Yen-I Lee1, Chun-Chih Peng2, Nan-Chang Chiu3, Daniel Tsung-Ning Huang4, Fu-Yuan Huang1, Hsin Chi5. 1. Department of Pediatrics, Mackay Memorial Hospital, Taipei, Taiwan. 2. Department of Pediatrics, Mackay Memorial Hospital, Taipei, Taiwan; Department of Medicine, Mackay Medical College, New Taipei City, Taiwan. 3. Department of Pediatrics, Mackay Memorial Hospital, Taipei, Taiwan; Mackay Junior College of Medicine, Nursing and Management, Taipei, Taiwan. 4. Department of Pediatrics, Mackay Memorial Hospital, Taipei, Taiwan; Graduate Institute of Clinical Medicine, National Taiwan University College of Medicine, Taipei, Taiwan. 5. Department of Pediatrics, Mackay Memorial Hospital, Taipei, Taiwan; Department of Medicine, Mackay Medical College, New Taipei City, Taiwan; Mackay Junior College of Medicine, Nursing and Management, Taipei, Taiwan; Graduate Institute of Clinical Medicine, National Taiwan University College of Medicine, Taipei, Taiwan. Electronic address: chi.4531@mmh.org.tw.
Abstract
BACKGROUND: Respiratory syncytial virus (RSV) infection is an important cause of viral respiratory tract infection in children. This retrospective study describes the clinical characteristics of severe RSV infection and determines the risk factors for death. METHODS: Patients were identified through a review of all patients discharged with a diagnosis of RSV lower respiratory tract infection and admitted to hospital in the pediatric intensive care unit (PICU) of a tertiary medical center between July 1, 2001 and June 30, 2010. The medical and demographic variables were recorded and analyzed. RESULTS: The 186 RSV-positive patients admitted to the PICU had a median age of 5.3 months (interquartile range 2.3-12.4 months) and included 129 boys and 57 girls. Among them, 134 had at least one underlying disease: prematurity in 92, neurological disease in 57, bronchopulmonary dysplasia in 40, congenital heart disease in 26, hematological malignancies in 11, and Down's syndrome in nine patients. The 10 patients who died from RSV-related causes had a median age of 20.8 months (interquartile range 6.6-89.2 months) and all had a comorbidity. In multivariate analysis, the risk factors for death in severe RSV infection were Down's syndrome (odds ratio 7.20, 95% confidence interval 1.13-45.76; p = 0.036) and nosocomial RSV infection (odds ratio 4.46, 95% confidence interval 1.09-18.27; p = 0.038). CONCLUSION: Down's syndrome and nosocomial RSV infection are significantly associated with death in severe RSV infections. Clinicians should be alert to these conditions.
BACKGROUND:Respiratory syncytial virus (RSV) infection is an important cause of viral respiratory tract infection in children. This retrospective study describes the clinical characteristics of severe RSV infection and determines the risk factors for death. METHODS:Patients were identified through a review of all patients discharged with a diagnosis of RSV lower respiratory tract infection and admitted to hospital in the pediatric intensive care unit (PICU) of a tertiary medical center between July 1, 2001 and June 30, 2010. The medical and demographic variables were recorded and analyzed. RESULTS: The 186 RSV-positive patients admitted to the PICU had a median age of 5.3 months (interquartile range 2.3-12.4 months) and included 129 boys and 57 girls. Among them, 134 had at least one underlying disease: prematurity in 92, neurological disease in 57, bronchopulmonary dysplasia in 40, congenital heart disease in 26, hematological malignancies in 11, and Down's syndrome in nine patients. The 10 patients who died from RSV-related causes had a median age of 20.8 months (interquartile range 6.6-89.2 months) and all had a comorbidity. In multivariate analysis, the risk factors for death in severe RSV infection were Down's syndrome (odds ratio 7.20, 95% confidence interval 1.13-45.76; p = 0.036) and nosocomial RSV infection (odds ratio 4.46, 95% confidence interval 1.09-18.27; p = 0.038). CONCLUSION: Down's syndrome and nosocomial RSV infection are significantly associated with death in severe RSV infections. Clinicians should be alert to these conditions.
Authors: Nienke M Scheltema; Angela Gentile; Florencia Lucion; D James Nokes; Patrick K Munywoki; Shabir A Madhi; Michelle J Groome; Cheryl Cohen; Jocelyn Moyes; Kentigern Thorburn; Somsak Thamthitiwat; Hitoshi Oshitani; Socorro P Lupisan; Aubree Gordon; José F Sánchez; Katherine L O'Brien; Bradford D Gessner; Agustinus Sutanto; Asuncion Mejias; Octavio Ramilo; Najwa Khuri-Bulos; Natasha Halasa; Fernanda de-Paris; Márcia Rosane Pires; Michael C Spaeder; Bosco A Paes; Eric A F Simões; Ting F Leung; Maria Tereza da Costa Oliveira; Carla Cecília de Freitas Lázaro Emediato; Quique Bassat; Warwick Butt; Hsin Chi; Uzma Bashir Aamir; Asad Ali; Marilla G Lucero; Rodrigo A Fasce; Olga Lopez; Barbara A Rath; Fernando P Polack; Jesse Papenburg; Srđan Roglić; Hisato Ito; Edward A Goka; Diederick E Grobbee; Harish Nair; Louis J Bont Journal: Lancet Glob Health Date: 2017-10 Impact factor: 26.763