Children with health care-associated RSV more likely to need respiratory support
Key takeaways:
- More than half of children with hospital-associated RSV had multiple comorbid conditions.
- They were also up to five times more likely to need respiratory support.
Children with health care-associated respiratory syncytial virus were more likely to need respiratory support, compared with children with community-associated RSV, according to a recent study.
“Health care-associated respiratory syncytial virus (HA-RSV) infection is associated with morbidity and occasional mortality, especially in children with chronic conditions,” Lisa Saiman, MD, MPH, professor of pediatrics and an epidemiologist at New York-Presbyterian Morgan Stanley Children’s Hospital and Columbia University Irving Medical Center in New York, and colleagues wrote in the Journal of the Pediatric Infectious Diseases Society. “However, our understanding of adverse outcomes associated with HA-RSV infections has been limited due to the lack of a control group [with] which to compare outcomes. Thus, we compared risk factors and outcomes in children with HA-RSV infections vs. hospitalized children without HA-RSV infections.”
Saiman and colleagues conducted a prospective cohort study of 26 children (50% boys; median age, 15 months; interquartile range [IQR], 4-51 months) with HA-RSV who were hospitalized between October 2020 and April 2022 at six children’s hospitals across the United States. The control group included 78 children (51.3% boys; median age, 15.3 months; IQR, 3-41 months) hospitalized with non-HA-RSV matched by location, age and length of hospital stay.
Most children in the HA-RSV group and control group had two or more comorbid conditions (57.7% and 55.2%, respectively). Children in the HA-RSV group were more likely to have cardiovascular comorbidities (P = .005), but they were less likely to have respiratory comorbidities (P = .02), according to the researchers.
Five patients with HA-RSV also tested positive for adenovirus, human metapneumovirus, influenza A H3 or rhinovirus/enterovirus, the researchers wrote. In addition, three patients with HA-RSV tested positive for pathogens in their blood, whereas the control group had no positive blood cultures. Zero patients had positive respiratory cultures.
Saiman and colleagues also found that children with HA-RSV were three times more likely to need respiratory support compared with the control group (OR = 3.5; 95% CI, 1.1-10.7). Children with HA-RSV had even higher odds of needing respiratory support after the researchers adjusted for comorbidities (adjusted OR = 5.1; 95% CI, 1.4-19.1).
The odds of being transferred to the pediatric ICU were not significantly different between two groups, the researchers found. No patients with HA-RSV died during hospitalization, but two patients with non-HA-RSV died.
“HA-RSV infection was an independent factor associated with escalation of respiratory support,” the researchers wrote. “Strategies to reduce HA respiratory viral infections in children and standardizing case definitions and surveillance strategies are needed for HA-RSV and other respiratory viral pathogens.”
Collapse
Read more about