Children with Down Syndrome Are High-Risk for Severe Respiratory Syncytial Virus Disease

RSV infection in Istanbul: risk factors and frequency

“…In literature, common risk factors that increase LRTI with RSV in children are: being younger than six months of age, prematurity, underlying lung disease, congenital hearth disease, down syndrome, exposed to secondhand smoke, immunodeficiency status and infants who are born during the first half of the RSV season [16][17][18][19][20]. Risk factors of RSV positive LRTI are not well defined in our country.…”

Question 1: Palivizumab for all children with Down syndrome?

“…The authors of a retrospective cohort study concluded that DS was more robustly associated with hospitalisation due to RSV than any other risk factor apart from immunodeficiency. Furthermore, when the estimated per cent of children with RSV hospitalisation was stratified by any known risk factor and whether DS was present or not, it was found that having DS without risk factors carried a higher risk than not having DS with risk factors 12. A UK-based study examining the risk factors for hospital admission with RSV bronchiolitis found that DS (with and without CHD) had a higher relative risk of hospitalisation versus prematurity or CLD (RR=2.5, 95% CI 1.7 to 3.7 vs RR=1.9, 95% CI 1.8 to 2.0 vs RR=1.6, 95% CI 1.4 to 1.8, respectively) 17.…”

“…Stagliano et al 12 reported that children with DS were more likely to require respiratory support and that those without additional risk factors such as CHD or prematurity were also more likely to require longer hospital stay compared with controls. Another retrospective cohort study found a more severe clinical course in children with DS once admitted: longer admissions and an increased need for intensive care support 13.…”

Healthy Late-preterm infants born 33–36+6 weeks gestational age have higher risk for respiratory syncytial virus hospitalization

“…High-risk children are considered those b2 years old who require therapy for chronic lung disease (CLD) or hemodynamically-significant congenital heart disease (CHD), are unable to handle respiratory secretions from neuromuscular disease or anatomical airway abnormalities, are severely immunodeficient, and/or have premature birth [7][8][9][10][11][12][13]. A recent study also shows Down syndrome as a risk factor for severe RSV disease with increased risk for hospitalization [14]. In the phase III trial used to support licensure, palivizumab reduced RSV-related hospitalizations by 80% in infants born 32 through 35 weeks gestational age (WGA) [7].…”