Viral lower respiratory tract infections and preterm infants’ healthcare utilisation

Drysdale, Simon B.; Alcazar-Paris, Mireia; Wilson, Theresa; Smith, M. A.; Zuckerman, Mark; Peacock, Janet L.; Johnston, Sebastian L.; Greenough, Anne

doi:10.1007/s00431-014-2380-9

Cited by 18 publications

(17 citation statements)

References 14 publications

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“…Increased clinical care for preterm infants hospitalised with RSV translates to increased morbidity, healthcare utilisation and costs of care for respiratory illnesses later in life [65,66]. Early-life hospitalisation with RSV infection among preterm infants has been associated with more than a 2-fold increase in the mean number of subsequent hospitalisations during the 4 years following the initial infection (1.28 vs. 2.96; P < 0.001), when compared with non RSV-related hospitalisation [67].…”

Section: Viral Infection Requiring Readmission In Early Lifementioning

confidence: 99%

The impact of respiratory viruses on lung health after preterm birth

Townsi

Laing

Hall

et al. 2018

European Clinical Respiratory Journal

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Children born preterm, less than 37 weeks’ gestation, are at increased risk of viral respiratory infections and associated complications both during their initial birth hospitalisation and in their first years following discharge. This increased burden of viral respiratory infections is likely to have long term implications for lung health and function in individuals born preterm, particularly those with bronchopulmonary dysplasia. Several hypotheses have been put forward to explain the association between early life viral respiratory infection and development of suboptimal lung health and function later in life following preterm birth. Although preterm infants with diminished lung function, particularly small airways, might be particularly susceptible to asthma and wheezing disorders following viral infection, there is evidence that respiratory viruses can activate number of inflammatory and airway re-modelling pathways. Therefore, the aim of this review is to highlight the perinatal and early life risk factors that may contribute to increased susceptibility to viral respiratory infections among preterm infants during early life and to understand how respiratory viral infection may influence the development of abnormal lung health and function later in life.

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Section: Viral Infection Requiring Readmission In Early Lifementioning

confidence: 99%

The impact of respiratory viruses on lung health after preterm birth

Townsi

Laing

Hall

et al. 2018

European Clinical Respiratory Journal

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“…Data from a 2003 retrospective study suggest that prematurity ≤35 wGA is a risk factor for greater use of hospital resources and poorer clinical outcomes during hospitalization for severe RSV infection [14]. In addition, RSV infection in preterm infants has been associated with chronic respiratory morbidity and increased healthcare costs [15–19]. Currently, no effective vaccine against RSV exists, but RSV immunoprophylaxis is available for certain high-risk groups to prevent RSV disease.…”

Section: Introductionmentioning

confidence: 99%

Defining the Risk and Associated Morbidity and Mortality of Severe Respiratory Syncytial Virus Infection Among Preterm Infants Without Chronic Lung Disease or Congenital Heart Disease

Manzoni

Paes

et al. 2016

Infect Dis Ther

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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 second publication covers the risk and burden of RSV infection in preterm infants born at <37 weeks’ gestational age (wGA) without chronic lung disease or congenital heart disease.MethodsA systematic review was undertaken for articles published between January 1, 1995 and December 31, 2015. Studies reporting data for hospital visits/admissions for RSV infection among preterm infants as well as studies reporting RSV-associated morbidity, mortality, and risk factors were included. Study quality and strength of evidence (SOE) were graded using recognized criteria.Results2469 studies were identified of which 85 were included. Preterm infants, particularly those born at lower wGA, tended to have higher RSV hospitalization (RSVH) rates compared with otherwise healthy term infants (high SOE). RSVH rates ranged from ~5 per 1000 children to >100 per 1000 children with the highest rates shown in the lowest gestational age infants (high SOE). Independent risk factors associated with RSVH include: proximity of birth to the RSV season, living with school-age siblings, smoking of mother during pregnancy or infant exposure to environmental smoking, reduced breast feeding, male sex, and familial atopy (asthma) (high SOE). Predictive models can identify 32/33–35 wGA infants at risk of RSVH (high SOE).ConclusionRSV infection remains a major burden on Western healthcare systems and is associated with significant morbidity. Further studies focusing on the prevalence and burden of RSV in different gestational age cohorts, the changing risk of RSVH during the first year of life, and on RSV-related mortality in preterm infants are needed to determine the true burden of disease.FundingAbbVie.Electronic supplementary materialThe online version of this article (doi:10.1007/s40121-016-0130-1) contains supplementary material, which is available to authorized users.

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“…Numerous studies document an increased risk of LRI due to respiratory viruses in premature infants, though many studies focus on RSV. 56–59 In preterm infants, respiratory viral LRI in the first years are later associated with long-term pulmonary consequences and diminished lung function. 60–63 …”

Section: Premature Infants and Respiratory Virusesmentioning

confidence: 99%

Human metapneumovirus in the preterm neonate: current perspectives

Maitre

Williams

2016

RRN

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Premature birth (<37 weeks gestation) occurs in ~11% of all births in the US. These infants are at risk of chronic lung disease and respiratory conditions, including bronchopulmonary dysplasia. Respiratory viruses are important causes of acute respiratory illness (ARI) in preterm infants, leading to rehospitalization, increased health care burden, and long-term morbidity. Human metapneumovirus (HMPV) is a paramyxovirus discovered in 2001 that is related to respiratory syncytial virus. Epidemiologic studies show that HMPV is a leading cause of ARI in children and adults worldwide. Prematurity is a major risk factor for severe HMPV disease, requiring hospitalization. Moreover, limited data suggest that HMPV infection during infancy is associated with asthma and recurrent wheezing, which are common long-term pulmonary complication of prematurity. HMPV causes nosocomial outbreaks of ARI in hospitals and long-term care facilities, although there are few studies of the prevalence of HMPV in neonatal intensive care unit populations. HMPV is a common and important virus in premature infants, and caregivers for preterm infants should consider this virus in patients with acute respiratory symptoms.

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Viral lower respiratory tract infections and preterm infants’ healthcare utilisation

Abstract: RSV LRTIs are associated with increased healthcare utilisation and cost of care in the first and second year; nevertheless, if prophylaxis is to be cost-effective in the second year, a high risk group needs to be identified.

Cited by 18 publications

References 14 publications

The impact of respiratory viruses on lung health after preterm birth

The impact of respiratory viruses on lung health after preterm birth

Defining the Risk and Associated Morbidity and Mortality of Severe Respiratory Syncytial Virus Infection Among Preterm Infants Without Chronic Lung Disease or Congenital Heart Disease

Human metapneumovirus in the preterm neonate: current perspectives

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