Related Experiment Video
Updated: May 11, 2026
An Improved and High Throughput Respiratory Syncytial Virus (RSV) Micro-neutralization Assay
Published on: January 26, 2019
Respiratory syncytial virus prophylaxis in children with cardiac disease: a retrospective single-centre study
Michelle Butt1, Amanda Symington2, Marianne Janes2
11 School of Nursing, McMaster University, Hamilton, Ontario, Canada.
Insights
This study found that palivizumab prophylaxis is effective in preventing breakthrough respiratory syncytial virus infections in infants with congenital heart disease, with only 2.2% experiencing breakthrough infections. This demonstrates good efficacy in a high-risk population.
Area of Science:
- Pediatric Cardiology
- Infectious Diseases
- Respiratory Medicine
Background:
- Congenital heart disease (CHD) increases the risk of severe respiratory syncytial virus (RSV) infections.
- Palivizumab prophylaxis is used to reduce RSV-related hospitalizations in high-risk infants, including those with CHD.
Purpose of the Study:
- To characterize CHD patients hospitalized with RSV post-prophylaxis.
- To identify associated comorbidities in these patients.
- To determine the incidence of breakthrough RSV infections despite prophylaxis.
Main Methods:
- Retrospective, single-center study over 7 years.
- RSV infection identified via codes and virological tests.
- Analysis of demographics, cardiac anomalies, comorbidities, illness characteristics, management, complications, and palivizumab use.
Main Results:
- 30 CHD patients hospitalized with RSV; majority ≤ 2 years old.
- Common admission reasons: respiratory distress (86.7%), hypoxemia (66.7%), fever (60%).
- 2.2% breakthrough RSV infections in infants who received prophylaxis, indicating good efficacy.
Conclusions:
- Palivizumab prophylaxis demonstrates good efficacy in preventing RSV hospitalizations in infants with CHD.
- Breakthrough infections are rare, suggesting successful risk reduction in this vulnerable population.
- Further research can inform prophylaxis strategies for CHD infants.
Objectives:
To examine the characteristics of congenital heart disease patients hospitalised with respiratory syncytial virus infection after prophylaxis and determine the associated comorbidities and the incidence of breakthrough respiratory syncytial virus infections.
Study Design:
This is a retrospective, single-centre study that was conducted over a period of 7 years. Respiratory syncytial virus infection was identified by classification codes and confirmed by virological tests. Data on baseline demographics, cardiac anomalies, other underlying disease, criteria for hospitalisation, type of respiratory illness and management, complications, and palivizumab prophylaxis were analysed by standard descriptive methods and comparative statistics.
Results:
A total of 30 patients were enrolled. The majority were ≤ 2 years (n = 24). The mean admission age was 15.1 months (standard deviation = 18.3). In all, 90% were acyanotic, 40% had haemodynamically significant disease, and 60% had ≥ 1 underlying medical illness. Patients were admitted with: respiratory distress (86.7%), hypoxaemia (66.7%), fever (60%), inability to maintain oral intake (36.7%), and apnoea (16.7%). More than 50% required mechanical ventilation and intensive care with a median stay of 11 days (range: 1-43); the length of hospital stay for all children was 10 days (range: 1-65). Complications included: concurrent bacterial sepsis (20%), electrolyte abnormalities (16.7%), and worsening pulmonary hypertension (13.3%). Of 10 infants ≤ 2 years with haemodynamically significant heart disease, four had received prophylaxis. There was one death, which was attributed to respiratory syncytial virus infection.
Conclusions:
Overall, 185 infants ≤ 2 years with haemodynamically significant cardiac disease received prophylaxis. In all, six qualifying infants missed immunisation and were hospitalised. Breakthrough respiratory syncytial virus infections occurred in 2.2%, demonstrating good efficacy of palivizumab in this population compared with the original, multi-centre, randomised trial.
More Related Videos
Related Concept Videos
01:31Common Respiratory Disorders
Upper respiratory disorders impact the airways above the vocal cords, encompassing areas like the nose, sinuses, and throat. Various conditions fall under this category, including the common cold and allergic rhinitis. These disorders can stem from several causes,...
01:22Rheumatic Heart Disease II: Clinical Manifestations and Diagnostic Studies
01:21Acute Respiratory Failure-II
The underlying physiological abnormalities that contribute to hypoxemic respiratory failure include:
01:21Rheumatic Heart Disease III: Medical Management
01:29Acute Respiratory Failure-V
Ensure that patients are monitored continuously for their response to therapy, including changes in...
01:23Rheumatic Heart Disease I: Introduction