Epidemiology of respiratory syncytial virus infection and its effect on children with heart disease in Hong Kong: a multicentre review

Abstract

C M E disease. Predictors of severe RSV infection in patients with heart disease were heart failure, pulmonary hypertension, and severe airway abnormalities associated with congenital heart disease. Conclusions: Respiratory syncytial virus infection occurs mainly in spring and summer in Hong Kong, and is related to meteorological conditions. Respiratory syncytial virus infection poses a heavy disease burden on children with heart disease. A local guideline on RSV immunoprophylaxis for these children is therefore needed. This article was published on 9 Oct 2019 at www.hkmj.org. New knowledge added by this study • This study reviewed the epidemiology and impact of respiratory syncytial virus (RSV) infection on children with heart disease (HD) in Hong Kong. • RSV infections are common in Hong Kong, and the incidence peaks from March to August; prevalence is greatest in children aged <1 year, and there is a mild male preponderance. Infection is favoured by high relative humidity, low wind speed, and low atmospheric pressure. • HD, both congenital and acquired, is a distinct risk factor for severe RSV infection in terms of hospital length of stay, reinfection, complication, respiratory failure, and the requirements for intensive care unit care and mechanical ventilation. Implications for clinical practice or policy • A local guideline on RSV immunoprophylaxis is needed for children with HD. • In Hong Kong, an RSV immunoprophylaxis scheme administered monthly for 5 months, beginning in the first year of life, should be considered in children with HD who exhibit any of the following severity predictors: heart failure, pulmonary hypertension, and severe airway abnormalities associated with congenital HD. • The optimal timing for immunoprophylaxis may be during the local peak of infection, from March to August.

Kawasaki disease in siblings and a review of drug treatment

“…In a multicenter review on the epidemiology of respiratory syncytial virus infection and its effect on children with heart disease in Hong Kong, KD is noted to be a complication. 9 In a recent pandemic of coronavirus infection, severe Kawasaki-like disease is associated. Pediatric multisystem inflammatory syndrome (PMIS), or multisystem-inflammatory syndrome-in-children (MIS-C), or pediatric inflammatory multisystem syndrome-temporally associated with severe acute respiratory syndrome-coronavirus-2 (SARS-CoV-2) (PIM-TS) are newly coined acronynms representing a systemic disease involving persistent fever, inflammation, and organ dysfunction following exposure to SARS-CoV-2, the virus responsible for coronavirus disease 2019 (COVID-19).…”

“…Hence, SARS-CoV-2 is just one of the many respiratory viruses that can cause MIS-C or PIMS-TS or KD. 4 , 9 …”

Respiratory syncytial virus infection in an infant with familial Noonan disease and hypertrophic obstructive cardiomyopathy

“…To the Editor-We refer to the multicentre review in Hong Kong Medical Journal about respiratory syncytial virus (RSV) and children with heart disease in Hong Kong. 1 There is no universal guideline in Hong Kong regarding RSV immunoprophylaxis for children with heart disease because of a lack of local data on RSV infection. The authors found predictors of severe RSV infection in patients with heart disease were heart failure, pulmonary hypertension, and severe airway abnormalities associated with congenital heart disease, and conclude RSV infection poses a heavy disease burden on children with heart disease.…”

“…Noonan syndrome is an autosomal dominant genetic disorder that may present with mildly unusual facial features, short height and skeletal malformations, and a very common syndromic cause of congenital heart disease, including pulmonary valvular stenosis, atrial septal defects, ventricular septal defects and hypertrophic cardiomyopathy. 1,3,4 The mother also had Noonan syndrome and hypertrophic obstructive cardiomyopathy. Children aged ≤12 months with haemodynamically significant cardiomyopathy are at a higher risk for RSV infections and may benefit from palivizumab prophylaxis.…”

Respiratory failure caused by cardiac dysfunction triggered by bronchiolitis

“…1 With infection, cardiac function may deteriorate in children with congenital heart disease. 2 Therefore, point-of-care echocardiography should be performed in patients suffering from respiratory distress or respiratory tract infection with an identified pathogenic microorganism, especially if they have a history of heart disease.…”