Risk factors for hospitalization due to respiratory syncytial virus infection among infants in the Basque Country, Spain

Abstract

SUMMARYThis study analysed the role of several risk factors for hospitalization due to communityacquired, respiratory syncytial virus (RSV) infection. The risk factors detected in infants hospitalized for RSV infection in the first 24 months of life were compared with those in the general infant population in our region. There were 361 episodes of hospitalization in 357 infants. Eighty per cent of the infants did not present underlying conditions for severe RSV infection and only 10 (3 %) were candidates for palivizumab prophylaxis. In multivariate analysis, birthweight of <2500 g was independently associated with hospitalization for RSV infection and was the most commonly detected medical risk factor. Other risk factors were maternal age at delivery <25 years, birth in the second half of the year, prematurity, suburban residence and congenital heart disease. In conclusion, together with well-known risk factors, we found that low birthweight was an independent factor for severe RSV infection.

Defining the Risk and Associated Morbidity and Mortality of Severe Respiratory Syncytial Virus Infection Among Preterm Infants Without Chronic Lung Disease or Congenital Heart Disease

“…Preterm infants, particularly those born at lower gestational ages, tended to have higher rates of hospitalization for RSV compared to otherwise healthy term infants [4, 5, 31, 37, 43, 47–51]. In a 5-year prospective, population-based study, very preterm infants (<30 wGA) accounted for only 3% of RSV cases, but had RSVH rates three times that of term infants [4].…”

“…In the Dutch LOLLIPOP (Longitudinal Preterm Outcome Project) study (ClinicalTrials.gov identifier: ISRCTN80622320) [43], the rates of RSVH were found to be higher in preterm infants 32–36 wGA than full term infants (3.9% vs. 1.2%, relative rate [RR]: 3.2; 95% CI: 1.4–7.1, P  = 0.003), but similar to that among preterm infants <32 wGA (3.9% vs. 3.2%, RR: 1.2, 95% CI: 0.7–2.1, P  = 0.50) and higher than that among full term infants. Overall, rates of RSVH tended to be around 3 times higher in premature than term infants, albeit with considerable heterogeneity across studies (range 1.1–8.1 times higher) [5, 31, 37, 43, 47–51]. In these studies, the majority of preterm infants were previously healthy, providing evidence that preterm infants without underlying conditions, such as CLD (BPD) and CHD, are at increased risk of developing severe RSV infection.…”

Epidemiology of laboratory-confirmed respiratory syncytial virus infection in young children in England, 2010–2014: the importance of birth month

“…Birth in close proximity to the beginning of RSV season has been shown to be a significant risk factor for RSV-associated hospitalisation in infancy (7)(8)(9)(10)(11). However, these studies rely solely on clinical diagnoses, are based outside of the UK or are of small study populations (7).…”

Impact of Respiratory Syncytial Virus

“…In northern latitudes, the 'RSV season' Table I. Factors that contribute to increased risk of severe respiratory syncytial virus (RSV) infection a Premature birth [21][22][23] Chronic illness/disease chronic lung disease [25,32] hemodynamically significant congenital heart disease [25,32] cystic fibrosis and/or pulmonary hypoplasia [26,27] Down syndrome [28] neuromuscular disease [29] severe immune compromise [29] Male sex [30] Low birthweight for gestational age [23,33] Young chronologic age (£12 weeks at start of RSV season) [34][35][36] Attendance in daycare centers [36][37][38] Presence of pre-school or school-aged sibling(s) [35][36][37]39] High number of people in home or multiple people sharing a bedroom [38,40] Not breastfeeding [37] Exposure to tobacco smoke [41,42] Family history without eczema [43,44] a Specific risk factors may vary in impact depending on geographic region and ethnic population.…”