Chronic Diseases, Chromosomal Abnormalities, and Congenital Malformations as Risk Factors for Respiratory Syncytial Virus Hospitalization: A Population-Based Cohort Study

Kristensen, Kim; Hjuler, Thomas; Ravn, Henrik; Simões, Eric A F; Stensballe, Lone Graff

doi:10.1093/cid/cir928

Cited by 135 publications

(146 citation statements)

References 39 publications

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“…First, the groups were assembled in 2 different countries over different time frames with varying baseline characteristics and environmental risk factors that could influence the severity of RSV infection and hospitalization in the respective DS populations. [39][40][41][42] However, studies on children with DS from the Netherlands, 3 Denmark, 2 Israel, 5 and the United States 1,6 have reported similar RSV hospitalization rates, as previously reported in this untreated cohort. 3 Moreover, the greater prevalence of risk factors in the treated group suggests possible underestimation of the treatment effect of RSV prophylaxis.…”

Section: Discussionsupporting

confidence: 80%

“…Down syndrome (DS) is an independent risk factor for respiratory illness and severe respiratory syncytial virus (RSV)-related infection and hospitalization in children. [1][2][3][4][5][6][7][8] The combined attributes of a compromised innate and adaptive immune system in early infancy [9][10][11][12][13] with anatomic [14][15][16] and physiologic aberrations such as gastroesophageal reflux disease, 17 obstructive sleep apnea, 18 and hemodynamically significant heart disease 4,19 all lead to significant morbidity and mortality in DS during the first 2 years of life. [20][21][22] Palivizumab, a humanized monoclonal antibody, has been proven safe and efficacious against RSV in randomized, placebo-controlled studies involving preterm infants #35 weeks' gestational age during their first RSV season and children aged ,2 years with severe chronic lung disease (CLD) and hemodynamically significant cardiac disease.…”

Section: Discussionmentioning

confidence: 99%

“…[1][2][3][4][5][6] Across 4 reported studies, [1][2][3]5 which have cumulatively evaluated 1646 children with DS aged ,2 years, the risk estimate for RSV hospitalizations ranged from 9.9% to a Adjusted for hemodynamically significant CHD, insignificant CHD, gestational age, and birth weight. Ratios .1 indicate higher risk in the untreated group.…”

Section: Discussionmentioning

confidence: 99%

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Respiratory Syncytial Virus Prophylaxis in Down Syndrome: A Prospective Cohort Study

Lanctôt

Bont

et al. 2014

Pediatrics

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BACKGROUND AND OBJECTIVES: Children with Down syndrome (DS) are at significant risk for respiratory syncytial virus (RSV) infection and related hospitalization. We compared hospitalization rates due to respiratory tract infection in children with DS aged <2 years who prospectively received palivizumab during the RSV season with a previously published, similar untreated DS birth cohort. METHODS: A total of 532 children with DS who prospectively received palivizumab were assembled from the prospective Canadian RSV Evaluation Study of Palivizumab registry between 2005 and 2012. The untreated group included 233 children with DS derived from a nationwide Dutch birth cohort from 2003 to 2005. Events during the RSV seasons were counted. Poisson regression analysis was performed to compare incidence rate ratios (95% confidence intervals [CIs]) between groups while controlling for observation length and known risk factors for severe RSV infection. RESULTS: In total, 31 (23 untreated, 8 treated) RSV-related hospitalizations were documented. The adjusted risk of RSV-related hospitalizations was higher in untreated subjects than in palivizumab recipients (incidence rate ratio 3.63; 95% CI, 1.52–8.67). The adjusted risk of hospitalization for all respiratory tract infection (147 events; 73 untreated, 74 treated) was similar (incidence rate ratio untreated versus palivizumab 1.11; 95% CI, 0.80–1.55). CONCLUSIONS: These results suggest that palivizumab is associated with a 3.6-fold reduction in the incidence rate ratio for RSV-related hospitalization in children with DS during the first 2 years of life. A randomized trial is needed to determine the efficacy of RSV immunoprophylaxis in this specific high-risk patient population.

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Section: Discussionsupporting

confidence: 80%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Respiratory Syncytial Virus Prophylaxis in Down Syndrome: A Prospective Cohort Study

Lanctôt

Bont

et al. 2014

Pediatrics

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“…7,22 The reported proportions of children with chronic conditions hospitalized with RSV have ranged widely, possibly reflecting the variable underlying populations and study designs. 6,15,17,24 Stockman et al 6 recently found that 12% of RSV-hospitalized children ,12 months old and 2.4% of those 12 to 23 months old had heart disease, chronic neonatal respiratory distress, or prematurity, as determined by RSV ICD-9-CMcoded discharge diagnoses. In comparison, we found that 21% of RSV-hospitalized children ,12 months old and 53% of children 12 to 23 months old had chronic conditions, as determined by medical chart review.…”

Section: Discussionmentioning

confidence: 99%

Respiratory Syncytial Virus–Associated Hospitalizations Among Children Less Than 24 Months of Age

Hall

Weinberg²,

Blumkin³

et al. 2013

Pediatrics

531

430

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WHAT'S KNOWN ON THIS SUBJECT: Respiratory syncytial virus (RSV) infection is a leading cause of hospitalization among infants. Most estimates of RSV hospitalization rates are imprecise, having been calculated by using retrospective discharge diagnosis data and stratified age groups no narrower than 6 to 12 months.WHAT THIS STUDY ADDS: Prospective, population-based surveillance data for infants hospitalized with laboratoryconfirmed RSV infection were combined with birth certificate information to yield more precise age-specific hospitalization rates. These data should help determine priorities for the use of existing and future RSV prophylaxis strategies. abstract BACKGROUND: Respiratory syncytial virus (RSV) infection is a leading cause of hospitalization among infants. However, estimates of the RSV hospitalization burden have varied, and precision has been limited by the use of age strata grouped in blocks of 6 to $12 months. METHODS:We analyzed data from a 5-year, prospective, population-based surveillance for young children who were hospitalized with laboratoryconfirmed (reverse-transcriptase polymerase chain reaction) RSV acute respiratory illness (ARI) during October through March 2000-2005. The total population at risk was stratified by month of age by birth certificate information to yield hospitalization rates.RESULTS: There were 559 (26%) RSV-infected children among the 2149 enrolled children hospitalized with ARI (85% of all eligible children with ARI). The average RSV hospitalization rate was 5.2 per 1000 children ,24 months old. The highest age-specific rate was in infants 1 month old (25.9 per 1000 children). Infants #2 months of age, who comprised 44% of RSV-hospitalized children, had a hospitalization rate of 17.9 per 1000 children. Most children (79%) were previously healthy. Very preterm infants (,30 weeks' gestation) accounted for only 3% of RSV cases but had RSV hospitalization rates 3 times that of term infants.CONCLUSIONS: Young infants, especially those who were 1 month old, were at greatest risk of RSV hospitalization. Four-fifths of RSVhospitalized infants were previously healthy. To substantially reduce the burden of RSV hospitalizations, effective general preventive strategies will be required for all young infants, not just those with risk factors. Pediatrics 2013;132:e341-e348 AUTHORS:

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“…They may benefit from the pneumococcal vaccine (213), an annual influenza vaccination (213), and routine childhood immunizations, with the exception of live-virus vaccines in immunosuppressed patients. Respiratory syncytial virus can increase the morbidity and mortality of infants and young children with chronic lung diseases, such as chILD syndrome (214); a recent study found significantly increased risk for respiratory syncytial virus hospitalization in children with chILD (215). For this reason, palivizumab is usually considered in significantly compromised infants and young children, even though there have been no related studies to confirm the theoretical benefits of palivizumab.…”

Section: Supportive and Preventive Carementioning

confidence: 99%

An Official American Thoracic Society Clinical Practice Guideline: Classification, Evaluation, and Management of Childhood Interstitial Lung Disease in Infancy

Kurland¹,

Deterding²,

Hagood³

et al. 2013

Am J Respir Crit Care Med

395

499

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Chronic Diseases, Chromosomal Abnormalities, and Congenital Malformations as Risk Factors for Respiratory Syncytial Virus Hospitalization: A Population-Based Cohort Study

Abstract: Chronic disease per se is an important risk factor for RSV hospitalization.

Cited by 135 publications

References 39 publications

Respiratory Syncytial Virus Prophylaxis in Down Syndrome: A Prospective Cohort Study

Respiratory Syncytial Virus Prophylaxis in Down Syndrome: A Prospective Cohort Study

Respiratory Syncytial Virus–Associated Hospitalizations Among Children Less Than 24 Months of Age

An Official American Thoracic Society Clinical Practice Guideline: Classification, Evaluation, and Management of Childhood Interstitial Lung Disease in Infancy

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