Down syndrome as risk factor for respiratory syncytial virus hospitalization: A prospective multicenter epidemiological study

Abstract

BackgroundRespiratory syncytial virus (RSV) infection in childhood, particularly in premature infants, is associated with significant morbidity and mortality.ObjectivesTo compare the hospitalization rates due to RSV infection and severity of disease between infants with and without Down syndrome (DS) born at term and without other associated risk factors for severe RSV infection.Patients/MethodsIn a prospective multicentre epidemiological study, 93 infants were included in the DS cohort and 68 matched by sex and data of birth (±1 week) and were followed up to 1 year of age and during a complete RSV season.ResultsThe hospitalization rate for all acute respiratory infection was significantly higher in the DS cohort than in the non‐DS cohort (44.1% vs 7.7%, P<.0001). Hospitalizations due to RSV were significantly more frequent in the DH cohort than in the non‐DS cohort (9.7% vs 1.5%, P=.03). RSV prophylaxis was recorded in 33 (35.5%) infants with DS. The rate of hospitalization according to presence or absence of RSV immunoprophylaxis was 3.0% vs 15%, respectively.ConclusionsInfants with DS showed a higher rate of hospitalization due to acute lower respiratory tract infection and RSV infection compared to non‐DS infants. Including DS infants in recommendations for immunoprophylaxis of RSV disease should be considered.

National cohort study showed that infants with Down's syndrome faced a high risk of hospitalisation for the respiratory syncytial virus

“…As this was a register‐based study, we were not able to validate the accuracy of the diagnosis or compare the intention to test for the RSV infection among the children with Down's or the controls. However, our data on children hospitalised for RSV were in line with the results of a prospective study on RSV hospitalisation .…”

“…The presence of older siblings was also a significant risk factor for RSV hospitalisation, which has been reported by others . Advanced maternal age has also been associated with both multiparity and Down's . Accordingly, children with Down's are more likely to have older siblings, which further increases their risk of RSV hospitalisation.…”

“…A number of previous studies have found an increased risk of RSV hospitalisation among children with Down's . Most studies reported that 6–19% of children with Down's and 1–4% of non‐Down's controls were hospitalised due to RSV before the age of two.…”

“…Children with Down's syndrome are known to be at risk of severe airway infections with a complicated course . Previous studies have shown an increased risk of RSV hospitalisation among children with Down's , but this could partly be explained by congenital heart diseases, which are common among children with Down's . Only a few of the previous studies were adjusted for this and other known confounding factors.…”

Pediatric intensive care unit admission due to respiratory syncytial virus: Retrospective multicenter study

“…In addition, although there is no doubt that Down syndrome is a risk factor for severe RSV infection, it remains controversial as to whether PZ prophylaxis is efficacious, including the cost-benefit aspects. [26][27][28] Therefore, further studies are needed.…”