scholarly journals Respiratory Syncytial Virus Prophylaxis in Infants With Congenital Diaphragmatic Hernia in the Canadian Respiratory Syncytial Virus Evaluation Study of Palivizumab, 2005–2017

2018 ◽  
Vol 69 (6) ◽  
pp. 980-986 ◽  
Author(s):  
Doyoung Kim ◽  
Mahwesh Saleem ◽  
Bosco Paes ◽  
Ian Mitchell ◽  
Krista L Lanctôt
Keyword(s):  
Respiratory Syncytial Virus ◽  
Congenital Diaphragmatic Hernia ◽  
Diaphragmatic Hernia ◽  
Respiratory Illness ◽  
Evaluation Study ◽  
Cox Proportional Hazards ◽  
Respiratory Morbidity ◽  
Increased Risk ◽  
Syncytial Virus ◽  
Tract Infections

Abstract Background Infants with congenital diaphragmatic hernia (CDH) are at an increased risk of respiratory morbidity from recurrent respiratory tract infections including those from respiratory syncytial virus (RSV). Prospective studies on RSV prophylaxis in CDH infants are limited. We determined the risk of respiratory illness– and RSV-related hospitalizations (RIH and RSVH, respectively) among infants prophylaxed for CDH, standard indications (SIs) and those without increased risk (NR). Methods The prospective Canadian Respiratory Syncytial Virus Evaluation Study of Palivizumab (CARESS) registry was searched for infants who received palivizumab during 12 RSV seasons (2005–2017) in Canada. Cox proportional hazards analyses were conducted to compare RIH and RSVH risks across the groups adjusted for potential confounders. Results In total, 21 107 infants (201 CDH, 389 NR, and 20 517 SI) were included. RIH incidences were 10.0% (CDH), 2.1% (NR), and 6.2% (SI). CDH patients had a significantly higher RIH hazard compared with NR (hazard ratio [HR], 3.6 [95% confidence interval {CI}, 1.5–8.8]; P = .005) but not SI (HR, 1.2 [95% CI, .8–2.0]; P = .379). RSVH incidences were 0.6%, 0.3%, and 1.5% for CDH, NR, and SI, respectively. RSVH risk was similar across groups (SI: HR, 0.0, P = .922; NR: HR, 0.0, P = .934). Conclusions CDH infants had a 3-fold increased risk of RIH compared to NR but not SI infants. RSVH risk was similar with low RSVH incidences across all groups, implying that CDH infants may benefit from palivizumab during the RSV season, similar to other high-risk groups. Clinical Trials Registration NCT00420966.

scholarly journals Respiratory syncytial virus associated hospitalizations in children with congenital diaphragmatic hernia

2018 ◽  
Vol 59 (2) ◽  
pp. 184-188 ◽  
Author(s):  
Bernhard Resch ◽  
Krisztina Liziczai ◽  
Friedrich Reiterer ◽  
Thomas Freidl ◽  
Michaela Haim ◽  
...  
Keyword(s):  
Respiratory Syncytial Virus ◽  
Congenital Diaphragmatic Hernia ◽  
Diaphragmatic Hernia ◽  
Syncytial Virus

scholarly journals Pediatric Antiviral Stewardship: Defining the Potential Role of Ribavirin in Respiratory Syncytial Virus–Associated Lower Respiratory Illness

2018 ◽  
Vol 23 (5) ◽  
pp. 372-378
Author(s):  
Jessica Hoover ◽  
Shannan Eades ◽  
Weng Man Lam
Keyword(s):  
Mechanical Ventilation ◽  
Respiratory Syncytial Virus ◽  
Respiratory Tract ◽  
Univariate Analysis ◽  
Pediatric Intensive Care ◽  
Patient Characteristics ◽  
Respiratory Illness ◽  
Acute Respiratory Tract Infection ◽  
Syncytial Virus ◽  
Tract Infections

OBJECTIVES Although no longer included in the American Academy of Pediatrics guideline, ribavirin was shown to be beneficial in a subset of adult patients with severe respiratory syncytial virus (RSV)–associated bronchiolitis. This study aimed to investigate risk factors for progression to severe acute respiratory tract infections in hospitalized pediatric patients with RSV-associated bronchiolitis to identify which patients may benefit from inhaled ribavirin therapy, despite its substantial cost, diffcult administration, and potential complications. METHODS Patients were identified by ICD-9 codes for RSV bronchiolitis and were only included if they had a confirmed positive result for RSV via polymerase chain reaction for detection and typing of respiratory viruses. Patient characteristics, including underlying conditions and comorbidities, were analyzed for the risk of severe acute respiratory tract infection. RESULTS A total of 299 patients were included in the study population. Ninety-six patients (32%) were admitted to the pediatric intensive care unit, and almost half of those patients (46%) required mechanical ventilation. Weight and presence of atrial septal defect were the only factors significantly associated with the need for mechanical ventilation, as identified by univariate analysis. Two patients required extracorporeal membrane oxygenation (ECMO), and a total of 5 patients, including one who received ECMO, died with RSV infection as the primary cause. Of these patients, all were less than 1 year of age. Two had a history of prematurity; however, no variables were associated with mortality. CONCLUSIONS Given the side effect profile and expense of ribavirin therapy, it is prudent to limit use to patients at risk for significant morbidity and mortality from RSV disease. Because we were unable to identify patients who would most likely benefit from ribavirin antiviral therapy, we cannot recommend the routine use of ribavirin to prevent mechanical ventilation, ECMO, or death from RSV bronchiolitis in our institution.

scholarly journals Passive Immunoprophylaxis against Respiratory Syncytial Virus in Children: Where Are We Now?

2021 ◽  
Vol 22 (7) ◽  
pp. 3703
Author(s):  
Alessandro Rocca ◽  
Carlotta Biagi ◽  
Sara Scarpini ◽  
Arianna Dondi ◽  
Silvia Vandini ◽  
...  
Keyword(s):  
Respiratory Syncytial Virus ◽  
Neuromuscular Disorders ◽  
Passive Immunization ◽  
Symptomatic Treatment ◽  
Effective Vaccine ◽  
Radiographic Appearance ◽  
Development Of Resistance ◽  
Increased Risk ◽  
Syncytial Virus ◽  
Tract Infections

Respiratory syncytial virus (RSV) represents the main cause of acute respiratory tract infections in children worldwide and is the leading cause of hospitalization in infants. RSV infection is a self-limiting condition and does not require antibiotics. However hospitalized infants with clinical bronchiolitis often receive antibiotics for fear of bacteria coinfection, especially when chest radiography is performed due to similar radiographic appearance of infiltrate and atelectasis. This may lead to unnecessary antibiotic prescription, additional cost, and increased risk of development of resistance. Despite the considerable burden of RSV bronchiolitis, to date, only symptomatic treatment is available, and there are no commercially available vaccines. The only licensed passive immunoprophylaxis is palivizumab. The high cost of this monoclonal antibody (mAb) has led to limiting its prescription only for high-risk children: infants with chronic lung disease, congenital heart disease, neuromuscular disorders, immunodeficiencies, and extreme preterm birth. Nevertheless, it has been shown that the majority of hospitalized RSV-infected children do not fully meet the criteria for immune prophylaxis. While waiting for an effective vaccine, passive immune prophylaxis in children is mandatory. There are a growing number of RSV passive immunization candidates under development intended for RSV prevention in all infants. In this review, we describe the state-of-the-art of palivizumab’s usage and summarize the clinical and preclinical trials regarding the development of mAbs with a better cost-effectiveness ratio.

scholarly journals Molecular epidemiology of respiratory syncytial virus among children and adults in India 2016 to 2018

Virus Genes ◽  
2021 ◽  
Author(s):  
Suresh S. Bandla ◽  
Santhosha Devadiga ◽  
Rushil Bhatt ◽  
Oliver C. Dsa ◽  
Arunkumar Govindakarnavar
Keyword(s):  
Phylogenetic Analysis ◽  
Respiratory Syncytial Virus ◽  
Hypervariable Region ◽  
Febrile Illness ◽  
Respiratory Illness ◽  
The Elderly ◽  
Nasopharyngeal Swab ◽  
Syncytial Virus ◽  
Tract Infections ◽  
First Time

AbstractRespiratory syncytial virus (RSV) is a common cause of respiratory tract infections among children less than 5 years of age and the elderly. This study intended to determine the circulating genotypes of RSV among severe acute respiratory illness (SARI) cases during the period 2016–2018 in India, among hospitalized acute febrile illness cases of age ranging from 1 to 65 years. Throat/nasopharyngeal swab samples were subjected for testing RSV and subgroups by real-time reverse transcriptase polymerase chain reaction (RT-PCR), further sequencing and phylogenetic analysis were performed for the second hypervariable region of the G gene. RSV-A and B subtypes co-circulated during the years 2016, 2017, and 2018, with RSV-A as the dominant subtype in 2016, and RSV-B as the dominant subgroup in 2017 and 2018. Phylogenetic analysis revealed that the circulating genotypes of RSV were GA2 (16/16), of RSV-A, and GB5 (23/23) of RSV-B in the South, North, and Northeast region of India during the period between 2016 and 2018. Here we report the first study comprising the distribution of RSV-A and B genotypes in the different geographic regions of India among children and adults during the year 2016 to 2018. We also report GA2.3.7 lineage of GA2 genotype for the first time in India to the best of our knowledge.

scholarly journals Using linked routinely collected health data to explore the burden of respiratory syncytial virus (RSV) in Scotland

2018 ◽  
Vol 3 (4) ◽  
Author(s):  
Rachel Reeves ◽  
Anne Douglas ◽  
Harry Campbell
Keyword(s):  
Respiratory Syncytial Virus ◽  
Economic Burden ◽  
Hospital Admissions ◽  
Health Data ◽  
Icu Admission ◽  
Routinely Collected Health Data ◽  
Increased Risk ◽  
Syncytial Virus ◽  
Tract Infections ◽  
Regulatory Decisions

IntroductionRespiratory syncytial virus (RSV) is the most frequent cause of lower respiratory tract infections (RTIs), particularly bronchiolitis, in young children worldwide. In order to inform policymaking and regulatory decisions regarding novel RSV vaccines and therapeutics, the health and economic burden of RSV needs to be quantified in further detail. Objectives and ApproachThis project is part of the REspiratory Syncytial virus Consortium in Europe (RESCEU), a collaborative IMI funded EU project assembling routinely collected health data from at least seven European countries to produce detailed estimates of RSV health and economic burden. This study links national data on hospital admissions, deaths, RSV laboratory testing, prescriptions, and maternal/perinatal data. Using this linked data we calculate rates of hospital admissions, intensive care unit (ICU) admissions, and deaths (a) potentially due to RSV, (b) likely due to RSV, and (c) confirmed due to RSV. We also investigate maternal and perinatal characteristics associated with RSV-related episodes. ResultsRSV is a major cause of hospital admission in Scotland, particularly in children <6 months old. Around 2,000 admissions with a primary diagnosis of bronchiolitis occur in children <12 months old per year, on average, with approximately 75% of these estimated to be due to RSV.  Children with known clinical risk factors, such as prematurity or chronic conditions, are at increased risk of ICU admission and death due to RSV.  Results will be presented on the age- and risk-group specific hospitalisation, ICU admission and mortality rates for RSV-associated RTI in children <5 years old.  The maternal and perinatal characteristics (e.g. maternal smoking, type of delivery, breastfeeding status, birthweight, APGAR score (5 mins), mechanical ventilation, oxygen use) associated with RSV-related RTI hospital episodes will be presented. Conclusion/ImplicationsThis is the first study to explore the national burden of RSV in Scotland. Our results demonstrate the benefits of using linked routinely collected data to explore the epidemiology and burden of infectious diseases and inform policymaking and regulatory decisions. Our methodology can be applied to other countries and pathogens.

Respiratory Syncytial Virus–Associated Hospitalizations Among Adults With Chronic Medical Conditions

2020 ◽  
Author(s):  
Namrata Prasad ◽  
Tiffany A Walker ◽  
Ben Waite ◽  
Tim Wood ◽  
Adrian A Trenholme ◽  
...  
Keyword(s):  
Respiratory Syncytial Virus ◽  
Length Of Hospital Stay ◽  
Respiratory Illness ◽  
Chronic Obstructive ◽  
Chronic Medical Conditions ◽  
Age Group ◽  
Medical Conditions ◽  
Hospitalization Rates ◽  
Increased Risk ◽  
Syncytial Virus

Abstract Background In contrast with respiratory disease caused by influenza, information on the risk of respiratory syncytial virus (RSV) disease among adults with chronic medical conditions (CMCs) is limited. Methods We linked population-based surveillance of acute respiratory illness hospitalizations to national administrative data to estimate seasonal RSV hospitalization rates among adults aged 18–80 years with the following preexisting CMCs: chronic obstructive pulmonary disease (COPD), asthma, congestive heart failure (CHF), coronary artery disease (CAD), cerebrovascular accidents (CVA), diabetes mellitus (DM), and end-stage renal disease (ESRD). Age- and ethnicity-adjusted rates stratified by age group were estimated. Results Among 883 999 adult residents aged 18–80 years, 281 RSV-positive hospitalizations were detected during 2012–2015 winter seasons. Across all ages, RSV hospitalization rates were significantly higher among adults with COPD, asthma, CHF, and CAD compared with those without each corresponding condition. RSV hospitalization rates were significantly higher among adults with ESRD aged 50–64 years and adults with DM aged 18–49 years and 65–80 years compared with adults in each age group without these conditions. No increased risk was seen for adults with CVA. The CMC with the highest risk of RSV hospitalization was CHF (incidence rate ratio [IRR] range, 4.6–36.5 across age strata) and COPD (IRR range, 9.6–9.7). Among RSV-positive adults, CHF and COPD were independently associated with increased length of hospital stay. Conclusions Adults with specific CMCs are at increased risk of RSV hospitalizations. Age affects this relationship for some CMCs. Such populations maybe relevant for future RSV prevention strategies.

Acute and long-term effects of infection by the respiratory syncytial virus in children with congenital cardiac malformations

2005 ◽  
Vol 15 (3) ◽  
pp. 266-273 ◽  
Author(s):  
Timothy F. Feltes ◽  
Jessie R. Groothuis
Keyword(s):  
Respiratory Syncytial Virus ◽  
Young Children ◽  
Severe Disease ◽  
Newborn Infants ◽  
Later Life ◽  
Respiratory Morbidity ◽  
Long Term Effects ◽  
Increased Risk ◽  
Syncytial Virus

All newborn infants have limited pulmonary reserve compared with older children. This puts them at increased risk of respiratory complications, such as those associated with infection by the respiratory syncytial virus. Young children with congenital cardiac disease are particularly likely to suffer severe disease related to infection by the virus. In these children, the extreme vulnerability of the lung to pulmonary oedema is compounded by the additional burden caused by the respiratory syncytial virus.In addition to the well-documented acute pulmonary effects of infection with the respiratory syncytial virus, there may also be consequent long-term respiratory morbidity. Clinical studies have shown that infection by the virus in infancy is associated with a higher risk of developing subsequent bronchial obstructive disease. Much debate surrounds the mechanisms underlying this association. It is thought that a combined immunological and neurogenic response mechanism is likely. Prevention of severe respiratory disease in infants and young children with congenital heart disease due to infection by the virus may, therefore, offer both immediate and long-term benefits. Indeed, an increasing body of evidence supports this hypothesis, indicating a clinical rationale for prophylaxis against the virus in infancy, in order to reduce the chance of developing reactive airways disease and asthma in later life.

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