Rhinovirus infection and healthcare utilisation in prematurely born infants

Abstract

Our aim was to determine whether rhinovirus (RV) lower respiratory tract infections (LRTIs) in prematurely born infants increase health-related cost of care during infancy.153 infants born at ,36 weeks of gestation were prospectively followed to 1 year. Cost of care was calculated from the National Health Service reference costing scheme and healthcare utilisation determined by examining hospital/general practitioner records. 20 infants developed RV LRTIs (RV group), 17 respiratory syncytial virus (RSV) LRTIs (RSV group), 12 both RV and RSV LRTIs (RV/RSV group) and 74 had no LRTI (no LRTI group). Compared with the no LRTI group, the RV/RSV LRTI group had the greatest increase in adjusted mean cost (difference GBP 5769), followed by the RV LRTI group (difference GBP 278) and, finally, the RSV LRTI group (difference GBP 172) (p50.045). The RV group had more outpatient (p,0.05) and respiratory-related general practitioner (p,0.05) attendances, more wheezed at follow-up (p,0.001) than the no LRTI group and more had respiratory-related outpatient attendances than the RSV LRTI group (p,0.05).We conclude that RV LRTIs were associated with increased health-related cost of care during infancy; our results suggest that the RV group compared with the RSV group suffered greater chronic respiratory morbidity. @ERSpublications Rhinovirus LRTIs in prematurely born infants increases health-related cost of care during infancy

Viral lower respiratory tract infections and preterm infants’ healthcare utilisation

“…NPAs were collected on each occasion an infant was admitted with a LRTI. Real-time polymerase chain reaction (PCR) was performed on the NPAs for 13 viruses (rhinovirus [RV], RSV A and B, human metapneumovirus, influenza A and B, parainfluenza 1-3, enterovirus, parechovirus, adenovirus and human bocavirus) as previously described [5].…”

“…The lung function results at 36 weeks PMA from the whole cohort have been previously reported [6]. In addition, the healthcare utilisation results of the whole cohort, at 1 year corrected age, related to whether or not the infant had had a rhinovirus LRTI have also been published [5].…”

“…The aim of this study was to test that hypothesis, as such data would inform the cost-benefit of prophylaxis in the second year. It has also been demonstrated that rhinovirus LRTIs increase health-related cost of care in the first year after birth in prematurely born infants [5]. A subsidiary aim then of this study was to determine whether other viral LRTIs, in particular rhinovirus infections, might also be associated with an increased health-related cost of care in the second year after birth.…”

The impact of respiratory viruses on lung health after preterm birth

“…Rhinovirus (RV) is a major cause of acute respiratory illnesses and wheezing episodes in infants and young children and has been associated with an increased health burden, particularly among preterm infants [91–94]. Although RV infections have long been thought to be limited to the common cold and mild self-limiting upper respiratory illnesses, the application of improved viral molecular detection methods has substantially improved understating of the epidemiology and the clinical significance of RV, particularly among high risk children [94–98]. In a 2-year prospective study, RV was detected in 41% of all episodes of acute respiratory illnesses and 33% of related hospitalisations during the first year of life in a cohort of preterm infants [99].…”

Paediatrics in Barcelona

“…In a prospective study of 152 infants born at ,36 weeks' gestation, RV-associated lower respiratory tract infections were linked with increased health-related costs of care during infancy, and RV-infected infants suffered greater chronic respiratory morbidity [91]. A study by MACK et al [92] suggests that these symptomatic RV infections are the tip of a very large iceberg.…”