scholarly journals Burden of respiratory syncytial virus hospitalisation among infants born at 32–35 weeks' gestational age in the Northern Hemisphere: pooled analysis of seven studies

2020 ◽  
Vol 148 ◽  
Author(s):  
M. Lanari ◽  
E.J. Anderson ◽  
M. Sheridan-Pereira ◽  
X. Carbonell-Estrany ◽  
B. Paes ◽  
...  
Keyword(s):  
Respiratory Syncytial Virus ◽  
Northern Hemisphere ◽  
Gestational Age ◽  
Pooled Analysis ◽  
Hospital Length ◽  
Hospital Length Of Stay ◽  
Non Invasive ◽  
Non Invasive Ventilation ◽  
Comprehensive Information ◽  
Syncytial Virus

Abstract To provide comprehensive information on the epidemiology and burden of respiratory syncytial virus hospitalisation (RSVH) in preterm infants, a pooled analysis was undertaken of seven multicentre, prospective, observational studies from across the Northern Hemisphere (2000–2014). Data from all 320–356 weeks' gestational age (wGA) infants without comorbidity were analysed. RSVH occurred in 534/14 504 (3.7%) infants; equating to a rate of 5.65 per 100 patient-seasons, with the rate in individual wGA groups dependent upon exposure time (P = 0.032). Most RSVHs (60.1%) occurred in December–January. Median age at RSVH was 88 days (interquartile range (IQR): 54–159). Respiratory support was required by 82.0% of infants: oxygen in 70.4% (median 4 (IQR: 2–6) days); non-invasive ventilation in 19.3% (median 3 (IQR: 2–5) days); and mechanical ventilation in 10.2% (median 5 (IQR: 3–7) days). Intensive care unit admission was required by 17.9% of infants (median 6 days (IQR: 2–8) days). Median overall hospital length of stay (LOS) was 5 (IQR: 3–8) days. Hospital resource use was similar across wGA groups except for overall LOS, which was shortest in those born 35 wGA (median 3 vs. 4–6 days for 32–34 wGA; P < 0.001). Strategies to reduce the burden of RSVH in otherwise healthy 32–35 wGA infants are indicated.

The influence of birth weight amongst 33–35 weeks gestational age (wGA) infants on the risk of respiratory syncytial virus (RSV) hospitalisation: a pooled analysis

2016 ◽  
Vol 30 (2) ◽  
pp. 134-140
Author(s):  
Xavier Carbonell-Estrany ◽  
John R. Fullarton ◽  
Katherine L. Gooch ◽  
Jean-Bernard Gouyon ◽  
Marcello Lanari ◽  
...  
Keyword(s):  
Respiratory Syncytial Virus ◽  
Birth Weight ◽  
Gestational Age ◽  
Pooled Analysis ◽  
Syncytial Virus

Respiratory syncytial virus hospitalisation trends in children with haemodynamically significant heart disease, 1997–2012

2016 ◽  
Vol 27 (1) ◽  
pp. 16-25 ◽  
Author(s):  
Patricia Y. Chu ◽  
Christoph P. Hornik ◽  
Jennifer S. Li ◽  
Michael J. Campbell ◽  
Kevin D. Hill
Keyword(s):  
Heart Disease ◽  
Respiratory Syncytial Virus ◽  
Length Of Stay ◽  
The United States ◽  
Hospital Length ◽  
Cost Utility ◽  
Hospital Length Of Stay ◽  
Chi Square ◽  
Before And After ◽  
Syncytial Virus

AbstractObjectiveThe aim of the study was to evaluate the trends in respiratory syncytial virus-related hospitalisations and associated outcomes in children with haemodynamically significant heart disease in the United States of America.Study designThe Kids’ Inpatient Databases (1997–2012) were used to estimate the incidence of respiratory syncytial virus hospitalisation among children ⩽24 months with or without haemodynamically significant heart disease. Weighted multivariable logistic regression and chi-square tests were used to evaluate the trends over time and factors associated with hospitalisation, comparing eras before and after publication of the 2003 American Academy of Pediatrics palivizumab immunoprophylaxis guidelines. Secondary outcomes included in-hospital mortality, morbidity, length of stay, and cost.ResultsOverall, 549,265 respiratory syncytial virus-related hospitalisations were evaluated, including 2518 (0.5%) in children with haemodynamically significant heart disease. The incidence of respiratory syncytial virus hospitalisation in children with haemodynamically significant heart disease decreased by 36% when comparing pre- and post-palivizumab guideline eras versus an 8% decline in children without haemodynamically significant heart disease (p<0.001). Children with haemodynamically significant heart disease had higher rates of respiratory syncytial virus-associated mortality (4.9 versus 0.1%, p<0.001) and morbidity (31.5 versus 3.5%, p<0.001) and longer hospital length of stay (17.9 versus 3.9 days, p<0.001) compared with children without haemodynamically significant heart disease. The mean cost of respiratory syncytial virus hospitalisation in 2009 was $58,166 (95% CI:$46,017, $70,315).ConclusionsThese data provide stakeholders with a means to evaluate the cost–utility of various immunoprophylaxis strategies.

scholarly journals Burden of illness in infants and young children hospitalized for respiratory syncytial virus: A rapid review

2021 ◽  
Vol 47 (09) ◽  
pp. 381-396
Author(s):  
Aireen Wingert ◽  
Jennifer Pillay ◽  
Dorothy L Moore ◽  
Ben Vandermeer ◽  
Michele P Dyson ◽  
...  
Keyword(s):  
Down Syndrome ◽  
Respiratory Syncytial Virus ◽  
Length Of Stay ◽  
Young Children ◽  
Medication Use ◽  
Hospital Length ◽  
Asthma Medication ◽  
Hospital Length Of Stay ◽  
Rapid Review ◽  
Syncytial Virus

Respiratory syncytial virus (RSV) infections are common among young children and represent a significant burden to patients, their families and the Canadian health system. Here we conduct a rapid review of the burden of RSV illness in children 24 months of age or younger. Four databases (Medline, Embase, Cochrane Database of Clinical Trials, ClinicalTrials.gov from 2014 to 2018), grey literature and reference lists were reviewed for studies on the following: children with or without a risk factor, without prophylaxis and with lab-confirmed RSV infection. Of 29 studies identified, 10 provided within-study comparisons and few examined clinical conditions besides prematurity. For infants of 33–36 weeks gestation (wGA) versus term infants, there was low-to-moderate certainty evidence for an increase in RSV-hospitalizations (n=599,535 infants; RR 2.05 [95% CI 1.89–2.22]; 1.3 more per 100 [1.1–1.5 more]) and hospital length of stay (n=7,597 infants; mean difference 1.00 day [95% CI 0.88–1.12]). There was low-to-moderate certainty evidence of little-to-no difference for infants born at 29–32 versus 33–36 wGA for hospitalization (n=12,812 infants; RR 1.20 [95% CI 0.92–1.56]). There was low certainty evidence of increased mechanical ventilation for hospitalized infants born at 29–32 versus 33–35 wGA (n=212 infants; RR 1.58, 95% CI 0.94–2.65). Among infants born at 32–35 wGA, hospitalization for RSV in infancy may be associated with increased wheeze and asthma-medication use across six-year follow-up (RR range 1.3–1.7). Children with versus without Down syndrome may have increased hospital length of stay (n=7,206 children; mean difference 3.00 days, 95% CI 1.95–4.05; low certainty). Evidence for other within-study comparisons was of very low certainty. In summary, prematurity is associated with greater risk for RSV-hospitalization and longer hospital length of stay, and Down syndrome may be associated with longer hospital stay for RSV. Respiratory syncytial virus-hospitalization in infancy may be associated with greater wheeze and asthma-medication use in early childhood. Lack of a comparison group was a major limitation for many studies.

scholarly journals Palivizumab reimbursement criteria and neonatal RSV hospitalisation: a regional retrospective review

2021 ◽  
Vol 5 (1) ◽  
pp. e000985
Author(s):  
Valeria Belleudi ◽  
Federico Marchetti ◽  
Marco Finocchietti ◽  
Marina Davoli ◽  
Antonio Addis
Keyword(s):  
Respiratory Syncytial Virus ◽  
Gestational Age ◽  
Retrospective Review ◽  
Lower Prevalence ◽  
Different Seasons ◽  
Syncytial Virus

In Italy, reimbursement restrictions regarding palivizumab prophylaxis approved in 2016 have been revoked in 2017, restoring use in infants with Gestational Age (GA) >29 weeks. Respiratory Syncytial Virus (RSV) hospitalisations and prevalence of palivizumab use in infants aged <6 months during five seasons (2014–2019), were considered according to different GA. Although RSV hospitalisations rate showed no significant changes, during different seasons in all GA, lower prevalence of palivizumab use in 2016 (0.8% vs 0.3%), returned to a higher level following the revoke of restrictions. Changes in reimbursement criteria were not associated with neonatal RSV hospitalisations rate but with a significant impact on palivizumab use.

The Use of Intermittent Non-Invasive Ventilation as an Alveolar Recruitment Method for Patient with Severe COVID 19 Pneumonia

2021 ◽  
Vol 03 ◽  
Author(s):  
Mazen Zouwayhed ◽  
Saria Gouher ◽  
Balu Bhaskar ◽  
Moeena Zain ◽  
Samer Burghleh ◽  
...  
Keyword(s):  
Length Of Stay ◽  
Standard Care ◽  
Alveolar Recruitment ◽  
Hospital Length Of Stay ◽  
Invasive Ventilation ◽  
Recruitment Method ◽  
American Hospital ◽  
Non Invasive ◽  
Non Invasive Ventilation ◽  
Taking Care

Background: The use of non-invasive ventilation (NIV) as a therapy for acute respiratory distress syndrome (ARDS) secondary to COVID 19 pneumonia has been controversial. NIV is an aerosol generating procedure which may increase the risk of viral transmission amongst patients and staff. Because of fear of aerosolizing the virus and transmitting the disease, initial expert recommendation was to avoid NIV and proceed with early intubation. With further experience of the virus, this recommendation has been challenged and NIV has been used widely with some retrospective studies quoting between 11 to 56 percent of COVID 19 related respiratory failures being treated with NIV. Objective: The objective of this study is to assess the efficacy and safety of using non-invasive mechanical ventilation as an alveolar recruitment method for patients with severe COVID 19 pneumonia. This method was used by our respiratory team on selected patients during the early phase of the COVID 19 pandemic. Methods: We reviewed the charts of patients that were admitted to the American Hospital Dubai intensive care unit, or our medical step-down unit who had diffuse bilateral infiltrates requiring oxygen supplementation between March and October 2020. We identified patients who were on intermittent BiPAP in addition to standard care. We also monitored the rate of infection among staff taking care of these patients. Results: Average length of stay after starting BIPAP therapy was 6.8 days, while the average total length of stay was 13.6 days. Only one patient was transferred to the ICU after being on the BIPAP protocol and did not need intubation. All patients were discharged home either without oxygen or with their chronic baseline home oxygen requirement. Radiological improvement in aeration was seen in 100% of patients at follow-up x-ray post-intervention. There were no reported pulmonary complications from barotrauma, such as pneumothorax or pneumomediastinum. There were no reported cases of staff infection to the health care workers that were taking care of these patients Conclusion: Our first of its kind observational study showed clearly that using BIPAP therapy for one hour three times daily during nebulization therapy in addition to standard care resulted in a significant reduction in hospital length of stay and hastened the clinical and radiological improvement of patients with severe COVID 19 pneumonia.

Abstract 16190: National Trends in RSV Hospitalizations in Children With Hemodynamically Significant Heart Disease, 1997-2009

Circulation ◽  
2014 ◽  
Vol 130 (suppl_2) ◽  
Author(s):  
Patricia Y Chu ◽  
Christoph P Hornik ◽  
Jennifer S Li ◽  
Michael J Campbell ◽  
Kevin D Hill
Keyword(s):  
Heart Disease ◽  
Hospital Length ◽  
Hospital Length Of Stay ◽  
Early Adoption ◽  
Rsv Infection ◽  
Common Ventricle ◽  
Syncytial Virus ◽  
National Trends ◽  
Left Heart Syndrome ◽  
The Impact

Background: Children with hemodynamically significant heart disease (HS-HD) are at risk for morbidities and mortality due to respiratory syncytial virus (RSV). Palivizumab was approved for RSV prophylaxis in 1998. Guidelines released in December 2003 recommend palivizumab for all children < 2 yrs with HS-HD. We sought to define the impact of RSV prophylaxis in children with HS-HD by evaluating trends in U.S. RSV hospitalizations. Methods: The 1997, ’00, ’03, ’06 and ’09 Healthcare Cost and Utilization Project (HCUP) Kids’ Inpatient Databases (KID) were used to estimate U.S. RSV hospitalizations in children < 2 yrs, overall and in those with HS-HD, using standard HCUP weighting methods. RSV was defined by ICD-9-CM codes for RSV infection. HS-HD was defined using ICD-9-CM codes from the Clinical Classifications Software for congestive heart failure, or an ICD-9-CM code for pulmonary hypertension, common truncus, common ventricle, or hypoplastic left heart syndrome. Results: Our cohort included an estimated 461,491 RSV hospitalizations; 2,132 in children with HS-HD. Figure 1 depicts hospitalizations over time. There was no evident trend in number of overall RSV hospitalizations, however RSV hospitalizations in children with HS-HD declined by 39% from ’97 to ‘09. The largest decline was from ’97-’03. RSV hospitalizations in children with HS-HD relative to overall hospitalizations in children with HS-HD declined annually from ’97-’06 with a small increase in ‘09 (3.8%, 3.5%, 3.0%, 2.3% and 2.6% for successive analytic years). In 2009 mean hospital length of stay for children with HS-HD and RSV was 22.5 ± 2.1 days. Conclusions: RSV disease burden in children with HS-HD has declined since palivizumab approval. Much of this decline occurred before palivizumab was recommended for use in HS-HD, perhaps reflecting early adoption of prophylaxis, or greater awareness of alternative preventative strategies. RSV remains a significant cause of morbidity in children with HS-HD.

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