Clinical outcomes in outpatient respiratory syncytial virus infection in immunocompromised children

Abstract

BackgroundImmunocompromised patients are at high risk for morbidity and mortality due to respiratory syncytial virus (RSV) infection. Increasingly, pediatric patients with malignancy or undergoing transplantation are managed primarily as outpatients. Data regarding the clinical presentation and outcomes of RSV in the outpatient pediatric immunocompromised population are limited.MethodsWe performed a retrospective cohort study of children with hematologic malignancy or hematopoietic or solid organ transplant with laboratory‐confirmed RSV infection diagnosed as outpatients at an academic medical center between 2008 and 2013.ResultsOf 54 patients with RSV detected while outpatients, 15 (28%) were hospitalized, 7 (13%) received ribavirin, and one (2%) received intravenous immunoglobulin. One (2%) patient was critically ill, but there were no deaths due to RSV infection. Fever (P < 0·01) was associated with increased risk of hospitalization.ConclusionsMost immunocompromised children with RSV detected while outpatients did not require hospitalization or receive antiviral treatment. Potential studies of RSV therapies should consider inclusion of patients in an ambulatory setting.

A Multicenter Consortium to Define the Epidemiology and Outcomes of Pediatric Solid Organ Transplant Recipients With Inpatient Respiratory Virus Infection

“…With the exception of pediatric lung transplantation, past literature on RVI in SOT recipients is limited mainly to single-center reports from studies that focused on 1 pathogen and/ or organ and often included patients who did not undergo a transplant [5][6][7][8]18]. Compared to previous literature that provided cases in SOT but did not acquire full denominator data [8], our large cohort enables calculation of RVI incidence rates, because all pediatric SOT recipients at the participating institutions were included.…”

Characteristics and Outcomes of Coronavirus Infection in Children: The Role of Viral Factors and an Immunocompromised State

“…Data from a recent study suggested that HCoV-related LRTD is associated with high rates of oxygen use and death in immunocompromised hosts; however, that study included only 1 pediatric patient [12]. Immunocompromised children might be predisposed to serious HCoV infection, as seen with other respiratory viruses [13,14]. The purpose of this study was to compare the clinical characteristics of HCoV infection and its outcomes in immunocompromised and nonimmunocompromised children.…”

Oral ribavirin for paramyxovirus infection after alemtuzumab‐containing reduced‐intensity conditioning HCT regimen

“…In patients receiving HCT, viral upper respiratory infections have an increased risk of progressing to lower respiratory tract infections and can lead to long‐term decline in respiratory function . While these infections are not typically treated in the general population, in immunocompromised patients, several different approaches have been used to prevent complications, most commonly including ribavirin and IVIG …”