Burden of Respiratory Syncytial Virus Disease and Mortality Risk Factors in Argentina: 18 Years of Active Surveillance in a Children’s Hospital
Tóm tắt
Respiratory syncytial virus is the leading cause of acute lower respiratory infection in children. We aimed to describe the clinical-epidemiologic pattern and risk factors for mortality associated with RSV infection.
This is a prospective, cross-sectional study of acute lower respiratory infection in children admitted to the Children’s Hospital during 2000 to 2017. Viral diagnosis was made by fluorescent antibody techniques or real-time-polymerase chain reaction. We compared clinical-epidemiologic characteristics of RSV infection in nonfatal versus fatal cases. Multiple logistic regression was used to identify independent predictors of mortality.
Of 15,451 patients with acute lower respiratory infection, 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 (
RSV showed an epidemic pattern affecting mostly young children. Malnourishment, chronic neurologic disease, congenital heart disease and the age less than 6 months were the independent risk factors for RSV mortality.
Từ khóa
Tài liệu tham khảo
Shi, 2017, Global, regional, and national disease burden estimates of acute lower respiratory infections due to respiratory syncytial virus in young children in 2015: a systematic review and modelling study., Lancet, 390, 946, 10.1016/S0140-6736(17)30938-8
Hall, 2009, The burden of respiratory syncytial virus infection in young children., N Engl J Med, 360, 588, 10.1056/NEJMoa0804877
Prendergast, 2013, Rapid antigen-based testing for respiratory syncytial virus: moving diagnostics from bench to bedside?, Future Microbiol, 8, 435, 10.2217/fmb.13.9
Korppi, 2004, Rhinovirus-associated wheezing in infancy: comparison with respiratory syncytial virus bronchiolitis., Pediatr Infect Dis J, 23, 995, 10.1097/01.inf.0000143642.72480.53
Jartti, 2004, Respiratory picornaviruses and respiratory syncytial virus as causative agents of acute expiratory wheezing in children., Emerg Infect Dis, 10, 1095, 10.3201/eid1006.030629
DeVincenzo, 2010, Viral load drives disease in humans experimentally infected with respiratory syncytial virus., Am J Respir Crit Care Med, 182, 1305, 10.1164/rccm.201002-0221OC
Falsey, 2005, Respiratory syncytial virus infection in elderly and high-risk adults., N Engl J Med, 352, 1749, 10.1056/NEJMoa043951
Fernandez Jonusas, 2016, [Recommendations for palivizumab use. Update 2015]., Arch Argent Pediatr, 114, 84
2010, Consenso de la Sociedad Latinoamericana de Infectología Pediátrica sobre neumonia adquirida en la comunidad., Revista de Enfermedades Infecciosas en Pediatria, 24, 1
Scheltema, 2017, Global respiratory syncytial virus-associated mortality in young children (RSV GOLD): a retrospective case series., Lancet Glob Health, 5, e984, 10.1016/S2214-109X(17)30344-3
Roth, 2008, Acute lower respiratory infections in childhood: opportunities for reducing the global burden through nutritional interventions., Bulletin of the World Health Organization, 86, 321, 10.2471/BLT.07.049114
Panozzo, 2007, Variation in timing of respiratory syncytial virus outbreaks: lessons from national surveillance., Pediatr Infect Dis J, 26, S41, 10.1097/INF.0b013e318157da82
Piñeros, 2013, Respiratory syncytial virus infection as a cause of hospitalization in population under 1 year in Colombia., J Pediatr (Rio J), 89, 544, 10.1016/j.jped.2013.04.002
Gamiño-Arroyo, 2017, Epidemiology and clinical characteristics of respiratory syncytial virus infections among children and adults in Mexico., Influenza Other Respir Viruses, 11, 48, 10.1111/irv.12414
Gurgel, 2016, Relative frequency, Possible Risk Factors, Viral Codetection Rates, and Seasonality of Respiratory Syncytial Virus Among Children With Lower Respiratory Tract Infection in Northeastern Brazil., Medicine (Baltimore), 95, e3090, 10.1097/MD.0000000000003090
Kamigaki, 2016, Seasonality of Influenza and Respiratory Syncytial Viruses and the Effect of Climate Factors in Subtropical-Tropical Asia Using Influenza-Like Illness Surveillance Data, 2010 -2012., PLoS One, 11, e0167712, 10.1371/journal.pone.0167712
Meerhoff, 2009, Variation of respiratory syncytial virus and the relation with meteorological factors in different winter seasons., Pediatr Infect Dis J, 28, 860, 10.1097/INF.0b013e3181a3e949
Walton, 2010, Predicting the start week of respiratory syncytial virus outbreaks using real time weather variables., BMC Med Inform Decis Mak, 10, 68, 10.1186/1472-6947-10-68
Walsh, 2017, Respiratory Syncytial Virus Infection: An Illness for All Ages., Clin Chest Med, 38, 29, 10.1016/j.ccm.2016.11.010
García, 2010, Risk factors in children hospitalized with RSV bronchiolitis versus non-RSV bronchiolitis., Pediatrics, 126, e1453, 10.1542/peds.2010-0507
Andres, 2012, Hospitalization due to respiratory syncytial virus infection in patients under 2 years of age with hemodynamically significant congenital heart disease., J Pediatr (Rio J), 88, 246, 10.2223/JPED.2202
Stein, 2017, Respiratory syncytial virus hospitalization and mortality: Systematic review and meta-analysis., Pediatr Pulmonol, 52, 556, 10.1002/ppul.23570
Robledo-Aceves, 2018, Risk factors for severe bronchiolitis caused by respiratory virus infections among Mexican children in an emergency department., Medicine (Baltimore), 97, e0057, 10.1097/MD.0000000000010057
Checchia, 2017, Defining the Risk and Associated Morbidity and Mortality of Severe Respiratory Syncytial Virus Infection Among Infants with Congenital Heart Disease., Infect Dis Ther, 6, 37, 10.1007/s40121-016-0142-x
Medrano López, 2010, Community-acquired respiratory infections in young children with congenital heart diseases in the palivizumab era: the Spanish 4-season civic epidemiologic study., Pediatr Infect Dis J, 29, 1077, 10.1097/INF.0b013e3181efdac5
Butt, 2014, Respiratory syncytial virus prophylaxis in children with cardiac disease: a retrospective single-centre study., Cardiol Young, 24, 337, 10.1017/S1047951113000401
Byington, 2015, Respiratory syncytial virus-associated mortality in hospitalized infants and young children., Pediatrics, 135, e24, 10.1542/peds.2014-2151
Bardach, 2014, Systematic review and meta-analysis of respiratory syncytial virus infection epidemiology in Latin America., Rev Med Virol, 24, 76, 10.1002/rmv.1775
Castillo, 2017, One-year observational study of palivizumab prophylaxis on infants at risk for respiratory syncytial virus infection in Latin America., J Pediatr (Rio J), 93, 467, 10.1016/j.jped.2016.11.006
Nair, 2010, Global burden of acute lower respiratory infections due to respiratory syncytial virus in young children: a systematic review and meta-analysis., Lancet, 375, 1545, 10.1016/S0140-6736(10)60206-1
Portillo, 2000, A quick diagnostic immunofluorescence test in children hospitalized with acute respiratory infections., Arch Argent Pediatr, 98, 99
Griffin, 2004, Epidemiology of respiratory infections in young children: insights from the new vaccine surveillance network., Pediatr Infect Dis J, 23, S188, 10.1097/01.inf.0000144660.53024.64
Sadeghi, 2011, Twelve years’ detection of respiratory viruses by immunofluorescence in hospitalised children: impact of the introduction of a new respiratory picornavirus assay., BMC Infect Dis, 11, 41, 10.1186/1471-2334-11-41
Lucion, 2018, RSV a promising future for vaccines., Rev Hosp Niños, 60, 118