Influenza and other respiratory viruses: standardizing disease severity in surveillance and clinical trials

Expert Rev Anti Infect Ther. 2017 Jun;15(6):545-568. doi: 10.1080/14787210.2017.1295847. Epub 2017 May 12.


Influenza-Like Illness is a leading cause of hospitalization in children. Disease burden due to influenza and other respiratory viral infections is reported on a population level, but clinical scores measuring individual changes in disease severity are urgently needed. Areas covered: We present a composite clinical score allowing individual patient data analyses of disease severity based on systematic literature review and WHO-criteria for uncomplicated and complicated disease. The 22-item ViVI Disease Severity Score showed a normal distribution in a pediatric cohort of 6073 children aged 0-18 years (mean age 3.13; S.D. 3.89; range: 0 to 18.79). Expert commentary: The ViVI Score was correlated with risk of antibiotic use as well as need for hospitalization and intensive care. The ViVI Score was used to track children with influenza, respiratory syncytial virus, human metapneumovirus, human rhinovirus, and adenovirus infections and is fully compliant with regulatory data standards. The ViVI Disease Severity Score mobile application allows physicians to measure disease severity at the point-of care thereby taking clinical trials to the next level.

Keywords: Disease severity; adenovirus; antivirals; clinical trials; human metapneumovirus; human rhinovirus; influenza; influenza-like illness; respiratory syncytial virus; seasonality.

Publication types

  • Review
  • Systematic Review

MeSH terms

  • Adenoviridae / drug effects
  • Adenoviridae / growth & development
  • Adenoviridae / pathogenicity
  • Adolescent
  • Anti-Bacterial Agents / therapeutic use*
  • Child
  • Child, Preschool
  • Clinical Trials as Topic
  • Coinfection
  • Female
  • Humans
  • Infant
  • Influenza A virus / drug effects
  • Influenza A virus / growth & development
  • Influenza A virus / pathogenicity
  • Influenza B virus / drug effects
  • Influenza B virus / growth & development
  • Influenza B virus / pathogenicity
  • Male
  • Metapneumovirus / drug effects
  • Metapneumovirus / growth & development
  • Metapneumovirus / pathogenicity
  • Mobile Applications / statistics & numerical data*
  • Respiratory Syncytial Virus, Human / drug effects
  • Respiratory Syncytial Virus, Human / growth & development
  • Respiratory Syncytial Virus, Human / pathogenicity
  • Respiratory Tract Infections / diagnosis*
  • Respiratory Tract Infections / drug therapy*
  • Respiratory Tract Infections / pathology
  • Respiratory Tract Infections / virology
  • Rhinovirus / drug effects
  • Rhinovirus / growth & development
  • Rhinovirus / pathogenicity
  • Severity of Illness Index


  • Anti-Bacterial Agents