between RSV infection and subsequent wheezing, wheezing-related healthcare and family resources use, and its impact on family daily life. Methods: This cross-sectional online survey enrolled 1200 parents with at least one child ≤6y living in the United States, United Kingdom, Spain, and Italy. Children diagnosed with RSV bronchiolitis before age of 2 years were included in the RSV group, and those never diagnosed with RSV bronchiolitis in the Reference group. Results: The odds of wheezing were 4.5-fold (95%CI 3.5–5.9) higher in the RSV than in the Reference group. The odds increased to 7.7-fold (95%CI 5.4–11.1) among children who were hospitalized, and 9-fold (95%CI 5.1–16.6) among those admitted to pediatric intensive care with RSV bronchiolitis. Similar trends were observed across all countries. In total, 57% of parents reported their child's wheezing to have moderate to severe impact on their emotional well-being, and 53% on their daily life activities and/or social life. 64% of parents reported moderate–severe impact of wheezing on child's quality of sleep and 49% and 46% reported a moderate–severe impact on their children's emotional well-being and physical activities. Conclusions: This survey suggests an association between RSV infection and subsequent wheezing in children across different countries. Wheezing, especially in association with RSV infection, was associated with increased healthcare utilization and costs, and significantly impacted parents' and children daily life.