Clinical burden of severe respiratory syncytial virus  infection during the first 2 years of life in children born between 2000 and 2011 in Scotland

Thwaites, Richard; Buchan, Scot; Fullarton, John R.; Morris, Carole; Grubb, E.; Rodgers‐Gray, Barry; Coutts, J. R. T.

doi:10.1007/s00431-019-03564-9

Cited by 14 publications

(18 citation statements)

References 22 publications

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“…The deficiencies we observed in IFN responses in males are reflected in a significantly increased incidence of severe LRTIs requiring hospital admissions in the first and second years of life, as well as with a trend for increased incidence of RSV-proven bronchiolitis, a disease with a peak incidence at 4.5 months of age (29). We focused on severe LRTIs requiring hospital admissions in early life, as these are almost exclusively viral in aetiology.…”

Section: Discussionmentioning

confidence: 96%

Sex differences in innate anti-viral immune responses to respiratory viruses

Regis

Fontanella

Lin

et al. 2020

Preprint

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Males have excess morbidity and mortality from respiratory viral infections and especially so in COVID-19. The mechanisms explaining this excess in disease burden in males are unknown. Innate immune responses are likely critical in protection against a novel virus like SARS-CoV-2. We hypothesised that innate immune responses may be deficient in males relative to females. To test this we stimulated peripheral blood mononuclear cells (PBMCs) from participants in a population-based birth cohort with three respiratory viruses (rhinoviruses-RV-A16 and RV-A1, and respiratory syncytial virus-RSV) and two viral mimics (R848 and CpG-A, to mimic responses to SARS-CoV-2). We measured interferon (IFN) and IFN-induced chemokine responses and investigated sex differences in virus-induced responses. IFN-α, IFN-β and IFN-γ responses to RV-A16 were deficient in males compared to females, fold-inductions being 1.92-fold (P<0.001), 2.04-fold (P<0.001) and 1.77-fold (P=0.003) lower in males than females, respectively. Similar significant deficiencies in innate immune responses were observed in males for eleven other cytokine-stimulus pairs. Responses in males were greater than those in females in only one of 35 cytokine-stimulus pairs investigated. Review of healthcare records revealed that 12.1% of males but only 6.6% of females were admitted to hospital with respiratory infections in the first year of life (P=0.017). Impaired innate anti-viral immunity in males likely results in high morbidity and mortality from respiratory viruses including COVID-19. Males may preferentially benefit from therapies that boost innate anti-viral immune responses.

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Section: Discussionmentioning

confidence: 96%

Sex differences in innate anti-viral immune responses to respiratory viruses

Regis

Fontanella

Lin

et al. 2020

Preprint

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“…Nair et al [28] estimated that in children <5 years of age there were nearly 33.8 million new cases attributed RSV infections in 2005, of which an estimated 3.4 million required hospitalization. In a study where more than 600,000 children aged <2 years in Scotland were evaluated for 12 years period, the hospitalization rate due to RSV infection was 14.2%, and immaturity, chronic lung disease and congenital heart disease were identified as risk factors [29]. A multicenter study that investigates the risk factors of RSV infection in Turkey found that the length of hospitalization and more oxygen support affected the infants with RSV [30].…”

Section: Discussionmentioning

confidence: 99%

Is respiratory syncytial virus infection more dangerous than COVID 19 in the neonatal period?

Özdemir

Soysal

Çalkavur

et al. 2020

The Journal of Maternal-Fetal & Neonatal Medicine

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Objective: We aimed to compare the clinical features, laboratory findings and primary outcomes of the neonates with RSV and neonates with SARS-CoV-2 infections. Materials and methods: This nested case-control study included the neonates who were administered in the neonatal intensive care unit (NICU) of the University of Health Sciences, Dr Behc¸et Uz Children's Hospital during the period of 01 March-30 April 2020. Respiratory PCR samples and COVID-19 samples were taken simultaneously. Only RSV positive and COVID-19 positive infants were compared. Demographic, epidemiological and clinical data were obtained from hospital electronic information system medical records. The chest radiographs at the admission were evaluated by using standard definitions for normal chest Xray, atelectasis, bronchopenumonia, peribronchial thickening and hyperinflation in various lung volumes. Results: A total of 30 infants were enrolled in the study and RSV was identified in 20/30 infants (66%). No significant differences were observed between the two groups in terms of general characteristics. Comparing to the infants with Covid-19 infections, infants with RSV infections had significantly higher rates of having oxygen support (p ¼ .03). Total NICU duration time was 6.7 ± 1.6 days in COVID positive group and 11.1 ± 5.1 days in the RSV group (p ¼ .01). Infants with COVID-19 had more normal chest X-rays. Infants with RSV-positive had a significantly higher proportion of atelectasis than those with COVID-19 infants (p ¼ .04). Discussion: This is the first study that compares RSV infection and COVID-19 infection. RSV infection can be more serious in the neonatal period. In cases with suspected COVID-19 infection, it should be kept in mind if atelectasis is seen on chest radiography. Respiratory failure may be more serious in RSV positive infants and RSV infection may be more dangerous for the neonatal period.

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“…Respiratory syncytial virus (RSV) remains a leading cause of lower respiratory tract infection (LRTI) in early childhood [1], causing over 375 000 hospitalisations (respiratory syncytial virus hospitalisation (RSVHs)) per year in children <5 years in high-income countries [2]. RSVHs are concentrated during seasonal outbreaks – the winter months in temperate countries – and place a major demand on neonatal and paediatric services at this time of year [3]. Certain children, such as those with co-morbidities, including congenital heart disease and chronic lung disease, immunodeficiency and those born prematurely, are known to be particularly vulnerable to severe RSV LRTI [4–6].…”

Section: Introductionmentioning

confidence: 99%

Burden of respiratory syncytial virus hospitalisation among infants born at 32–35 weeks' gestational age in the Northern Hemisphere: pooled analysis of seven studies

Lanari¹,

Anderson

Sheridan-Pereira

et al. 2020

Epidemiol. Infect.

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To provide comprehensive information on the epidemiology and burden of respiratory syncytial virus hospitalisation (RSVH) in preterm infants, a pooled analysis was undertaken of seven multicentre, prospective, observational studies from across the Northern Hemisphere (2000–2014). Data from all 320–356 weeks' gestational age (wGA) infants without comorbidity were analysed. RSVH occurred in 534/14 504 (3.7%) infants; equating to a rate of 5.65 per 100 patient-seasons, with the rate in individual wGA groups dependent upon exposure time (P = 0.032). Most RSVHs (60.1%) occurred in December–January. Median age at RSVH was 88 days (interquartile range (IQR): 54–159). Respiratory support was required by 82.0% of infants: oxygen in 70.4% (median 4 (IQR: 2–6) days); non-invasive ventilation in 19.3% (median 3 (IQR: 2–5) days); and mechanical ventilation in 10.2% (median 5 (IQR: 3–7) days). Intensive care unit admission was required by 17.9% of infants (median 6 days (IQR: 2–8) days). Median overall hospital length of stay (LOS) was 5 (IQR: 3–8) days. Hospital resource use was similar across wGA groups except for overall LOS, which was shortest in those born 35 wGA (median 3 vs. 4–6 days for 32–34 wGA; P < 0.001). Strategies to reduce the burden of RSVH in otherwise healthy 32–35 wGA infants are indicated.

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Clinical burden of severe respiratory syncytial virus infection during the first 2 years of life in children born between 2000 and 2011 in Scotland

Cited by 14 publications

References 22 publications

Sex differences in innate anti-viral immune responses to respiratory viruses

Sex differences in innate anti-viral immune responses to respiratory viruses

Is respiratory syncytial virus infection more dangerous than COVID 19 in the neonatal period?

Burden of respiratory syncytial virus hospitalisation among infants born at 32–35 weeks' gestational age in the Northern Hemisphere: pooled analysis of seven studies

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