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Clinical and Viral Factors Associated With Disease Severity and Subsequent Wheezing in Infants With Respiratory

Joseph P McGinley1, Gu Lung Lin1, Deniz Öner2

  • 1Oxford Vaccine Group, Department of Paediatrics, University of Oxford, Oxford, United Kingdom.

The Journal of Infectious Diseases
|July 28, 2022
PubMed

Insights

Younger infants face higher risks from respiratory syncytial virus (RSV) infections, including severe outcomes and later wheezing. RSV-A and RSV-B strains showed similar disease severity in this study.

Area of Science:

  • Pediatrics
  • Virology
  • Infectious Diseases

Background:

  • Respiratory syncytial virus (RSV) is a major cause of illness and death in young children globally.
  • Understanding factors influencing RSV disease severity is crucial for prevention and treatment strategies.

Purpose of the Study:

  • To investigate host demographic and viral factors linked to RSV disease severity in infants.
  • To assess the association between RSV infection severity and subsequent wheezing development.

Main Methods:

  • A study of 325 infants under 1 year old infected with RSV across three European countries (2017-2020).
  • Evaluation of clinical severity using the ReSViNET score, hospitalization rates, intensive care needs, and respiratory support.
  • Analysis of viral load, RSV-A and RSV-B strains, and demographic factors like age.

Main Results:

  • Younger infants (<3 months and 3-6 months) exhibited higher ReSViNET scores and increased need for hospitalization and respiratory support.
  • Higher viral load, RSV-A strain, and older age (≥6 months) were associated with a greater likelihood of fever.
  • RSV-A and RSV-B strains demonstrated comparable disease severity and viral dynamics.
  • Infants with more severe RSV infections were more prone to developing wheezing by one year of age.

Conclusions:

  • Infant age is a significant determinant of RSV disease severity, with younger infants being more vulnerable.
  • Specific viral and host factors influence symptom presentation, but RSV-A and RSV-B severity are similar.
  • Severe RSV infection in infancy is a predictor of subsequent wheezing, highlighting the long-term respiratory impact.

Keywords:
disease severityrespiratory syncytial virussubgroupviral loadwheezing

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