RSV hospitalisation and healthcare utilisation in moderately prematurely born infants

Shefali-Patel, Deena; Alcazar-Paris, Mireia; Watson, F R; Peacock, Janet L.; Campbell, Morag; Greenough, Anne

doi:10.1007/s00431-012-1673-0

Cited by 26 publications

(38 citation statements)

References 23 publications

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“…Other studies confirmed that RSV-infected children pay a significantly greater number of visits to the doctor than their uninfected counterparts [20],[34]. RSV-infected preterm children 32-35 weeks GA have an average of 12.4 doctor visits during their first two years of life (median?=?12; range?=?1-27) for any cause and 5 visits on average (median?=?4; range?=?0-14) for respiratory causes, whereas the same data for children with no respiratory pathology were 9.4 (median?=?8; range?=?0-34) and 2.9 (median?=?2; range?=?0-17), respectively [34]. A multicenter Spanish study reported that 18.8% of first AB episodes in children under the age of 2 were diagnosed in primary care [30].…”

Section: Resultsmentioning

confidence: 90%

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Social, economic, and health impact of the respiratory syncytial virus: a systematic search

et al. 2014

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BackgroundBronchiolitis caused by the respiratory syncytial virus (RSV) and its related complications are common in infants born prematurely, with severe congenital heart disease, or bronchopulmonary dysplasia, as well as in immunosuppressed infants. There is a rich literature on the different aspects of RSV infection with a focus, for the most part, on specific risk populations. However, there is a need for a systematic global analysis of the impact of RSV infection in terms of use of resources and health impact on both children and adults. With this aim, we performed a systematic search of scientific evidence on the social, economic, and health impact of RSV infection.MethodsA systematic search of the following databases was performed: MEDLINE, EMBASE, Spanish Medical Index, MEDES-MEDicina in Spanish, Cochrane Plus Library, and Google without time limits. We selected 421 abstracts based on the 6,598 articles identified. From these abstracts, 4 RSV experts selected the most relevant articles. They selected 65 articles. After reading the full articles, 23 of their references were also selected. Finally, one more article found through a literature information alert system was included.ResultsThe information collected was summarized and organized into the following topics: 1. Impact on health (infections and respiratory complications, mid- to long-term lung function decline, recurrent wheezing, asthma, other complications such as otitis and rhino-conjunctivitis, and mortality; 2. Impact on resources (visits to primary care and specialists offices, emergency room visits, hospital admissions, ICU admissions, diagnostic tests, and treatments); 3. Impact on costs (direct and indirect costs); 4. Impact on quality of life; and 5. Strategies to reduce the impact (interventions on social and hygienic factors and prophylactic treatments).ConclusionsWe concluded that 1. The health impact of RSV infection is relevant and goes beyond the acute episode phase; 2. The health impact of RSV infection on children is much better documented than the impact on adults; 3. Further research is needed on mid- and long-term impact of RSV infection on the adult population, especially those at high-risk; 4. There is a need for interventions aimed at reducing the impact of RSV infection by targeting health education, information, and prophylaxis in high-risk populations.Electronic supplementary materialThe online version of this article (doi:10.1186/s12879-014-0544-x) contains supplementary material, which is available to authorized users.

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Section: Resultsmentioning

confidence: 90%

“…RSV involvement has been confirmed in 0.7% to 8% of COPD flare-ups [34]-[40]. RSV presence has also been detected in 11% of patients admitted with pneumonia, COPD (11%), heart failure (5%), and asthma (7%) [22].…”

Section: Resultsmentioning

confidence: 99%

Social, economic, and health impact of the respiratory syncytial virus: a systematic search

et al. 2014

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“…F protein | human respiratory syncytial virus | neutralizing antibodies R espiratory syncytial virus (RSV) is a highly contagious human pathogen, infecting the majority of infants before age 2 y, and is the leading cause of viral bronchiolitis and viral pneumonia in infants and children (1,2). RSV remains a top priority for vaccine development, as thousands of deaths are recorded worldwide each year because of complications from infection (3).…”

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confidence: 99%

Structural basis for nonneutralizing antibody competition at antigenic site II of the respiratory syncytial virus fusion protein

Mousa

Sauer

Sevy

et al. 2016

Proc. Natl. Acad. Sci. U.S.A.

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Palivizumab was the first antiviral monoclonal antibody (mAb) approved for therapeutic use in humans, and remains a prophylactic treatment for infants at risk for severe disease because of respiratory syncytial virus (RSV). Palivizumab is an engineered humanized version of a murine mAb targeting antigenic site II of the RSV fusion (F) protein, a key target in vaccine development. There are limited reported naturally occurring human mAbs to site II; therefore, the structural basis for human antibody recognition of this major antigenic site is poorly understood. Here, we describe a nonneutralizing class of site II-specific mAbs that competed for binding with palivizumab to postfusion RSV F protein. We also describe two classes of site II-specific neutralizing mAbs, one of which escaped competition with nonneutralizing mAbs. An X-ray crystal structure of the neutralizing mAb 14N4 in complex with F protein showed that the binding angle at which human neutralizing mAbs interact with antigenic site II determines whether or not nonneutralizing antibodies compete with their binding. Fine-mapping studies determined that nonneutralizing mAbs that interfere with binding of neutralizing mAbs recognize site II with a pose that facilitates binding to an epitope containing F surface residues on a neighboring protomer. Neutralizing antibodies, like motavizumab and a new mAb designated 3J20 that escape interference by the inhibiting mAbs, avoid such contact by binding at an angle that is shifted away from the nonneutralizing site. Furthermore, binding to rationally and computationally designed site II helixloop-helix epitope-scaffold vaccines distinguished neutralizing from nonneutralizing site II antibodies.F protein | human respiratory syncytial virus | neutralizing antibodies R espiratory syncytial virus (RSV) is a highly contagious human pathogen, infecting the majority of infants before age 2 y, and is the leading cause of viral bronchiolitis and viral pneumonia in infants and children (1, 2). RSV remains a top priority for vaccine development, as thousands of deaths are recorded worldwide each year because of complications from infection (3). To date, there is no licensed RSV vaccine. A major focus of RSV vaccine development has been inclusion of the RSV fusion (F) protein, a class I fusion glycoprotein that is synthesized as a precursor and cleaved into two disulfide-linked fragments upon maturation into a trimer (4). Although the RSV virion contains two additional surface proteins, the highly-glycosylated attachment (G) protein and the small hydrophobic protein, the F protein is highly conserved among strains of RSV strains and is the major target of protective neutralizing antibodies.The F protein is known to adopt at least two major conformations: the metastable prefusion conformation and the postfusion conformation. Following attachment of the virion to a cell by the G protein, the F protein undergoes a dramatic structural rearrangement, resulting in fusion of the viral and cell membranes, and in cultured cells causes...

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“…In another study, the 2-year-long health expenditures of 20 cases admitted due to RSV + RTI of out the premature infants born 32-35 weeks were compared with 30 infants admitted due to RSV -RTI and similarly with 108 infants without RTI, it was reported that the health expenditures in the RSV + group were significantly higher than the other two groups (16). In our study, it was found that the average direct medical hospitalization cost of a patient with RSV + LRTI was $910 and that of a RSV -patients $1028 (p>0.05) and in contrast to the studies mentioned above, RSV + LRTI costs were not higher than RSV -LRTI (Table 2).…”

Section: Discussionmentioning

confidence: 99%

Direct Medical Cost Assessment in the <2 Years Old Hospitalized RSV+LRTI Patients

Bozdemir¹,

Çelebi²,

Çakır³

et al. 2017

Çocuk Enf Derg

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Amaç: Çok merkezli bu çalışmada, bir yıllık sürede 3 büyük çocuk hastanesinde 0-2 yaş arası Respiratuvar Sinsityal Virüs (RSV) saptanan alt solunum yolu enfeksiyonu (ASYE) nedeniyle hastaneye yatırılan olgularda direkt tıbbi maliyet değerlendirilmesi amaç-landı. Gereç ve AbstractObjective: This multi-center study aimed to assess the direct medical costs in patients aged between 0-2 year-old admitted to the hospital due to lower respiratory tract infection (LRTI), which was identified as respiratory syncytial virus (RSV) in 3 big pediatric hospitals for a year. Material and Methods: During one-year period, <2-year-old LRTI patients with RSV + and RSV -were included in the study conducted in 3 different pediatric hospitals. RSV was diagnosed with the detection of nasopharyngeal antigen. Direct medical costs (hospitalization, laboratory and treatment costs) were removed from the hospitals bills. Antibiotic costs of the antibiotic-treated cases were calculated independently. The indirect costs in the study were not considered and evaluated. Results: In the study, 10% of the total inpatients aged <2-years were hospitalized with LRTI. 38% (254/671) of patients with LRTI, 41% (151/368) of those with acute bronchiolitis and 34% (103/303) of those with pneumonia were RSV positive. 4% of all hospitalized cases were RSV

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RSV hospitalisation and healthcare utilisation in moderately prematurely born infants

Cited by 26 publications

References 23 publications

Social, economic, and health impact of the respiratory syncytial virus: a systematic search

Social, economic, and health impact of the respiratory syncytial virus: a systematic search

Structural basis for nonneutralizing antibody competition at antigenic site II of the respiratory syncytial virus fusion protein

Direct Medical Cost Assessment in the <2 Years Old Hospitalized RSV+LRTI Patients

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