Respiratory syncytial virus prophylaxis in children with cardiac disease: a retrospective single-centre study

Butt, Michelle; Symington, Amanda; Janes, Marianne; Steele, Susan M.; Elliott, LouAnn; Chant-Gambacort, Catherine; Mondal, Tapas; Paes, Bosco

doi:10.1017/s1047951113000401

Cited by 5 publications

(8 citation statements)

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“…Length of stay in hospital and ICU admissions vary among studies, but, on average, children with CHD and severe RSV infection spent an average of 4.4–14 days in hospital [5, 6, 8, 10, 27, 30, 33, 38–40, 42, 45, 47, 48, 52]. Up to 53% were admitted to ICU with a median stay of 9.5–11 days [5, 6, 10, 27, 30, 44]. A retrospective, single-center study of 30 children with CHD and severe RSV infection reported that more than half (53.3%) were admitted to PICU for treatment [6].…”

Section: Resultsmentioning

confidence: 99%

“…Up to 53% were admitted to ICU with a median stay of 9.5–11 days [5, 6, 10, 27, 30, 44]. A retrospective, single-center study of 30 children with CHD and severe RSV infection reported that more than half (53.3%) were admitted to PICU for treatment [6]. The majority (87.5%) of PICU admissions were in infants ≤2 years of age and the median number of days spent in PICU was 11 days (range 1–43 days).…”

Section: Resultsmentioning

confidence: 99%

“…The overall hospital LOS for all patients was 10 days (range: 1–65 days). Hospitalized children were susceptible to major complications following RSV infection: 20% were found to have concurrent bacterial sepsis, 16.7% electrolyte abnormalities, and 13.3% worsening of pulmonary hypertension [6]. …”

Section: Resultsmentioning

confidence: 99%

“…Available data from the published literature suggest that the case fatality rate for RSV is relatively low among infants and children with CHD in Western countries, ranging from 0 to 3.3% [5, 6, 8, 10, 30, 38–40, 42, 44, 47, 48, 52]. In a retrospective, single-center study of 30 children with CHD by Butt et al [6], conducted over a period of 7 years, only one death (3.3%) was attributed to RSV. Meberg et al [8] reported one death related to RSV infection among 500 RSVH children with CHD; a 4-month-old premature, male infant with Down syndrome, suffering from CLD, atrioventricular septal defect and heart failure.…”

Section: Resultsmentioning

confidence: 99%

“…If an infant develops respiratory syncytial virus (RSV) LRTI, oxygen uptake can be further impaired and the work of breathing in these infants with compromised cardiac reserve is increased [5]. Infants and young children with CHD are especially at risk for severe disease and hospitalization and, in some instances, may require admission to the intensive care unit (ICU), supplemental oxygen therapy and prolonged mechanical ventilation [5, 6]. Furthermore, RSV LRTI can cause mortality in the immediate period surrounding either palliative or corrective cardiac surgery employing cardiopulmonary bypass [7].…”

Section: Introductionmentioning

confidence: 99%

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Defining the Risk and Associated Morbidity and Mortality of Severe Respiratory Syncytial Virus Infection Among Infants with Congenital Heart Disease

et al. 2017

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IntroductionThe REGAL (RSV Evidence—a Geographical Archive of the Literature) series provide a comprehensive review of the published evidence in the field of respiratory syncytial virus (RSV) in Western countries over the last 20 years. This fourth publication covers the risk and burden of RSV infection in infants with congenital heart disease (CHD).MethodsA systematic review was undertaken for articles published between January 1, 1995 and December 31, 2015 across PubMed, Embase, The Cochrane Library, and Clinicaltrials.gov. Studies reporting data for hospital visits/admissions for RSV infection among children with CHD as well as studies reporting RSV-associated morbidity, mortality, and healthcare costs were included. The focus was on children not receiving RSV prophylaxis. Study quality and strength of evidence (SOE) were graded using recognized criteria.ResultsA total of 1325 studies were identified of which 38 were included. CHD, in particular hemodynamically significant CHD, is an independent predictor for RSV hospitalization (RSVH) (high SOE). RSVH rates were generally high in young children (<4 years) with CHD (various classifications), varying between 14 and 357/1000 (high SOE). Children (<6 years) with RSV infection spent 4.4–14 days in hospital, with up to 53% requiring intensive care (high SOE). Infants (<2 years) with CHD had a more severe course of RSVH than those without CHD (high SOE). Case fatality rates of up to 3% were associated with RSV infection in children with CHD (high SOE). RSV infection in the perioperative period of corrective surgery and nosocomial RSV infection in intensive care units also represent important causes of morbidity (moderate SOE).ConclusionCHD poses a significant risk for RSVH and subsequent morbidity and mortality. RSV infection often complicates corrective heart surgery. To reduce the burden and improve outcomes, further research and specific studies are needed to determine the longer-term effects of severe RSV infection in young children with CHD.Electronic supplementary materialThe online version of this article (doi:10.1007/s40121-016-0142-x) contains supplementary material, which is available to authorized users.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations

Defining the Risk and Associated Morbidity and Mortality of Severe Respiratory Syncytial Virus Infection Among Infants with Congenital Heart Disease

et al. 2017

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Respiratory Syncytial Virus and Associations With Cardiovascular Disease in Adults

Ivey

Edwards

Talbot³

2018

Journal of the American College of Cardiology

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Respiratory syncytial virus (RSV) is historically known for causing respiratory illness in young children, but the appreciation of its impact on older adults is growing. Studies have shown that hospitalization for respiratory illness due to RSV is complicated by cardiovascular events in 14% to 22% of adult patients, including worsening congestive heart failure, acute coronary syndrome, and arrhythmias. Additionally, underlying cardiovascular disease is associated with hospitalization in 45% to 63% of adults with confirmed RSV. In summary, patients with cardiopulmonary disease have higher rates of health care utilization for RSV-related illness and worse outcomes. Patients with cardiovascular disease likely represent an important target population for the rapidly developing field of RSV vaccines.

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Burden of Respiratory Syncytial Virus Disease and Mortality Risk Factors in Argentina: 18 Years of Active Surveillance in a Children’s Hospital

Gentile¹,

Lución²,

Juárez³

et al. 2019

Pediatric Infectious Disease Journal

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Background: Respiratory Syncytial Virus (RSV) is the leading cause of acute lower respiratory infection (ALRI) in children. We aimed to describe the clinical-epidemiological pattern and risk factors for mortality associated with RSV infection. Methods: A prospective, cross-sectional study of ALRI in children admitted to the Children's Hospital among 2000-2017. Viral diagnosis was made by fluorescent antibody techniques or real time-PCR. We compared clinical-epidemiological characteristics of RSV infection in non-fatal versus fatal cases. Multiple logistic regression was used to identify independent predictors of mortality. Results: Of a total 15,451 patients with ALRI, 13,033 were tested for respiratory viruses and 5831 (45%) were positive: RSV 81.3% (4738), influenza 7.6% (440), parainfluenza 6.9% (402) and adenovirus 4.3% (251). RSV had a seasonal epidemic pattern coinciding with months of lowest average temperature. RSV cases show a case fatality rate of 1.7% (82/4687). Fatal cases had a higher proportion of: prematurity (p<0.01), perinatal respiratory history (p<0.01), malnourishment (p<0.01), congenital heart disease (p<0.01), chronic neurological disease (p<0.01) and pneumonia at clinical presentation (p=0.014). No significant difference between genders was observed. Most deaths occurred among children who had complications: respiratory distress (80.5%), nosocomial infections (45.7%), sepsis (31.7%) and atelectasis (13.4%). Independent predictors of RSV mortality were: moderate to severe malnourishment, OR 3.69 (95% CI 1.98-6.87) p< 0.0001, chronic neurological disease, OR 4.14 (95% CI 2.12-8.08) p< 0.0001, congenital heart disease, OR 4.18 (95% CI 2.39-7.32) p< 0.0001 and the age less than 6 months, OR 1.99 (95%CI 1.24-3.18) p=0.004.

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Respiratory syncytial virus prophylaxis in children with cardiac disease: a retrospective single-centre study

Cited by 5 publications

References 39 publications

Defining the Risk and Associated Morbidity and Mortality of Severe Respiratory Syncytial Virus Infection Among Infants with Congenital Heart Disease

Defining the Risk and Associated Morbidity and Mortality of Severe Respiratory Syncytial Virus Infection Among Infants with Congenital Heart Disease

Respiratory Syncytial Virus and Associations With Cardiovascular Disease in Adults

Burden of Respiratory Syncytial Virus Disease and Mortality Risk Factors in Argentina: 18 Years of Active Surveillance in a Children’s Hospital

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