Table 5. Summary of evidence for lung function associated with RSV infection among within-study population comparisons.
| Outcome | Comparator 1 | Comparator 2 | FU | Study design (no. of studies); Sample size |
Absolute difference (95% CI) | Relative risk (95% CI) |
Certainty of evidence | Conclusion | |
|---|---|---|---|---|---|---|---|---|---|
| Comparator 2 risk | Absolute risk differencea | ||||||||
| Lung function: FEV1 Z-score ranking [-2,-1] | |||||||||
| At-risk with RSV-H vs. at-risk without RSV-H | Prematurity: 32–35 wGA, RSV-H |
Prematurity: 32–35 wGA, No RSV-H |
During 6th y | PC32 (n=1); 243 |
21 per 100 | NS | RR 0.83 (0.45, 1.53) |
Lowb,c |
Little to no difference For forced expiratory volume in one second (Z-score rank of [-2, -1], considered extreme range) during the 6th year of age among children hospitalized with RSV at <12 months |
| Lung function (FEV1 pre-BD, mean % of predicted) | |||||||||
| Not-at-risk population | RSV-H | No RSV-H | 17–20 y; 28–31 y |
PC27,28 (n=2); 202 |
MD -7.63 (-11.35, -3.91) |
N/A | Lowc,d |
Small decrease For forced expiratory volume in one second (mean % of predicted, pre-bronchodilation test) in adulthood (17–31 years of age) among infants with vs. without hospitalization for RSV at age <24 months |
|
| Lung function (FEV1, change in mean % predicted) | |||||||||
| Not-at-risk population | RSV-H | No RSV-H | 17–20 y; 28–31 y |
PC27,28 (n=2); 202 |
MD 0.81 (-0.67, 2.30) |
N/A | Lowc,d |
Little to no difference For forced expiratory volume in one second (change in mean % predicted, pre vs. post-bronchodilation test) in adulthood (17–31 years of age) among infants with vs. without hospitalization for RSV at age <24 months |
|
| Lung function (FVC pre-BD, mean % of predicted) | |||||||||
| Not-at-risk population | RSV-H | No RSV-H | 17–20 y; 28–31 y |
PC27,28 (n=2); 202 |
MD -4.74 (-7.80, -1.67) |
N/A | Lowc,d |
Small decrease For forced vital capacity (mean % of predicted, pre-bronchodilation test) in adulthood (17–31 years of age) among infants with vs. without hospitalization for RSV at age <24 months |
|
| Lung function (FVC, change in mean % predicted) | |||||||||
| Not-at-risk population | RSV-H | No RSV-H | 17–20 y | PC27 (n=1); 74 |
MD 0.60 (-0.67, 1.87) |
N/A | Very lowc,d,e |
Very uncertain For forced vital capacity (change in mean % predicted, pre vs. post-bronchodilation test) in adulthood (17–20 years of age) among infants with vs. without hospitalization for RSV at age <24 months |
|
| Lung function (FEV1/FVC pre-BD, % of predicted) | |||||||||
| Not-at-risk population | RSV-H | No RSV-H | 17–20 y; 28–31 y |
PC27,28 (n=2); 202 |
MD -3.20 (-9.07, 2.67) |
N/A | Very lowb,c,d |
Very uncertain For FEV1/FVC (mean % of predicted, pre-bronchodilation test) in adulthood (17–31 years of age) among infants with vs. without hospitalization for RSV at age <24 months |
|
| Lung function (FEV1/FVC, change in mean % predicted) | |||||||||
| Not-at-risk population | RSV-H | No RSV-H | 17–20 y | PC27 (n=1); 74 |
MD -0.20 (-2.71, 2.31) |
N/A | Very lowb,c,e |
Very uncertain For FEV1/FVC (change in mean % predicted, pre vs. post-bronchodilation test) in adulthood (17–20 years of age) among infants with vs. without hospitalization for RSV at age <24 months |
|
| Lung function (FENO, mean ppb) | |||||||||
| Not-at-risk population | RSV-H | No RSV-H | 17–20 y; 28–31 y |
PC27,28 (n=2); 202 |
MD -1.00 (-14.49, 12.49) |
N/A | Lowc,d |
Little to no difference For fractional exhaled nitric oxide (mean ppb) in adulthood (17–31 years of age) among infants with vs. without hospitalization for RSV at age <24 months |
|
| Lung function (MEF50 pre-BD, mean % of predicted) | |||||||||
| Not-at-risk population | RSV-H | No RSV-H | 17–20 y | PC27 (n=1); 74 |
MD -4.00 (-14.95, 6.95) |
N/A | Very lowb,c,d,e |
Very uncertain For maximum expiratory flow after 50% of expired FVC (change in mean % predicted, pre-bronchodilation test) in adulthood (17–20 years of age) among infants with vs. without hospitalization for RSV at age <24 months |
|
| Lung function (MEF50, change in mean % predicted) | |||||||||
| Not-at-risk population | RSV-H | No RSV-H | 17–20 y | PC27 (n=1); 74 |
MD 3.70 (-5.42, 12.82) |
N/A | Very lowb,c,d,e |
Very uncertain For maximum expiratory flow after 50% of expired FVC (change in mean % predicted, pre vs. post-bronchodilation test) in adulthood (17–20 years of age) among infants with vs. without hospitalization for RSV at age <24 months |
|
Abbreviations: BD, bronchodilator; CI, confidence interval; FENO, fractional exhaled nitric oxide; FEV1, forced expiratory volume in one second; FU, follow-up; FVC, forced vital capacity; MD, mean difference; MEF50, maximum expiratory flow after 50% of expired FVC; N/A, not applicable; no., number; NS, not significant; PC, prospective cohort; ppb, parts per billion; RR, risk ratio; RSV, respiratory syncytial virus; RSV-H, respiratory syncytial virus hospitalization; vs., versus; wGA, weeks’ gestational age; y, year(s)
a Absolute risk reductions were calculated when findings were statistically significant; NS denotes when findings were not statistically significant
Certainty of evidence was assessed for each outcome using the Grading of Recommendations Assessment, Development and Evaluation (GRADE) methodology. Starting at high for observational studies (for prognosis evidence) each outcome is rated as high, moderate, low or very low based on downgrading (if any) for one or more of the following domains:
b Indirectness
c Imprecision
d Study limitations, including selective outcome reporting
e Two decrements (-2) due to very serious concerns for this domain