scholarly journals Utilization of chronic lung disease treatment before the respiratory syncytial virus season

2021 ◽  
Author(s):  
Yoonyoung Choi ◽  
H. Cody Meissner ◽  
Christian Hampp ◽  
Haesuk Park ◽  
Almut G. Winterstein
Keyword(s):  
Diuretic Therapy ◽  
Supplemental Oxygen ◽  
Cumulative Exposure ◽  
Disease Treatment ◽  
Medical Treatments ◽  
Acute Infections ◽  
Respiratory Syncytial Virus Season ◽  
Utilization Patterns ◽  
Syncytial Virus ◽  
Chronic Corticosteroid

Abstract Guidelines recommend palivizumab immunoprophylaxis for children with CLD in their second year of life if they continue to need treatment within 6 months before the RSV season. The utilization patterns of treatment (chronic corticosteroid therapy, diuretic therapy, or supplemental oxygen) are not well understood. We examined variations in CLD treatment for ten consecutive 20-day segments preceding RSV season onset. Among infants and children with CLD (n = 19,026), 35.2% received one or more medical treatments for CLD any time within 200 days before entering the second RSV season: 8.6%, 3.2%, and 29.7% received oxygen, diuretics, and corticosteroids, respectively. Utilization decreased as infants’ age increased with corticosteroids surpassing oxygen and diuretics. To avoid the capture of intermittent use of corticosteroids for acute infections, we found a minimum of 45 days cumulative exposure was necessary to determine chronic use.

scholarly journals A Phase 2b, Randomized, Double-blind, Placebo-Controlled Multicenter Study Evaluating Antiviral Effects, Pharmacokinetics, Safety, and Tolerability of Presatovir in Hematopoietic Cell Transplant Recipients with Respiratory Syncytial Virus Infection of the Lower Respiratory Tract

2019 ◽  
Vol 71 (11) ◽  
pp. 2787-2795 ◽  
Author(s):  
Francisco M Marty ◽  
Roy F Chemaly ◽  
Kathleen M Mullane ◽  
Dong-Gun Lee ◽  
Hans H Hirsch ◽  
...  
Keyword(s):  
Viral Load ◽  
Respiratory Tract ◽  
Lower Respiratory Tract ◽  
Weighted Average ◽  
Supplemental Oxygen ◽  
Cell Transplant ◽  
Hematopoietic Cell Transplant ◽  
Average Change ◽  
Time Weighted Average ◽  
Syncytial Virus

Abstract Background Presatovir significantly reduced nasal viral load, signs, and symptoms of respiratory syncytial virus (RSV) infection in a human challenge study. We evaluated presatovir in hematopoietic-cell transplant (HCT) recipients with RSV lower respiratory tract infection (LRTI). Methods Patients with confirmed RSV in upper and lower respiratory tract and new chest X-ray abnormalities were randomized (1:1), stratified by supplemental oxygen and ribavirin use, to receive oral presatovir 200 mg or placebo every 4 days for 5 doses. The primary endpoint was time-weighted average change in nasal RSV viral load through day 9. Secondary endpoints included supplemental oxygen-free days, incident respiratory failure requiring mechanical ventilation, and all-cause mortality. Results From January 31, 2015, to March 20, 2017, 60 patients from 17 centers were randomized (31 presatovir, 29 placebo); 59 received study treatment (50 allogeneic, 9 autologous HCT). In the efficacy population (29 presatovir, 28 placebo), presatovir treatment did not significantly reduce time-weighted average change in viral load (−1.12 vs −1.09 log10 copies/mL; treatment difference −0.02 log10 copies/mL, 95% confidence interval: −.62, .57; P = .94), median supplemental oxygen-free days (26 vs 28 days, P = .84), incident respiratory failure (10.3 vs 10.7%, P = .98), or all-cause mortality (0 vs 7.1%, P = .19) versus placebo. Adverse events were similar between arms (presatovir 80%, placebo 79%). Resistance-associated substitutions in RSV fusion protein emerged in 6/29 presatovir-treated patients. Conclusions Presatovir treatment was well tolerated in HCT patients with RSV LRTI but did not improve virologic or clinical outcomes versus placebo. Clinical Trials Registration www.clinicaltrials.gov, NCT02254421; EudraCT, #2014-002475-29

scholarly journals 2626. Rhinovirus in Children Presenting to the Emergency Department: Role of Viral Load in Disease Severity and Co-Infections

2019 ◽  
Vol 6 (Supplement_2) ◽  
pp. S915-S916
Author(s):  
Alpana Waghmare ◽  
Bonnie Strelitz ◽  
Kirsten Lacombe ◽  
Garrett Perchetti ◽  
Arun Nalla ◽  
...  
Keyword(s):  
Emergency Department ◽  
Viral Load ◽  
Reverse Transcription ◽  
Digital Pcr ◽  
Tertiary Hospital ◽  
Supplemental Oxygen ◽  
Amplification Efficiency ◽  
Viral Loads ◽  
Syncytial Virus

Abstract Background Rhinovirus (RV) quantitation by reverse transcription-quantitative PCR is limited by variable amplification efficiency across genotypes. We used a precise viral quantitation method, reverse transcription-digital PCR (RT-dPCR), to characterize the role of viral load in clinical outcomes and in viral co-infections in children presenting to a tertiary hospital emergency department (ED). Methods Children < 18 years with respiratory symptoms for ≤ 14 days were enrolled from December 1, 2016 to December 31, 2018. Participants had nasal and throat specimens obtained and multiplex PCR testing with a commercial assay (FilmArray; bioMerieux). RV positive samples were quantified using RT-dPCR. Samples with sufficient viral load were sequenced at a 543 bp fragment of the RV VP4/VP2 region. RV species were assigned by comparison to RV sequences in GenBank using BLAST. Clinical data were collected into REDCap. T-tests were used to compare mean viral loads between groups. Results Of 1703 children enrolled in the ED, 697 were RV/enterovirus positive by FilmArray [median age 18 months (interquartile range 9–39 months)]. Of 590 subjects with viral load available, 276 (47%) were admitted to the hospital. Among RV mono-infections (N = 434), mean viral load did not differ between subjects admitted vs. discharged from the ED (7.03 log copies/mL for both, P = 0.97). Among admitted subjects with RV mono-infection, viral load also did not differ between subjects requiring supplemental oxygen vs. not (7.01 vs. 7.10 log copies/mL, P = 0.6). Subjects with viral co-infections had lower mean RV viral loads (6.31 log copies/mL) compared with those with RV only (7.03 log copies/mL; P < 0.001) (figure). Significantly different RV viral loads were seen with co-infections with respiratory syncytial virus (RSV), metapneumovirus (MPV) and parainfluenza (PIV), but not with influenza, adenovirus or coronavirus. In 525 sequenced samples (46% RV-A, 4% RV-B, 50% RV-C), viral load did not vary between RV viral species (P = 0.09). Conclusion Precise viral quantitation demonstrates children co-infected with RV and RSV, MPV or PIV have lower nasal viral loads than those with RV alone. Among RV mono-infections, RV viral load was not associated with admission or need for supplemental oxygen. Disclosures All authors: No reported disclosures.

Examining the entire delayed respiratory syncytial virus season in Western Australia

2021 ◽  
pp. archdischild-2021-323375
Author(s):  
David Anthony Foley ◽  
Linny Kimly Phuong ◽  
Joseph Peplinski ◽  
Selina Mei Jy Lim ◽  
Wei Hao Lee ◽  
...  
Keyword(s):  
Respiratory Syncytial Virus ◽  
Western Australia ◽  
Respiratory Syncytial Virus Season ◽  
Syncytial Virus

First-time wheezing in infants during respiratory syncytial virus season: Chest radiograph findings

2002 ◽  
Vol 18 (5) ◽  
pp. 333-336 ◽  
Author(s):  
MIRNA M. FARAH ◽  
LISA B. PADGETT ◽  
DAVID J. McLARIO ◽  
KEVIN M. SULLIVAN ◽  
HAROLD K. SIMON
Keyword(s):  
Respiratory Syncytial Virus ◽  
Chest Radiograph ◽  
Respiratory Syncytial Virus Season ◽  
Syncytial Virus ◽  
First Time

scholarly journals Respiratory Syncytial Virus in Infants and Children with Prader-Willi syndrome

2020 ◽  
Author(s):  
JL Miller ◽  
E Thornton
Keyword(s):  
Respiratory Syncytial Virus ◽  
Muscle Tone ◽  
The United States ◽  
Supplemental Oxygen ◽  
Lung Damage ◽  
Prader Willi Syndrome ◽  
Vaccine Recommendations ◽  
Routine Administration ◽  
Syncytial Virus ◽  
Contact Distribution

ABSTRACTBACKGROUNDPrader-Willi syndrome (PWS) is a complex disorder affecting approximately 1/15,000-1/30,000 people. Infants with PWS are at risk for serious complications with Respiratory Syncytial Virus (RSV) due to low muscle tone and a weakened pulmonary system.OBJECTIVESUnderstanding RSV incidence, hospitalization rates, lingering effects, and morbidity in children with PWS may help with planning health care, insurance and vaccine recommendations in children with PWS.METHODSLinks to volunteer surveys were provided via direct email and social media to families throughout the United States with children having PWS. The contact distribution lists were provided by PWSA(USA) and the Foundation for Prader-Willi Research.RESULTSA total of 220 surveys were completed by the parents/caregivers of children with PWS. Of those respondents, 60 (27.27%) had contracted the RSV virus during early childhood. Of those with RSV, 44 children required hospitalization, with 16 reporting multiple hospitalizations, some for several weeks. Of those with the virus, 22 required PICU admission, 10 required intubation, 20 needed CPAP, and 46 children needed supplemental oxygen during the infection. Of those who had contracted RSV, 42% were over age 1 year at the time of infection, and 17 children developed chronic lung issues after the RSV infection. The case lethality was 1.37%.Only 38% had received the RSV Synagis shot, and 19% received more than one season of the vaccination. Prematurity prevalence was only 28%, but 99% reported that their child had significant hypotonia.Approximately 30% of parents sited lack of insurance authorization or failure of the physician to recommend the treatment.CONCLUSIONSThe risk of contracting RSV for young children with PWS is high. The implications of contracting RSV include death or lung damage, along with high medical expenditures, which could be ameliorated with routine administration of the Synagis vaccine.

scholarly journals Clinical characteristics of children with airway malacia complicated by pneumonia

2021 ◽  
Author(s):  
Ting Wang ◽  
Qiuyan Xu ◽  
Ge Dai ◽  
Yu Hong ◽  
Zhengrong Chen ◽  
...  
Keyword(s):  
Mycoplasma Pneumoniae ◽  
Medical Records ◽  
Clinical Characteristics ◽  
Supplemental Oxygen ◽  
Premature Delivery ◽  
Duration Of Symptoms ◽  
Female Ratio ◽  
Delayed Recovery ◽  
Syncytial Virus ◽  
Male To Female

Abstract Objective To summarize the pathogens and clinical presentation of children with airway malacia complicated by pneumonia. Methods Children hospitalized with airway malacia complicated by pneumonia were eligible for enrollment from January 1, 2013 to December 31, 2019. Medical records of patients were reviewed for etiology, clinical characteristics, and laboratory examination results. Results A total of 164 pneumonia patients with airway malacia were admitted. The male-to-female ratio was 3:1. The age of patients ranged from 1 month to 4 years old. The median age was 6 (3–10) months. The most commonly detected pathogen were Mycoplasma pneumoniae (25/164, 15.24%), Streptococcus pneumoniae (18/164, 10.98%), and respiratory syncytial virus (16/164, 9.76%). Common signs among the 164 patients with confirmed airway malacia included cough (98.78%), wheezing (67.07%), fever (35.37%), intercostal retractions (23.17%), dyspnea (10.98%), cyanosis (11.11%), and crackles (50%). Compared with those without airway malacia, the incidence of premature delivery and mechanical ventilation was higher, and the duration of symptoms before admission (median, 13.5 d) and hospital stay (median 10.0 d) were longer. Of the children with pneumonia, 11.59% of those with airway malacia required supplemental oxygen compared with 4.88% of those without airway malacia (p < 0.05). Conclusion The median age of children with airway malacia was 6 months. The most common pathogen in patients with airway malacia complicated by pneumonia was Mycoplasma pneumoniae. Patients with airway malacia complicated by pneumonia often presented with a longer disease course, more severe symptoms, and had delayed recovery.

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