Acute respiratory infections in hospitalised infants with congenital heart disease

Ahuja, Namrata; Mack, Wendy J.; Wu, Susan; Wood, John C.; Russell, Christopher J.

doi:10.1017/s1047951120004333

Cited by 6 publications

(7 citation statements)

References 23 publications

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“…We also identified hospitalizations for respiratory illnesses among children without medical complexity. For each hospitalization, we described hospitalization-level characteristics (length of stay in days, respiratory etiology subdivided into infectious vs noninfectious [eTable 4 in Supplement 1], ICU admission, province or territory of hospitalization) and child-level characteristics (sex, age category, mortality, diagnosis code for medical technology [eg, feeding tube]). Race and ethnicity data were not available in the CIHI-DAD.…”

Section: Methodsmentioning

confidence: 99%

“…[4][5][6] Dramatic reductions in pediatric health care use were noted during the pandemic, due at least in part to the decrease in respiratory viral infections. [7][8][9][10][11] Children with medical complexity (CMC) are at risk of severe acute illness from respiratory infections (eg, children with cystic fibrosis, 12 congenital heart disease, 13 or sickle cell disease 14 ). In a Canadian evaluation, children who were admitted with SARS-CoV-2 infections during the early pandemic period often had existing comorbidities including obesity and neurologic impairment.…”

Section: Introductionmentioning

confidence: 99%

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Severe Respiratory Disease Among Children With and Without Medical Complexity During the COVID-19 Pandemic

Belza,

Pullenayegum,

Nelson

et al. 2023

JAMA Netw Open

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ImportanceSevere respiratory disease declined during the COVID-19 pandemic, partially due to decreased circulation of respiratory pathogens. However, the outcomes of children with higher risk have not been described using population-based data.ObjectiveTo compare respiratory-related hospitalizations, intensive care unit (ICU) admissions, and mortality during the pandemic vs prepandemic, among children with medical complexity (CMC) and without medical complexity (non-CMC).Design, Setting, and ParticipantsThis population-based repeated cross-sectional study used Canadian health administrative data of children aged younger than 18 years in community and pediatric hospitals during a pandemic period (April 1, 2020, to February 28, 2022) compared with a 3-year prepandemic period (April 1, 2017, to March 31, 2020). The pandemic period was analyzed separately for year 1 (April 1, 2020, to March 31, 2021) and year 2 (April 1, 2021, to February 28, 2022). Statistical analysis was performed from October 2022 to April 2023.Main Outcomes and MeasuresRespiratory-related hospitalizations, ICU admissions, and mortality before and during the pandemic among CMC and non-CMC.ResultsA total of 139 078 respiratory hospitalizations (29 461 respiratory hospitalizations for CMC and 109 617 for non-CMC) occurred during the study period. Among CMC, there were fewer respiratory hospitalizations in both 2020 (rate ratio [RR], 0.44 [95% CI, 0.42-0.46]) and 2021 (RR, 0.55 [95% CI, 0.51-0.62]) compared with the prepandemic period. Among non-CMC, there was an even larger relative reduction in respiratory hospitalizations in 2020 (RR, 0.18 [95% CI, 0.17-0.19]) and a similar reduction in 2021 (RR, 0.55 [95% CI, 0.54-0.56]), compared with the prepandemic period. Reductions in ICU admissions for respiratory illness followed a similar pattern for CMC (2020: RR, 0.56 [95% CI, 0.53-0.59]; 2021: RR, 0.66 [95% CI, 0.63-0.70]) and non-CMC (2020: RR, 0.22 [95% CI, 0.20-0.24]; RR, 0.65 [95% CI, 0.61-0.69]). In-hospital mortality for these conditions decreased among CMC in both 2020 (RR, 0.63 [95% CI, 0.51-0.77]) and 2021 (RR, 0.72 [95% CI, 0.59-0.87]).Conclusions and RelevanceThis cross-sectional study found a substantial decrease in severe respiratory disease resulting in hospitalizations, ICU admissions, and mortality during the first 2 years of the pandemic compared with the 3 prepandemic years. These findings suggest that future evaluations of the effect of public health interventions aimed at reducing circulating respiratory pathogens during nonpandemic periods of increased respiratory illness may be warranted.

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Section: Methodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Severe Respiratory Disease Among Children With and Without Medical Complexity During the COVID-19 Pandemic

Belza,

Pullenayegum,

Nelson

et al. 2023

JAMA Netw Open

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“…When encountering a respiratory virus, the innate immune response can be either adequate or incomplete, slowed or weakened, or delayed-in the form of an excessive response after a delay, which can lead to tissue damage [43]. This is particularly important in children with comorbidities and immunocompromised patients, including asthmatics [44,45]. In children with BA, the immune response is imbalanced and may lead to a mutually reinforcing effect of the allergic component of BA and the ARVI pathogen on the inflammation and exacerbation of respiratory tract lesions [45].…”

Section: Immune Response: Small But Important Accentsmentioning

confidence: 99%

The Common Cold and Influenza in Children: To Treat or Not to Treat?

et al. 2023

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The common cold, which is mostly caused by respiratory viruses and clinically represented by the symptoms of acute respiratory viral infections (ARVI) with mainly upper respiratory tract involvement, is an important problem in pediatric practice. Due to the high prevalence, socio-economic burden, and lack of effective prevention measures (except for influenza and, partially, RSV infection), ARVI require strong medical attention. The purpose of this descriptive literature review was to analyze the current practical approaches to the treatment of ARVI to facilitate the choice of therapy in routine practice. This descriptive overview includes information on the causative agents of ARVI. Special attention is paid to the role of interferon gamma as a cytokine with antiviral and immunomodulatory effects on the pathogenesis of ARVI. Modern approaches to the treatment of ARVI, including antiviral, pathogenesis-directed and symptomatic therapy are presented. The emphasis is on the use of antibody-based drugs in the immunoprophylaxis and immunotherapy of ARVI. The data presented in this review allow us to conclude that a modern, balanced and evidence-based approach to the choice of ARVI treatment in children should be used in clinical practice. The published results of clinical trials and systematic reviews with meta-analyses of ARVI in children allow us to conclude that it is possible and expedient to use broad-spectrum antiviral drugs in complex therapy. This approach can provide an adequate response of the child’s immune system to the virus without limiting the clinical possibilities of using only symptomatic therapy.

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“…In a previous study, it was explained that RTI patients underwent repeated hospitalization were known to have a history of CHD. 21 However, it stated that Klebsiella pneumonia infection increased through nosocomial transmission after cardiac surgery. 22 The results of this study found that patients with acyanotic CHD and RTI required 2 times fold longer duration These results are in line with a study conducted in Turkey, patients with subtype VSD with complications of pulmonary congestion often underwent hospitalization due to RTI even though the risk of hospitalization in the pediatric intensive care unit (ICU) is much greater.…”

Section: Comparative Study Of Hospitalization Time Of Rti Patients Be...mentioning

confidence: 99%

Incidence of Respiratory Tract Infection in Children with Cyanotic and Acyanotic Congenital Heart Disease: A Comparative Study

Yasmine

Utamayasa

Herwanto

2022

JUXTA

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Highlights:1. The incidence of respiratory tract infection (RTI) showed no difference between patients with cyanotic and acyanotic congenital heart disease (CHD).2. RTI patients with acyanotic CHD experienced longer hospital lengths of stay. AbstractIntroduction: Respiratory tract infection (RTI) is the leading cause of children mortality rate in the world. Congenital heart disease (CHD) is a common congenital disease that plays a role in RTI incidents. However, between the 2 types of CHD, which type that is more potential to cause the RTI is not well identified. The aim of this study was to compare the incidence and hospitalization time of RTI between 2 types of CHD and describe the profile of the patients based on gender, age, nutrition, and immunization status.Methods: This retrospective study identified the medical records of children with RTI and all types of CHD aged 0-18 years old at Dr. Soetomo General Hospital Surabaya. The diagnosis of CHD was observed by echocardiography and RTI was observed by clinical symptoms.Results: Of 135 patients, the incidence of RTI showed no difference between a patient with cyanotic and acyanotic CHD. The majority of the patient was aged less than 3 years old (93.3%) and dominated by male patients (53.3%). The frequency of children with severe underweight and good nutritional status was equal. There were 85 patients who had incomplete immunization based on their age. The most common type of acyanotic CHD was an atrial septal defect (ASD). Cyanotic CHD was dominated by the tetralogy of Fallot (ToF). Pneumonia was the common type of RTI (108/135). RTI patients with acyanotic CHD had a longer time of hospitalization than cyanotic patients (11 days).Conclusion: This study found that RTI patients with acyanotic CHD experienced longer hospital lengths of stay.

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Acute respiratory infections in hospitalised infants with congenital heart disease

Cited by 6 publications

References 23 publications

Severe Respiratory Disease Among Children With and Without Medical Complexity During the COVID-19 Pandemic

Severe Respiratory Disease Among Children With and Without Medical Complexity During the COVID-19 Pandemic

The Common Cold and Influenza in Children: To Treat or Not to Treat?

Incidence of Respiratory Tract Infection in Children with Cyanotic and Acyanotic Congenital Heart Disease: A Comparative Study

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