Down's syndrome is a risk factor for severe lower respiratory tract infection due to respiratory syncytial virus

Abstract

Children with Down's syndrome hospitalised due to RSV LRTI had longer hospital stays and worse clinical courses than controls, highlighting the need for RSV prophylaxis for children with Down's syndrome, especially under one year of age.

National cohort study showed that infants with Down's syndrome faced a high risk of hospitalisation for the respiratory syncytial virus

“…Finally, this study solely focused on the risk of RSV hospitalisation, not the severity of RSV disease. However, previous studies have showed that children with Down's syndrome hospitalised with RSV had a longer length of hospital stay and required more respiratory support .…”

Down Syndrome and the Risk of Severe RSV Infection: A Meta-analysis

“…15, 18 -21 Six studies were conducted in Europe, 12 -14, 16, 22, 23 3 studies were conducted in Asia, 15,18,21 2 studies were conducted in the United States, 17,19 and 1 study was conducted in Latin America. 20 A detailed description of these 12 studies is shown in Table 1, and a description of our quality assessment is presented in Table 2.…”

“…The authors of 3 studies reported oxygen use during RSV infection. 13,20,22 Children with DS were more likely to require oxygen support than controls (pooled OR: 6.53; 95% CI: 2.…”

Question 1: Palivizumab for all children with Down syndrome?

“…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. Lee et al 14 studied infants with RSV bronchiolitis requiring paediatric intensive care unit admission and found that the highest mortality risk was in children with DS compared with those with other at-risk cohorts such as prematurity or CLD.…”