Epidemiology of hospitalization for acute bronchiolitis in children: differences between RSV and non-RSV bronchiolitis

Abstract

We study the clinical, management and outcome differences between respiratory syncytial virus (RSV) positive and negative bronchiolitis. A retrospective review of the medical records of children ≤ 2 years of age with acute bronchiolitis between January 1995 and December 2006 was done. There were 2,384 patients hospitalized for acute bronchiolitis, and 1,495 (62.7%) were RSV infections. Overall, hospitalization rate was 55/1,000 admissions. Mortality occurred in 0.08% of cases. Bronchiolitis due to RSV was more frequent from November to March (97%). RSV bronchiolitis had longer hospital stays (6 vs. 5 days, P<0.0001), higher risk of intensive care unit (ICU) admission (OR 2.7; 95%CI 1.87-3.9) and more oxygen use (OR 2.2; 95%CI 1.8-2.6). Infants < 2 months had longer median hospital stay (6 vs. 5 days, P <0.0001) and higher risk of ICU admission (OR 3.4; 95%CI 2.5-4.6). Prematures of < 32 gestational weeks, congenital heart disease, and atelectasis/condensation were the main risk factors for ICU admission in both RSV and non-RSV bronchiolitis. The introduction of palivizumab in prematures diminished hospitalization for RSV bronchiolitis, oxygen need, length of hospital stay and mechanical ventilation. In conclusion, this study supports that RSV bronchiolitis seems to be a more severe disease than that caused by other viruses.

The Prevalence of Human Metapneumovirus and Respiratory Syncytial Virus and Coinfection With Both in Hospitalized Children With Acute Respiratory Infection in South of Iran

“…As shown in Figure 2, RSV was detected in 84 patients (30.0%) (47 males and 37 Females), which was in agreement with the findings of similar studies (21,22). Recently, a retrospective review of the medical records of children ≤ 2 years of age with acute bronchiolitis between January 1995 and December 2006 was published.…”

“…Recently, a retrospective review of the medical records of children ≤ 2 years of age with acute bronchiolitis between January 1995 and December 2006 was published. The results showed that among 2384 patients hospitalized for acute bronchiolitis, 1495 (62.7%) were infected with RSV (22). In another study performed on 455 cases in Brazil, the prevalence of RSV was reported to be 49.3% (23).…”

The role of Th17 and Treg responses in the pathogenesis of RSV infection

“…RSV infections are the most important reason for hospitalization in children with respiratory symptoms, of whom 1-2% require transfer to an intensive care unit with an associated mortality rate up to 10% (1,2). Fortunately, mortality merely related to bronchiolitis is rare (0.13%) and in most fatal cases underlying cardiac, respiratory and/or immunological diseases are present (2,3).…”

A systematic review of predictive modeling for bronchiolitis

“…For children with bronchiolitis, García et al [57][58][59] found three predictors of ICU admission: virus species (RSV vs. non-RSV), atelectasis/condensation, and co-infection. For children with RSV infection, Verger et al [60][61][62][63][64][65][66][67][68] identified several risk factors for ICU admission: immature lung development, prematurity, chronic lung disease, congenital heart disease (defined as congestive heart failure, cyanosis, or pulmonary hypertension), neuromuscular impairment, high nasal RSV viral load, surfactant protein A2 polymorphism, age < 6 weeks, neurological disease, cerebral palsy, male gender, lung consolidation, lethargy, grunting, high arterial PaCO 2 , an ED visit in the past week, presence of moderate to severe retractions, inadequate oral intake upon presentation in the ED, and mental retardation.…”

“…For infants hospitalized with RSV bronchiolitis, Kott et al [133,134] identified several predictors of hospital length of stay: age, urinary cysteinyl leukotriene E4 concentration, and impaired plasma tumor necrosis factor α and interleukin-6 production capacity. For patients hospitalized with bronchiolitis, Hervás et al [58] found virus species (RSV vs. non-RSV) to be a predictor of hospital length of stay.…”