ICU admissions, ventilation occur without immunoprophylaxis for RSV

NEW ORLEANS – Premature infants born at 29 to 35 weeks’ gestational aged younger than 3 months were frequently admitted to the ICU and needed invasive mechanical ventilation for RSV when they did not receive immunoprophylaxis, according to the SENTINEL1 AstraZeneca study data presented at IDWeek 2016.

“We previously reported for 2014 to 2015, and this year it’s the 2014, 2015 and 2016 RSV seasons and looks at the course primarily measured by the length of stay at hospitals, need for ICU admission, mechanical ventilation are the main measures of morbidity,” Leonard Krilov, MD, an Infectious Diseases in Children Editorial Board Member and Chair of pediatrics at Winthrop-University Hospital, said in an interview. “The study breaks down the combination of both spectrums of gestational age and chronological age, and the observation is up to 6 months for these premature babies if hospitalized, that there are significant rates of ICU admission and need for mechanical ventilation.”

Leonard Krilov

The researchers conducted SENTINEL1 — an ongoing, multicenter, observational study — to determine the characteristics of RSV hospitalizations among infants born at 29 to 35 weeks’ gestation who do not receive immunoprophylaxis as treatment. The study occurred over two RSV seasons and included 709 infants in Season 1 and 689 in Season 2 who were hospitalized for RSV. In Season 1, 99% (n = 702) infants had community-acquired RSV and 98% (n = 678) in Season 2. Study infants did not receive RSV immunoprophylaxis within 35 days of symptom onset and were characterized and identified by code NCT02273882. Data from Season 2 was available until March 31, and researchers applied the Cochran-Mantel-Haenszel test to compare both seasons.

At the end of Season 2, 78% of the 678 infants hospitalized with community-acquired RSV were aged younger than 6 months when admitted. Analysis demonstrated that among all infants born at 29 to 35 weeks’, those younger than 3 months were more frequently admitted to the ICU (56% vs. 34%; P < .001) and needed invasive mechanical ventilation (30% versus 10%; P < .001) compared with infants between 3 months and 1 year.

“The youngest babies under 3 months of age chronologically, when they acquired RSV infection, ICU admission rates ran from [60% or higher] in the first year to 40% in the second season in the most severe cases, and similarly there were high rates in the need for mechanical ventilation as well,” Krilov told Infectious Diseases in Children. – by Kate Sherrer

Reference:

Anderson EJ, et al. Abstract 1279. Presented at: IDWeek; Oct. 26-30, 2016; New Orleans.

Disclosure: The study was sponsored by AstraZeneca. Krilov is an investigator and grant recipient for AstraZeneca and Regeneron. Please see the full study for a list of all researchers’ relevant financial disclosures.