Children with Down syndrome are high-risk for severe respiratory syncytial virus disease

David R Stagliano1, Cade M Nylund2, Matilda B Eide2

  • 1Department of Pediatrics, Walter Reed National Military Medical Center, Bethesda, MD; Department of Pediatrics, Uniformed Services University of the Health Sciences, Bethesda, MD.

The Journal of Pediatrics
|January 18, 2015
PubMed

Insights

Children with Down syndrome face a significantly higher risk of respiratory syncytial virus (RSV) hospitalization and more severe illness. This increased risk persists beyond 24 months of age.

Area of Science:

  • Pediatric Infectious Diseases
  • Genetics and Developmental Disorders

Background:

  • Respiratory syncytial virus (RSV) is a common cause of respiratory illness in young children.
  • Down syndrome is a genetic disorder associated with various health complications, potentially increasing vulnerability to infections.

Purpose of the Study:

  • To determine if Down syndrome is an independent risk factor for RSV hospitalization in children under three years old.
  • To evaluate the severity of RSV illness in children with and without Down syndrome.

Main Methods:

  • Retrospective cohort study utilizing military health system data.
  • Cox proportional hazards model to assess RSV hospitalization risk, controlling for other factors.
  • Disease severity assessed by hospitalization length, respiratory support needs, and age at admission.

Main Results:

  • Children with Down syndrome had a 9.6% RSV hospitalization rate compared to 2.8% in others.
  • Down syndrome conferred a significantly higher adjusted hazard ratio (3.46) for RSV hospitalization.
  • Patients with Down syndrome experienced longer hospital stays (median 4 vs 2 days) and greater need for respiratory support (RR 5.5).

Conclusions:

  • Down syndrome is an independent risk factor for increased RSV hospitalization.
  • Children with Down syndrome exhibit more severe RSV illness and are older at hospitalization.
  • The elevated risk of RSV hospitalization associated with Down syndrome extends beyond 24 months of age.
Abstract

Related Concept Videos

Acute Respiratory Failure-II01:21

Acute Respiratory Failure-II

Type I Respiratory Failure, or hypoxemic respiratory failure, occurs when the partial pressure of oxygen (PaO2) in arterial blood falls below 60 mmHg while breathing room air without a corresponding increase in arterial carbon dioxide levels (PaCO2). This condition highlights a significant impairment in the lungs' capacity to oxygenate the blood.
The underlying physiological abnormalities that contribute to hypoxemic respiratory failure include:
1.6K
Common Respiratory Disorders01:31

Common Respiratory Disorders

Respiratory disorders, a prevalent health concern globally, are generally divided into two primary categories: upper and lower respiratory tract disorders. The categorization is based on the area of the respiratory system they affect.
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,...
1.9K
Cytomegalovirus Disease01:27

Cytomegalovirus Disease

Cytomegalovirus (CMV) disease is caused by human cytomegalovirus, a double-stranded DNA virus of the Herpesviridae family. While primary CMV infection is often asymptomatic in immunocompetent individuals, the virus can cause severe disease in neonates and immunocompromised patients. CMV is the most common cause of congenital viral infection in the United States, and a major pathogen in solid organ and hematopoietic stem cell transplant recipients.CMV is transmitted via bodily fluids, sexual...
71
Immunodeficiency Diseases01:25

Immunodeficiency Diseases

Immunodeficiency disorders are conditions in which the immune system's ability to fight infectious disease and cancer is compromised or entirely absent. The immune system comprises a complex network of cells, tissues, and organs that work together to protect the body from potentially harmful invaders. When this system is deficient or not functioning properly, it leaves the body susceptible to infections, diseases, or other complications.
There are three main causes of immunodeficiency...
3.7K
Acute Respiratory Failure-V01:29

Acute Respiratory Failure-V

The treatment for acute respiratory failure varies based on factors like the underlying cause, overall health, and severity. A collaborative healthcare team is essential for early detection, often through arterial blood gas analysis. Identifying the cause is the primary goal, with treatment strategies adjusted for ventilation/perfusion (V/Q) mismatch, shunting, or diffusion impairment.
Ensure that patients are monitored continuously for their response to therapy, including changes in...
691
Acute Respiratory Failure-III01:30

Acute Respiratory Failure-III

Hypercapnic respiratory failure, also known as Type 2 or ventilatory respiratory failure, is a severe condition characterized by the body's inability to effectively remove carbon dioxide (CO2) from the bloodstream. It leads to an arterial CO2 pressure (PaCO2) exceeding 45 mmHg and a blood pH above 7.35. This situation indicates that the body's ventilatory demand, or the ventilation needed to maintain normal PaCO2 levels, surpasses its supply or the maximum gas flow achievable without...
1.2K