Risk Factors and Clinical Prognosis Associated With RSV-ALRI Intensive Care Unit Admission in Children <2 Years of Age: A Multicenter Study.
Pediatr Infect Dis J
; 43(6): 511-517, 2024 Jun 01.
Article
in En
| MEDLINE
| ID: mdl-38377461
ABSTRACT
BACKGROUND:
Respiratory syncytial virus (RSV) is the leading cause of acute lower respiratory infections (ALRIs) in children <2 years of age. Currently, there are limited data on risk factors for very severe RSV-ALRI requiring intensive care unit (ICU) admission.METHODS:
We conducted a case-control study of children <2 years old admitted with RSV-ALRI to the Sydney Children's Hospital Network, comprising 2 large tertiary pediatric hospitals. Cases were children with laboratory-confirmed RSV-ALRI admitted to ICU, and controls were (12, matched on date of admission) children hospitalized with RSV-ALRI but not requiring ICU transfer. Data on risk factors were retrieved from the electronic medical record system. Adjusted odds ratios (aORs) with 95% confidence intervals (95% CI) associated with risk factors for ICU admission and the association with clinical and treatment factors were determined from logistic regression models.RESULTS:
A total of 44 (44%) of 100 cases and 90 (48.1%) of 187 controls were male. Age <6 months and preterm births were associated with a 2.10-fold (95% CI 1.14-3.79) and 2.35-fold (95% CI 1.26-4.41) increased risk in ICU admissions, respectively. The presence of any chronic health condition was a significant risk factor for ICU admission. The clinical presentations on admission more commonly seen in cases were apnea (aOR 5.01, 95% CI 1.50-17.13) and respiratory distress (aOR 15.91, 95% CI 4.52-55.97). Cases were more likely to be hospitalized for longer duration and require respiratory support.CONCLUSIONS:
Our results can be translated into a clinical risk algorithm to identify children at risk of very severe RSV disease.
Full text:
1
Collection:
01-internacional
Database:
MEDLINE
Main subject:
Respiratory Syncytial Virus Infections
Limits:
Female
/
Humans
/
Infant
/
Male
/
Newborn
Language:
En
Journal:
Pediatr Infect Dis J
/
Pediatr. infect. dis. j
/
Pediatric infectious disease journal
Journal subject:
DOENCAS TRANSMISSIVEIS
/
PEDIATRIA
Year:
2024
Document type:
Article
Affiliation country:
Australia
Country of publication:
Estados Unidos