Predictors of severity and mortality in children hospitalized with respiratory syncytial virus infection in a tropical region

Abstract

Summary Introduction Respiratory syncytial virus (RSV) is one of the leading causes of acute lower respiratory infection (ALRI) in infants and young children. Although ALRI is a major public health problem in developing countries located in tropical areas, studies about RSV epidemiology in these regions are scarce. Methods In a retrospective cohort study, we investigated the epidemiology and predictive variables that reflect disease severity and mortality in young children hospitalized with ALRI due to RSV in Colombia, South-America, during a 2-year period (2009–2011). Results Of a total of 6,344 children with a diagnosis of ALRI, we selected 2,147 (33.8%) that were positive for RSV. After controlling for pre-existing conditions, we found that independent predictors of severe disease in our population included age <6 months (RR 2.01; CI 95% 1.70–2.38; P < 0.001), prematurity (RR 1.61; CI 95% 1.20–2.17; P = 0.001), congenital heart disease (RR 2.03; CI 95% 1.16–3.54; P = 0.013), and mixed RSV-adenovirus infection (RR 2.09; CI 95% 1.60–2.73; P < 0.001). Multivariate analysis identified that cancer (RR 31.60; CI 95% 5.97–167.13; P < 0.001) is a predictor of mortality in our RSV-infected pediatric population independently of age and other co-morbidities. Conclusions RSV is an important cause of ALRI in infants and young children living in tropical regions, especially during the rainy season. The identified predictors of severe disease and mortality should be taken into account when planning interventions to reduce the burden of ALRI in young children living in these regions.

Risk Factors of Early Otitis Media in the Danish National Birth Cohort

“…Exclusion criteria were: children born premature before gestational week 34 because of increased incidence of infections[34–36]; children with lip-palate malformation due to cranial deformation resulting in increased OM incidence[37], and Down syndrome (Fig 1). …”

Viral Infection in the Development and Progression of Pediatric Acute Respiratory Distress Syndrome

“…In RSV infection, development of lower respiratory track disease in premature infants, with or without chronic neonatal lung disease is associated with a significantly higher risk of hospitalization, intensive care unit admission, need for mechanical ventilation, and death (12, 70–73). In a study of 2,147 children with lower respiratory infection due to RSV, Rodriguez et al reported age less than 6 months, history of prematurity, chronic respiratory disease or congenital heart disease, and coinfection with adenovirus were significant predictors of increased disease severity (74). Similar predictors exist for children infected with influenza A (H1N1) virus, including age less than 5 years, a history of chronic lung disease, congenital heart disease, and immune compromise (Table 1) (75).…”

Caracterización Epidemiológica de Pacientes con Infección Respiratoria Aguda (IRA) en un Hospital de Segundo Nivel en la Región Caribe colombiana

“…En el departamento del Atlántico similares resultados se han encontrado con respecto al resto del país, ya que los virus respiratorios más frecuentes para este departamento son:influenza A, virus sincitial respiratorio, adenovirus y parainfluenza 3 (10, 12) y al igual que en otras investigaciones nuestros resultados coinciden con los reportados en diferentes regiones del país al identificar la tos, fiebre y dificultad respiratoria como los síntomas más frecuentes en estos pacientes (19). En los resultados obtenidos se encontró muy baja frecuencia de enfermedades crónicas de base en los pacientes con IRA; sin embargo, estudios a nivel mundial han indicado que estas enfermedades de base se asocian como predictores de severidad y mortalidad en casos de IRAG (20).…”