scholarly journals Manifestations and Risk Factors in Children Hospitalized with Respiratory Syncytial Virus Infection

2020 ◽  
Vol In Press (In Press) ◽  
Author(s):  
Karolina Kuczborska ◽  
Agnieszka Rustecka ◽  
Agata Wawrzyniak ◽  
Agata Będzichowska ◽  
Bolesław Kalicki
Keyword(s):  
Risk Factors ◽  
Respiratory Syncytial Virus ◽  
Respiratory Failure ◽  
Family History ◽  
Inflammatory Markers ◽  
Laboratory Test Results ◽  
Rsv Infection ◽  
History Of ◽  
Syncytial Virus ◽  
Common Manifestation

Background: Acute lower respiratory infection (ALRI) is one of the main causes of morbidity and mortality in children under five years of age, and the respiratory syncytial virus (RSV) remains its leading etiological factor. Although RSV infections occur in all age groups, the most severe course is observed among children. The clinical manifestations include both mild upper respiratory infections and severe infections of the lower tract, such as bronchiolitis and pneumonia that can lead to hospitalization and severe complications, including respiratory failure. Objectives: The study aimed to evaluate the manifestations of RSV infection in hospitalized children younger than 18 months of age and predictors of disease severity, as well as their comparison with the same age group hospitalized due to ALRI of different etiology. Methods: A retrospective analysis was performed on medical records of 448 children hospitalized due to ALRI. The analysis was performed on the total study group and subgroups of children with positive and negative results of the nasal swab for RSV detection. In each group, clinical data, laboratory test results, and imaging results were analyzed. Results: The most common manifestation was pneumonia (n = 82; 63.08%). Otitis media was observed mainly in children under six months of age with lowered inflammatory markers (P < 0.05), conjunctivitis in those with a positive family history of allergies (P < 0.05), and pneumonia in children under six months of age, with lower blood oxygen saturation and inflammatory markers, features of acidosis, and fever-free course (P < 0.05). Respiratory failure affected 13 children (10%). However, no predictors of this complication were noted. Conclusions: As pneumonia was the most common manifestation in children with both RSV-positive and RSV-negative ALRI, it seems advisable to perform the imaging of the lungs on admission and carefully monitor the child’s condition during hospitalization. In both groups, special attention should be paid to the youngest children with low inflammatory markers on hospital admission, increased clinical symptoms, and family history of allergies. Nevertheless, widely known risk factors of RSV infection itself do not reflect the risk of developing pneumonia or respiratory failure in its course.

scholarly journals Respiratory Syncytial Virus Immunoprophylaxis with Palivizumab: 12-Year Observational Study of Usage and Outcomes in Canada

2021 ◽  
Author(s):  
Ian Mitchell ◽  
Abby Li ◽  
Candice L. Bjornson ◽  
Krista L. Lanctot ◽  
Bosco A. Paes ◽  
...  
Keyword(s):  
Risk Factors ◽  
Respiratory Syncytial Virus ◽  
Burden Of Illness ◽  
Respiratory Illness ◽  
Smoking Exposure ◽  
Key Points ◽  
Rsv Infection ◽  
History Of ◽  
Syncytial Virus ◽  
Airway Anomalies

Objective This study aimed to evaluate palivizumab (PVZ) use, trends in indications, and outcomes of respiratory illness hospitalizations (RIH) and respiratory syncytial virus hospitalizations (RSVH). Study Design It involves a large, Canadian prospective (2005–2017) observational multicenter study of children at high risk for RSV infection. Results A total of 25,003 infants (56.3% male) were enrolled at 32 sites; 109,579 PVZ injections were administered. Indications included: prematurity (63.3%); “miscellaneous” (17.8%); hemodynamically significant congenital heart disease (10.5%); bronchopulmonary dysplasia/chronic lung disease (8.4%). The “miscellaneous” group increased over time (4.4% in 2005–2006 to 22.5% in 2016–2017) and included: trisomy 21, airway anomalies, pulmonary disorders, cystic fibrosis, neurological impairments, immunocompromised, cardiac aged >2 years, multiple conditions, and a residual “unclassified” group. Adherence measured by expected versus actual doses plus correct interdose interval was 64.7%. A total of 2,054 RIH occurred (6.9%); 198 (9.6%) required intubation. Three hundred thirty-seven hospitalized children were RSV-positive (overall RSVH 1.6%). Risk factors for RSVH included having siblings, attending daycare, family history of atopy, smoking exposure, and crowded household. Infants with 5 risk factors were 9.0 times (95% CI or confidence interval 4.4–18.2; p < 0.0005) more likely to have RSVH than infants without risk factors. Three adverse events occurred; none were fatal. Conclusion Results are relevant to both clinicians and decision-makers. We confirmed the safety of PVZ. Use of PVZ increased steadily for children with miscellaneous conditions and medical complexity. Medical and social factors pose a risk for severe RIH and RSVH with accompanying burden of illness. A vaccine that protects against RSV is urgently required. Key Points

scholarly journals Infantile respiratory syncytial virus and human rhinovirus infections: respective role in inception and persistence of wheezing

2014 ◽  
Vol 45 (3) ◽  
pp. 774-789 ◽  
Author(s):  
Giovanni A. Rossi ◽  
Andrew A. Colin
Keyword(s):  
Respiratory Syncytial Virus ◽  
Airway Disease ◽  
Epidemiological Studies ◽  
Human Rhinovirus ◽  
Allergic Sensitisation ◽  
Cytokines And Chemokines ◽  
Rsv Infection ◽  
History Of ◽  
Syncytial Virus

There is evidence that respiratory viruses play a key role in the development and exacerbation of obstructive respiratory diseases in children. This review attempts to juxtapose the separate profiles and prototypes of pathogenenetic mechanisms represented by the two most common amongst such viruses: respiratory syncytial virus (RSV) and human rhinovirus (HRV).RSV represents the most common agent of severe airway disease in infants and young children, and is predominant in winter months. Large epidemiological studies have revealed an unequivocal relationship between RSV infection and subsequent wheezing into childhood, thought to be related to long-term changes in neuroimmune control of the airways rather than allergic sensitisation.HRV is a highly diverse group of viruses that affect subjects of all ages, is ubiquitous and occurs year-round. In contrast to RSV, infections with HRV cause minimal cytotoxicity but induce a rapid production of cytokines and chemokines with amplification of the inflammatory response. The susceptibility to HRV-induced bronchiolitis and subsequent wheezing appears to be linked to individual predisposition since it is often associated with a family or personal history of asthma/atopy.Thus, RSV probably serves as an “inducer” rather than a “trigger”. Conversely, HRVs seem to serve as a “trigger” rather than an “inducer” in predisposed individuals.

ASTHMA AND IMMUNOGLOBULIN E (IgE) ANTIBODIES AFTER RESPIRATORY SYNCYTIAL VIRUS (RSV) BRONCHIOLITIS: A PROSPECTIVE COHORT STUDY WITH MATCHED CONTROLS

PEDIATRICS ◽  
1996 ◽  
Vol 98 (2) ◽  
pp. 329-329
Author(s):  
James E. Gern
Keyword(s):  
Risk Factor ◽  
Cohort Study ◽  
Respiratory Syncytial Virus ◽  
Family History ◽  
Prospective Cohort ◽  
Immunoglobulin E ◽  
Specific Ige ◽  
Ige Antibodies ◽  
History Of ◽  
Syncytial Virus

RSV bronchiolitis was the most important risk factor for the development of asthma and allergen-specific IgE, although a family history of atopy or asthma further increased the risk.

Respiratory Syncytial Virus Infections (RVS) after Allogeneic Hematopoietic Stem Cell Transplantation (HSCT) in the Palivizumab (P) Era.

Blood ◽  
2006 ◽  
Vol 108 (11) ◽  
pp. 2847-2847
Author(s):  
Flore Sicre de Fontbrune ◽  
Marie Robin ◽  
Catherine Scieux ◽  
Régis Peffault de Latour ◽  
Christèle Ferry ◽  
...  
Keyword(s):  
Risk Factors ◽  
Overall Survival ◽  
Stem Cell ◽  
Respiratory Syncytial Virus ◽  
Respiratory Failure ◽  
Cord Blood ◽  
Cumulative Incidence ◽  
Virus Infections ◽  
Respiratory Syncytial Virus Infections ◽  
Syncytial Virus

Abstract Respiratory syncytial virus infections after HSCT can lead to severe respiratory failure and is associated with a fatal issue in a substantial number of patients (pts). P has been used to treat RSV infections in HSCT recipients, however its impact on outcome is not well established. From January 1999 to March 2006, all pts with RSV infections after HSCT at Saint Louis Hospital were retrospectively reviewed in order to determine cumulative incidence of RSV-related death, risk factors for 4-month transplant-related-mortality post RSV diagnosis (early TRM), and eventual impact of P. Forty pts with RSV infections were identified, RSV occurred in a median of 177 days (d) (range: −15 d to 987 d ) after HSCT in 3 to 65 year-old recipients (median age: 16 years). 30 pts had received a graft from an unrelated donor. Characteristics at diagnosis were: pneumonia in 16, bronchitis or bronchiolitis in 8 and upper respiratory disease in 16 pts; 16 pts had hypoxemia. Among the 40 pts, 18 received P at diagnosis (15mg/kg - intravenous course - 1 to 3 monthly injections). The groups of pts with or without P were significantly unbalanced for age, source of stem cells, neutrophil and lymphocyte counts, median time from to transplantation to diagnosis (younger age, more cord blood transplantations, lower neutrophil and lymphocyte counts, and shorter duration between transplantation and infection in the P group). Only one patient (treated with P) died from RSV pneumonia alone, giving a 2.6% cumulative incidence of RSV-related death (95% confidence interval (CI): 0–7.7). Seven other pts died during the 4 months following RSV diagnosis. All of them died from respiratory failure of multiple causes (RSV +: n = 4; RSV−: n = 3). Early TRM incidence was 22% (95%CI: 17–27) and 3-year overall survival was 59% (95%CI: 43–83). Risk factors for early TRM in a multiple Cox model were stem cell source (unrelated cord blood, hazard ratio (HR): 4.9, 95%CI: 1.1–22, p=0.039) and hypoxemia at RSV diagnosis (HR: 7.31, 95%CI: 1.8–49). As P was predominantly used in pts with poorer prognosis, we cannot easily test its impact on early TRM: 23% (95%CI: 0–50) and 9% (95%CI:0–22) with or without P, respectively. Nevertheless, pts who received an unrelated graft and who were receiving ≥ 0.5 mg/kg/d prednisolone equivalent at RSV diagnosis were at higher risk of early death (HR: 8.15, 95%CI: 1.56–42). Interestingly, cumulative incidence of death in this group did not change with or without P (37% versus 40%). In contrast, there was no death in pts grafted from a related donor if RSV was diagnosed after engraftment. Overall survival of HSCT pts with RSV infection appeared better than previously reported, and RSV was rarely the direct cause of death after transplantation. The impact of P remains to be defined.

scholarly journals Prevalence and Risk Factors of Respiratory Syncytial Virus in Children under 5 Years of Age in the WHO European Region: A Systematic Review and Meta-Analysis

2021 ◽  
Vol 11 (5) ◽  
pp. 416
Author(s):  
Nora Suleiman-Martos ◽  
Alberto Caballero-Vázquez ◽  
Jose Luis Gómez-Urquiza ◽  
Luis Albendín-García ◽  
Jose Luis Romero-Béjar ◽  
...  
Keyword(s):  
Risk Factors ◽  
Systematic Review ◽  
Respiratory Syncytial Virus ◽  
Meta Analysis ◽  
World Health ◽  
European Region ◽  
Healthy Children ◽  
Rsv Infection ◽  
Syncytial Virus ◽  
Children Under 5

A respiratory syncytial virus (RSV) is the major cause of respiratory tract infection in children under 5 years. However, RSV infection in the European Region of the World Health Organization has not been systematically reviewed. The aim was to determine the prevalence and factors associated with RSV in children under 5 years of age in European regions. A systematic review and meta-analysis was performed. CINAHL, Medline, LILACS, ProQuest, SciELO, and Scopus databases were consulted for studies published in the last 5 years, following Preferred Reporting Items for Systematic Reviews and Meta-analysis guidelines. The search equation was “respiratory syncytial virus AND (newborn OR infant OR child) AND (prevalence OR risk factors)”. Studies reporting the prevalence of RSV were eligible for inclusion in the meta-analysis. A total of 20 articles were included. The meta-analytic prevalence estimation of RSV, with a sample of n = 16,115 children, was 46% (95% CI 34–59%). The main risk factors were age, male gender, winter season, and environmental factors such as cold temperatures, higher relative humidity, high concentrations of benzene, exposure to tobacco, and living in urban areas. Robust age-specific estimates of RSV infection in healthy children should be promoted in order to determine the optimal age for immunization. In addition, it is necessary to analyse in greater depth the potentially predictive factors of RSV infection, to be included in prevention strategies.

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

2005 ◽  
Vol 134 (3) ◽  
pp. 506-513 ◽  
Author(s):  
G. CILLA ◽  
A. SARASUA ◽  
M. MONTES ◽  
N. AROSTEGUI ◽  
D. VICENTE ◽  
...  
Keyword(s):  
Risk Factors ◽  
Respiratory Syncytial Virus ◽  
Maternal Age ◽  
Congenital Heart ◽  
Low Birthweight ◽  
Basque Country ◽  
Medical Risk ◽  
Rsv Infection ◽  
Syncytial Virus

This study analysed the role of several risk factors for hospitalization due to community-acquired, 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.

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