Respiratory syncytial virus (RSV) infection in children with medical complexity

Collection Location Koleksi E-book & E-Journal Perpustakaan Pusat Unila
Edition Vol. 38, Issue 1
Call Number
ISBN/ISSN 1435-4373
Author(s) A. Lim...[et al.]
Subject(s) Biomedicine
Classification NONE
Series Title
GMD E-Journal
Language English
Publisher Springer
Publishing Year 2019
Publishing Place Switzerland
Abstract/Notes Abstract
Children with medical complexity (CMC) are vulnerable to respiratory illness hospitalization (RIH) and respiratory syncytial
virus (RSV)-related hospitalization (RSVH) due tomultisystem disorders and compromised airways. It is unknown whether RSV
prophylaxis is effective, or if RSVH is associated with significant morbidities in CMC. The study objectives were to (1)
determine the incidence of RSV-related infection in prophylaxed CMC during the first 3 years of life and (2) assess the burden
of illness following RSVH. A single tertiary center, retrospective study, was conducted of CMC who received palivizumab
during the 2012–2016 RSV seasons. Fifty-four subjects were enrolled; most received one (38.9%, n = 21) or two (57.4%, n = 31)
seasons of prophylaxis (mean = 4.2 [SD = 1.24], palivizumab doses per season). The cohort comprised children with multiple
medical conditions (n = 22, 40.8%), tracheostomy (n = 18, 33.3%), and invasive (n = 10, 18.5%) or non-invasive (n = 4, 7.4%)
ventilation. Of the CMC, 24 were hospitalized 47 times for a viral-related respiratory illness. RSVincidence in the first 3 years of
life was 7.4%. Viral-related RIH and RSVH rates were 44.4% (n = 24/54) and 1.9% (n = 1/54), respectively. Of the four RSVpositive
children, one was ventilated for 9 days, two acquired nosocomial RSV that was managed on the ward, and one was
discharged home under close complex care supervision. All four RSV-positive cases required additional oxygen during their
illness. CMC experience a high viral-related RIH rate and palivizumab likely minimizes RSV-related events and associated
morbidities. The efficacy of palivizumab in CMC, especially in those ≤ 3 years, should be prospectively evaluated.
Keywords Medical complexity . Children . Respiratory syncytial virus . Palivizumab . Outcomes
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