Rates and risk factors of severe respiratory syncytial virus infection in 2008‐2016 compared with 1986‐1998

Hamrin, Johan; Bennet, Rutger; Berner, Jonas; Rotzén-Östlund, Maria; Eriksson, Margareta

doi:10.1111/apa.15575

Cited by 7 publications

(19 citation statements)

References 30 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…In 2008–2016, there were 400 admissions/100 000 person‐years in children under the age of 5 years in Stockholm and the highest rate was in infants below 1 year of age. Children with underlying conditions were overrepresented among admitted cases in a previous study that included the RSV case group in the present study 12 . Internationally, RSV admissions have been linked to underlying chronic conditions, crowding, having lots of siblings, low socio‐economic status and a low educational level of parents 13 .…”

Section: Introductionmentioning

confidence: 61%

“…We previously showed that RSV infections are increasingly diagnosed in older children with medical risk factors, partly due to multiple-agent PCR tests. 12 The proportion of chickenpox cases with a chronic condition was also high, but as the case numbers were low, we could not establish this statistically. Children with influenza, RSV or chickenpox were more likely to be admitted to the PICU than rotavirus cases.…”

Section: The Northern Stockholm Populationmentioning

confidence: 91%

“…Children with underlying conditions were overrepresented among admitted cases in a previous study that included the RSV case group in the present study. 12 Internationally, RSV admissions have been linked to underlying chronic conditions, crowding, having lots of siblings, low socio-economic status and a low educational level of parents. 13 However, associations to low socio-economic levels and education do not appear to be as strong as other risk factors 13,14 or as strong as for LTRIs not caused by RSV.…”

Section: Backg Rou N Dmentioning

confidence: 99%

“…We chose a population we know well. 9,12,18 To our knowledge, this type of comparative study in children has not been carried out before and could inform prevention.…”

Section: Backg Rou N Dmentioning

confidence: 99%

See 3 more Smart Citations

Children hospitalised with four common viral diseases showed epidemiological differences but few socio‐economic variations

et al. 2021

Self Cite

View full text Add to dashboard Cite

Aim: This study explored the differences in demographic and socio-economic factors between children hospitalised due to four common viral infections.Methods: Demographic data were obtained from Statistics Sweden on >3000 children admitted to Astrid Lindgren Children's Hospital in 2009-2014 with rotavirus, influenza, respiratory syncytial virus (RSV) or chickenpox. We compared demographic and socio-economic factors between case groups using logistic regression with rotavirus cases as reference.Results: There were differences in the median age at admission; RSV cases were younger (0.4 years), influenza (2.4 years) and chickenpox cases (2.7 years) older than rotavirus cases (1.2 years). RSV, influenza and chickenpox cases lived in families with more children than rotavirus cases. RSV and influenza cases were more likely to have underlying chronic conditions. Mothers of RSV cases were more likely to be born in Sweden. Further socio-economic differences were not robustly confirmed in sensitivity analyses. Conclusion:We found a few differences in demographic factors between children hospitalised with the four common infections, which were mainly explained by the epidemiology and transmission patterns of these infections. K E Y W O R D Sdemographic factors, hospitalised children, risk factors, socio-economic factors, viral disease Key notes• This study compared demographic and socio-economic factors between children admitted to a Stockholm paediatric hospital with four viral diseases.• Demographic data were obtained from Statistics Sweden on >3000 children admitted in 2009-2014 with rotavirus, influenza, respiratory syncytial virus or chickenpox.• We found demographic differences, which could be explained by the diseases' epidemiology and transmission patterns. Socio-economic differences were few.This is an open access article under the terms of the Creative Commons Attribution-NonCommercial License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited and is not used for commercial purposes.

show abstract

Section: Introductionmentioning

confidence: 61%

Section: The Northern Stockholm Populationmentioning

confidence: 91%

Section: Backg Rou N Dmentioning

confidence: 99%

“…We chose a population we know well. 9,12,18 To our knowledge, this type of comparative study in children has not been carried out before and could inform prevention.…”

Section: Backg Rou N Dmentioning

confidence: 99%

See 2 more Smart Citations

Children hospitalised with four common viral diseases showed epidemiological differences but few socio‐economic variations

et al. 2021

Self Cite

View full text Add to dashboard Cite

show abstract

“…The study is limited by its retrospective design, with few clinical variables available, and results may be influenced by unmeasured confounders. In particular, caution should be taken in interpreting results for children with comorbidities predisposing for severe disease, as this is a heterogeneous group with varying degrees of disease severity and often multiple factors that may interact [2,8,42,43]. Studies assessing risk factors for major medical interventions in children with VLRTI often exclude high-risk groups from the analysis [24,38,44].…”

Section: Discussionmentioning

confidence: 99%

Viral lower respiratory tract infections—strict admission guidelines for young children can safely reduce admissions

et al. 2021

View full text Add to dashboard Cite

Viral lower respiratory tract infection (VLRTI) is the most common cause of hospital admission among small children in high-income countries. Guidelines to identify children in need of admission are lacking in the literature. In December 2012, our hospital introduced strict guidelines for admission. This study aims to retrospectively evaluate the safety and efficacy of the guidelines. We performed a single-center retrospective administrative database search and medical record review. ICD-10 codes identified children < 24 months assessed at the emergency department for VLRTI for a 10-year period. To identify adverse events related to admission guidelines implementation, we reviewed patient records for all those discharged on primary contact followed by readmission within 14 days. During the study period, 3227 children younger than 24 months old were assessed in the ED for VLRTI. The proportion of severe adverse events among children who were discharged on their initial emergency department contact was low both before (0.3%) and after the intervention (0.5%) (p=1.0). Admission rates before vs. after the intervention were for previously healthy children > 90 days 65.3% vs. 53.3% (p<0.001); for healthy children ≤ 90 days 85% vs. 68% (p<0.001); and for high-risk comorbidities 74% vs. 71% (p=0.5).Conclusion: After implementation of admission guidelines for VLRTI, there were few adverse events and a significant reduction in admissions to the hospital from the emergency department. Our admission guidelines may be a safe and helpful tool in the assessment of children with VLRTI. What is Known:• Viral lower respiratory tract infection, including bronchiolitis, is the most common cause of hospitalization for young children in the developed world. Treatment is mainly supportive, and hospitalization should be limited to the cases in need of therapeutic intervention.• Many countries have guidelines for the management of the disease, but the decision on whom to admit for inpatient treatment is often subjective and may vary even between physicians in the same hospital. What is New:• Implementation of admission criteria for viral lower respiratory tract infection may reduce the rate of hospital admissions without increasing adverse events.

show abstract

Risk factors for severe respiratory syncytial virus infection during the first year of life: development and validation of a clinical prediction model

Vartiainen

Jukarainen

Rhedin

et al. 2023

Preprint

View full text Add to dashboard Cite

Background Novel immunisation methods against respiratory syncytial virus (RSV) are emerging, but knowledge of risk factors for severe RSV disease is insufficient for their optimal targeting. We aimed to identify predictors for RSV hospitalisation, and to develop and validate a clinical prediction model to guide RSV immunoprophylaxis for under 1-year-old infants. Methods In this retrospective cohort study using nationwide registries, we studied all infants born in 1997-2020 in Finland (n = 1 254 913) and in 2006-2020 in Sweden (n = 1 459 472), and their parents and siblings. We screened 1 510 candidate predictors and we created a logistic regression model with 16 predictors and compared its performance to a machine learning model (XGboost) using all 1 510 candidate predictors. Findings In addition to known predictors such as severe congenital heart defects (CHD, adjusted odds ratio (aOR) 2.89, 95% confidence interval 2.28-3.65), we identified novel predictors for RSVH, most notably esophageal malformations (aOR 3.11, 1.86-5.19) and lower complexity CHDs (aOR 1.43, 1.25-1.63). In validation data from 2018-2020, the C-statistic was 0.766 (0.742-0.789) in Finland and 0.737 (0.710- 0.762) in Sweden. The clinical prediction model's performance was similar to the machine learning model (C-statistic in Finland 0.771, 0.754-0.788). Calibration varied according to epidemic intensity. Model performance was similar across different strata of parental income. The infants in the 90th percentile of predicted RSVH probability hospitalisation had 3.3 times higher observed risk than the population's average. Assuming 60% effectiveness, immunisation in this top 10% of infants at highest risk would have a number needed to treat of 23 in Finland and 40 in Sweden in preventing hospitalisations. Interpretation The identified predictors and the prediction model can be used in guiding RSV immunoprophylaxis in infants.

show abstract

Rates and risk factors of severe respiratory syncytial virus infection in 2008‐2016 compared with 1986‐1998

Cited by 7 publications

References 30 publications

Children hospitalised with four common viral diseases showed epidemiological differences but few socio‐economic variations

Children hospitalised with four common viral diseases showed epidemiological differences but few socio‐economic variations

Viral lower respiratory tract infections—strict admission guidelines for young children can safely reduce admissions

Risk factors for severe respiratory syncytial virus infection during the first year of life: development and validation of a clinical prediction model

Contact Info

Product

Resources

About