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An In vitro Model to Study Immune Responses of Human Peripheral Blood Mononuclear Cells to Human Respiratory Syncytial Virus Infection
Published on: December 10, 2013
Respiratory syncytial virus infections requiring hospitalization in patients with primary immunodeficiency
Luis Ignacio González-Granado1, Andrea Martín-Nalda2, Laia Alsina3
1Unidad de Inmunodeficiencias, Pediatría, Instituto de Investigación Hospital 12 de Octubre, Facultad de Medicina, Universidad Complutense, Madrid, Spain.
Insights
Children with primary immunodeficiencies (PIDs) admitted for severe respiratory syncytial virus (RSV) infection were most often diagnosed with combined immunodeficiency (CID) or CID with associated features (CIDwASF). These specific PIDs require focused RSV prevention strategies.
Area of Science:
- Pediatrics
- Immunology
- Infectious Diseases
Background:
- Severe acute respiratory infections (SARI) pose a significant risk to children with primary immunodeficiencies (PIDs).
- Respiratory syncytial virus (RSV) is a common pathogen causing SARI in this vulnerable population.
Purpose of the Study:
- To determine the incidence and severity of RSV-associated hospital admissions in children with PIDs.
- To identify specific types of PIDs at higher risk for severe RSV infections.
Main Methods:
- A nationwide, multicenter, cross-sectional study was conducted between 2011 and 2017 in Spain.
- Included were children with PIDs admitted for RSV-associated acute respiratory infections (RSV-ARI) across 15 hospitals.
Main Results:
- Out of 439 children with PIDs, 13 (3%) were hospitalized for RSV-ARI.
- Combined immunodeficiency (CID) and CID with associated or syndromic features (CIDwASF) were the most frequent PID types associated with RSV-ARI hospitalization.
- Complications occurred in 39% of admitted patients, with 31% requiring pediatric intensive care unit admission; no RSV-related deaths were reported.
Conclusions:
- Children with CID and CIDwASF are at a higher risk for severe RSV infections requiring hospitalization.
- Targeted preventive measures against RSV are crucial for these specific PID subgroups.
- Further research is warranted to validate these findings and inform clinical practice.
Introduction:
The aim of the study was to assess the incidence of hospital admission due to severe acute respiratory infection by respiratory syncytial virus (RSV-ARI) in children with primary immunodeficiencies (PIDs) and the severity of RSV-ARI in these patients.
Methods:
We conducted a nationwide cross-sectional retrospective and prospective multicentre study in the 2011-2017 period. The study was performed in 15 Spanish hospitals and included children with PID who required hospital admission due to RSV-ARI.
Results:
Out of 439 patients with PID followed up at participating hospitals, 13 (3%) required hospital admission due to RSV-ARI. The median age of admitted patients was 1.6 years (interquartile range, 0.5-2.2), and 7 were male. The types of PID most frequently associated with admission due to RSV-ARI were combined immunodeficiency (CID; 4/71; 6%) and CID with associated or syndromic features (CIDwASF; 6/147; 4%). Two of the 13 patients were receiving palivizumab for RSV prophylaxis, and 3 received potentially active therapies against RSV during the hospital stay. Viral coinfection was detected in 6 patients, 5 (39%) developed complications, and 4 (31%) required admission to the paediatric intensive care unit. There were no documented RSV-related deaths.
Conclusions:
In the group of patients with PID, severe RSV infection requiring hospitalization is more frequent in patients with CID and CIDwASF, in whom special efforts should be made to prevent RSV infection. Further studies are needed to confirm these results.
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