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Development of a Global Respiratory Severity Score for Respiratory Syncytial Virus Infection in Infants
Mary T Caserta1, Xing Qiu2, Brenda Tesini1
1Division of Infectious Diseases, Department of Pediatrics, University of Rochester Medical Center, Rochester, NY, USA.
Insights
A new Global Respiratory Severity Score (GRSS) effectively quantifies respiratory syncytial virus (RSV) infection severity in infants. This validated research tool aids in understanding RSV pathogenesis and evaluating new treatments.
Area of Science:
- Pediatrics
- Infectious Diseases
- Clinical Research
Background:
- Respiratory syncytial virus (RSV) infection in infants presents with recognizable symptoms, but quantifying disease severity is challenging.
- Existing scoring systems for RSV severity in infants have limitations.
- A need exists for a reliable research tool to evaluate RSV disease severity in infants.
Purpose of the Study:
- To develop a Global Respiratory Severity Score (GRSS) for infants with primary RSV infection.
- To create a research tool for evaluating RSV pathogenesis.
- To establish a valid outcome measure for therapeutic interventions.
Main Methods:
- Prospective evaluation of previously healthy infants (<10 months) with RSV infections.
- Collection of clinical signs and symptoms from hospitalized and ambulatory infants.
- Development of GRSS using factor analysis on clinical data, with hospitalization status as the output variable.
Main Results:
- A total of 139 infants were enrolled (84 hospitalized, 55 nonhospitalized).
- Nine clinical variables were identified and weighted to create the GRSS.
- The GRSS demonstrated high accuracy (AUC = 0.961) and significant construct validity (correlation with length of stay, r = 0.586).
Conclusions:
- A novel GRSS was developed using routine clinical variables for infants with RSV infection.
- The GRSS is a validated research tool for assessing RSV severity.
- The GRSS can serve as a valuable endpoint for pathogenesis studies and outcome measure for therapeutic trials.
Background:
Respiratory syncytial virus (RSV) infection in infants has recognizable clinical signs and symptoms. However, quantification of disease severity is difficult, and published scores remain problematic. Thus, as part of a RSV pathogenesis study, we developed a global respiratory severity score (GRSS) as a research tool for evaluating infants with primary RSV infection.
Methods:
Previously healthy infants <10 months of age with RSV infections representing the spectrum of disease severity were prospectively evaluated. Clinical signs and symptoms were collected at 3 time points from hospitalized infants and those seen in ambulatory settings. Data were also extracted from office, emergency department, and hospital records. An unbiased data-driven approach using factor analysis was used to develop a GRSS.
Results:
A total of 139 infants (84 hospitalized and 55 nonhospitalized) were enrolled. Using hospitalization status as the output variable, 9 clinical variables were identified and weighted to produce a composite GRSS. The GRSS had an area under the receiver operator curve of 0.961. Construct validity was demonstrated via a significant correlation with length of stay (r = 0.586, P < .0001).
Conclusions:
Using routine clinical variables, we developed a severity score for infants with RSV infection that should be useful as an end point for investigation of disease pathogenesis and as an outcome measure for therapeutic interventions.
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