{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,1]],"date-time":"2026-10-01T07:56:15Z","timestamp":1790841375740,"version":"4.1.0"},"reference-count":37,"publisher":"Public Library of Science (PLoS)","issue":"3","license":[{"start":{"date-parts":[[2025,3,28]],"date-time":"2025-03-28T00:00:00Z","timestamp":1743120000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Merck Sharp & Dohme LLC","award":["IIS#102695"],"award-info":[{"award-number":["IIS#102695"]}]}],"content-domain":{"domain":["www.plosone.org"],"crossmark-restriction":false},"short-container-title":["PLoS ONE"],"abstract":"<jats:sec id=\"sec001\">\n<jats:title>\nBackground\n<\/jats:title>\n<jats:p>Respiratory Syncytial Virus (RSV) is a leading cause of severe respiratory infections in young children and older adults. Accurate RSV surveillance is essential to understanding its disease burden and evaluating vaccine impact.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec002\">\n<jats:title>\nMethods\n<\/jats:title>\n<jats:p>We assessed the accuracy of ICD-10 coding for RSV hospitalizations in the Brazilian Hospital Information System (SIH) by linking it with the Severe Acute Respiratory Syndrome (SIVEP) notification system (2022\u20132023). Laboratory-confirmed RSV-positive and RSV-negative cases in SIVEP were used as the reference standard. Sensitivity and specificity were evaluated for ICD-10 definitions (RSV, RSV +\u2009 J21 [Acute Bronchiolitis], RSV +\u2009 Acute Respiratory Infection) overall and by age group (under 1 year, under 5 years, and over 60 years). The top 10 diagnoses of RSV-positive patients were also analyzed by age group.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec003\">\n<jats:title>\nResults\n<\/jats:title>\n<jats:p>Among 15,169 RSV-positive patients linked to an SIH record, 73.0% were under 12 months old, 20.8% were 1-5 years old, 3.7% were 5-59 years old, and 2.5% were 60\u2009+ years. Acute bronchiolitis was the most common diagnosis overall (43.5%), particularly in infants (53.5%). In older adults, pneumonia due to unspecified microorganisms was most frequent (24.6%). Sensitivity improved with broader case definitions, such as, RSV +\u2009 Acute Respiratory Infection (66.7%, 95%CI: 65.8\u201367.6 in infants; 23%, 95%CI: 18.9\u201327.6 in older adults). Specificity was higher in older adults (83.8%, 95%CI: 83.5\u201384.1) than in infants (45.1%, 95%CI: 44.4\u201345.6). Additionally, 40,701 RSV-positive notified cases lacked RSV-coded diagnoses in SIH.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec004\">\n<jats:title>\nConclusion\n<\/jats:title>\n<jats:p>Our study highlights the discrepancy between RSV-positive cases identified in SIVEP and those coded in the SIH database, reflecting limitations in ICD-10 coding, particularly in the older population. Reliance on symptomatic coding rather than confirmed diagnoses contributes to this issue. Accurate RSV identification is crucial, especially with new vaccines available. Improved diagnostic coding is essential for effective RSV surveillance and evaluating vaccine impact.<\/jats:p>\n<\/jats:sec>","DOI":"10.1371\/journal.pone.0319436","type":"journal-article","created":{"date-parts":[[2025,3,28]],"date-time":"2025-03-28T20:30:35Z","timestamp":1743193835000},"page":"e0319436","update-policy":"https:\/\/doi.org\/10.1371\/journal.pone.corrections_policy","source":"Crossref","is-referenced-by-count":13,"title":["Evaluating the accuracy of ICD-10 codes for syncytial respiratory virus diagnosis in hospitalized patients: A record-linkage study (2022\u20132023)"],"prefix":"10.1371","volume":"20","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6837-0636","authenticated-orcid":true,"given":"Ana Luiza","family":"Bierrenbach","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Olivia Tavares","family":"Ranzani","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"340","published-online":{"date-parts":[[2025,3,28]]},"reference":[{"key":"pone.0319436.ref001","doi-asserted-by":"crossref","first-page":"170","DOI":"10.1016\/j.ijid.2019.10.025","article-title":"Systematic review on respiratory syncytial virus epidemiology in adults and the elderly in Latin America","volume":"90","author":"A Ali","year":"2020","journal-title":"Int J Infect Dis"},{"issue":"17","key":"pone.0319436.ref002","doi-asserted-by":"crossref","first-page":"1749","DOI":"10.1056\/NEJMoa043951","article-title":"Respiratory syncytial virus infection in elderly and high-risk adults","volume":"352","author":"AR Falsey","year":"2005","journal-title":"N Engl J Med"},{"issue":"7","key":"pone.0319436.ref003","doi-asserted-by":"crossref","first-page":"ofab159","DOI":"10.1093\/ofid\/ofab159","article-title":"The global epidemiology of rsv in community and hospitalized care: findings from 15 countries","volume":"8","author":"L Staadegaard","year":"2021","journal-title":"Open Forum Infect Dis"},{"issue":"4","key":"pone.0319436.ref004","doi-asserted-by":"crossref","first-page":"261","DOI":"10.1007\/s40266-015-0258-9","article-title":"Respiratory syncytial virus infection in older adults: an under-recognized problem","volume":"32","author":"AR Branche","year":"2015","journal-title":"Drugs Aging"},{"issue":"3","key":"pone.0319436.ref005","doi-asserted-by":"crossref","first-page":"380.e9","DOI":"10.1016\/j.cmi.2018.05.023","article-title":"Are we missing respiratory viral infections in infants and children? Comparison of a hospital-based quality management system with standard of care","volume":"25","author":"M Alchikh","year":"2019","journal-title":"Clin Microbiol Infect"},{"issue":"1","key":"pone.0319436.ref006","doi-asserted-by":"crossref","first-page":"63","DOI":"10.1093\/jpids\/pis052","article-title":"Use of Administrative Data for the Identificationof Laboratory-Confirmed Influenza Infection: The Validity ofInfluenza-Specific ICD-9 Codes","volume":"2","author":"KA Feemster","year":"2013","journal-title":"J Pediatric Infect Dis Soc"},{"issue":"6","key":"pone.0319436.ref007","doi-asserted-by":"crossref","first-page":"568","DOI":"10.1159\/000364780","article-title":"Diagnosis of influenza: only a problem of coding?","volume":"23","author":"E Amodio","year":"2014","journal-title":"Med Princ Pract"},{"issue":"3","key":"pone.0319436.ref008","doi-asserted-by":"crossref","first-page":"255","DOI":"10.1093\/jpids\/pit036","article-title":"How Accurate Are International Classification of Diseases-10 Diagnosis Codes in Detecting Influenza and Pertussis Hospitalizations in Children?","volume":"3","author":"HC Moore","year":"2014","journal-title":"J Pediatric Infect Dis Soc"},{"issue":"11","key":"pone.0319436.ref009","doi-asserted-by":"crossref","first-page":"1484","DOI":"10.1007\/s00103-016-2454-0","article-title":"Evaluation of an ICD-10-based electronic surveillance of acute respiratory infections (SEEDARI) in Germany","volume":"59","author":"K K\u00f6pke","year":"2016","journal-title":"Bundesgesundheitsblatt Gesundheitsforschung Gesundheitsschutz"},{"issue":"4","key":"pone.0319436.ref010","doi-asserted-by":"crossref","first-page":"e248255","DOI":"10.1001\/jamanetworkopen.2024.8255","article-title":"Accuracy of Influenza ICD-10 Diagnosis Codes in Identifying Influenza Illness in Children","volume":"7","author":"JW Antoon","year":"2024","journal-title":"JAMA Netw 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[Guia de vigil\u00e2ncia integrada da Covid-19, Influenza e outros v\u00edrus respirat\u00f3rios de import\u00e2ncia em sa\u00fade p\u00fablica]","author":"Brasil","year":"2024"},{"issue":"6","key":"pone.0319436.ref034","doi-asserted-by":"crossref","first-page":"1293","DOI":"10.3390\/microorganisms9061293","article-title":"Bacterial and Viral Coinfections with the Human Respiratory Syncytial Virus","volume":"9","author":"GA Pacheco","year":"2021","journal-title":"Microorganisms"},{"issue":"11","key":"pone.0319436.ref035","doi-asserted-by":"crossref","first-page":"445","DOI":"10.47102\/annals-acadmedsg.V47N11p445","article-title":"Survey of Respiratory Virus in Patients Hospitalised for Acute Exacerbations of Heart Failure - A Prospective Observational Study","volume":"47","author":"CY Chan","year":"2018","journal-title":"Ann Acad Med Singap"},{"issue":"2","key":"pone.0319436.ref036","doi-asserted-by":"crossref","first-page":"158","DOI":"10.1177\/1753465815618113","article-title":"The role of viral infections in exacerbations of chronic obstructive pulmonary disease and asthma","volume":"10","author":"R Hewitt","year":"2016","journal-title":"Ther Adv Respir Dis"},{"issue":"9","key":"pone.0319436.ref037","doi-asserted-by":"crossref","first-page":"581","DOI":"10.1016\/j.arbres.2023.06.006","article-title":"The Path Towards Effective Respiratory Syncytial Virus Immunization Policies: Recommended Actions","volume":"59","author":"F Martin\u00f3n-Torres","year":"2023","journal-title":"Arch Bronconeumol"}],"container-title":["PLOS ONE"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/dx.plos.org\/10.1371\/journal.pone.0319436","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,3,28]],"date-time":"2025-03-28T20:32:27Z","timestamp":1743193947000},"score":1,"resource":{"primary":{"URL":"https:\/\/dx.plos.org\/10.1371\/journal.pone.0319436"}},"subtitle":[],"editor":[{"given":"Inge","family":"Roggen","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"editor"}]}],"short-title":[],"issued":{"date-parts":[[2025,3,28]]},"references-count":37,"journal-issue":{"issue":"3","published-online":{"date-parts":[[2025,3,28]]}},"URL":"https:\/\/doi.org\/10.1371\/journal.pone.0319436","relation":{},"ISSN":["1932-6203"],"issn-type":[{"value":"1932-6203","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,3,28]]}}}