Respiratory Syncytial Virus and Recurrent Wheeze in Healthy Preterm Infants

Blanken, Maarten O; Rovers, Maroeska M.; Molenaar, Jorine M; Winkler-Seinstra, Pauline; Meijer, Adam; Kimpen, Jan L. L.; Bont, Louis

doi:10.1056/nejmoa1211917

Cited by 585 publications

(532 citation statements)

References 42 publications

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“…12 This study also found lower rates of RSV-related hospitalization (0.9% vs 5.1%, P = .01) as well as a decrease in wheezing days ≥2 months after palivizumab prophylaxis ended (1.1% of days vs 3.9% of days, P < .001). We did not observe differences by palivizumab administration status in the infants of 33 to 36 weeks GA.…”

Section: Discussionsupporting

confidence: 62%

Observed Effectiveness of Palivizumab for 29–36-Week Gestation Infants

et al. 2016

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BACKGROUND: Respiratory syncytial virus (RSV) is a common reason for hospitalization of infants. In clinical trials, palivizumab reduced RSV hospitalization rates for premature infants. The 2014 American Academy of Pediatrics clinical practice guideline advised against use of palivizumab for otherwise healthy infants ≥29 weeks' gestation. The aim of this study was to determine the effect of palivizumab administration on hospitalization rates for RSV and bronchiolitis without RSV diagnosis among infants 29 to 36 weeks' gestation who do not have chronic illness.

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Section: Discussionsupporting

confidence: 62%

Observed Effectiveness of Palivizumab for 29–36-Week Gestation Infants

et al. 2016

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“…We questioned whether diminished neonatal lung function was associated with subsequently increased severity of RSV infection. It was recently shown that palivizumab treatment for RSV prevention in otherwise healthy preterm infants reduced recurrent wheeze in the first year of life [12]. This implies that RSV infection plays a causal role in post-infection recurrent wheeze.…”

Section: Introductionmentioning

confidence: 99%

Decreased lung function precedes severe respiratory syncytial virus infection and post-respiratory syncytial virus wheeze in term infants

et al. 2014

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It is unknown why respiratory syncytial virus (RSV) causes mild disease in some children and severe disease, requiring hospitalisation, in others. We aimed to assess whether diminished premorbid lung function in healthy term infants predisposes to hospitalisation during RSV bronchiolitis, and to post-RSV wheeze.In a prospective birth cohort study of unselected term healthy children, neonatal lung function was measured before the age of 2 months (n52133). From birth through the first year of life, respiratory symptoms were recorded in a diary, and general practitioner consultations and hospitalisations were documented. In a subgroup (n5417) repeated nose and throat swabs were collected for PCR to detect RSV infections.Median neonatal respiratory system compliance (Crs) was significantly lower (41.2 versus 47.4 mL?kPa -1 , p50.03) and resistance (Rrs) was higher (8.2 versus 6.3 kPa?s?L -1 , p50.10) in hospitalised RSV patients (n518) compared with nonhospitalised RSV-positive infants (n584). Every 10 mL?kPa -1 increase in Crs was associated with 55% less post-RSV wheeze (OR 0.56, 95% CI 0.35-0.90), and each kPa?s?L -1 increase in Rrs was associated with 42% more post-RSV wheeze, which was only marginally explained by pre-RSV wheeze or severity of the RSV disease.This unselected birth cohort study shows for the first time that decreased lung function at birth predisposes to severe RSV disease, and to post-RSV wheeze. @ERSpublications Impaired neonatal lung function precedes a severe course of RSV infection in unselected children

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“…Recent research has also added to a growing literature supporting a causal role for infant RSV infection in the development of wheeze and asthma in later life [3]. Despite this huge disease burden, potential for major impact on global health and decades of research, neither vaccines nor antivirals are yet available against human RSV.…”

Section: Introductionmentioning

confidence: 99%