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Generation, Amplification, and Titration of Recombinant Respiratory Syncytial Viruses
Published on: April 4, 2019
RSV causes more severe respiratory illness than influenza in admitted children under 2-years-old
Katherine M Tang1,2, Patricia Hametz1,2, William Southern2,3
1Department of Pediatrics, Children's Hospital at Montefiore, Division of Pediatric Hospital Medicine, Bronx, New York City, USA.
Insights
Respiratory syncytial virus (RSV) LRTI in infants leads to more complex hospital stays and respiratory support needs than influenza LRTI. This finding aids in hospital resource evaluation for pediatric respiratory infections.
Area of Science:
- Pediatric Infectious Diseases
- Respiratory Medicine
- Epidemiology
Background:
- Respiratory syncytial virus (RSV) and influenza cause severe lower respiratory tract infections (LRTI) in young children.
- Understanding differences in disease severity and hospital course is crucial for pediatric care.
Purpose of the Study:
- To compare the frequency of complex hospital courses in infants and toddlers admitted with RSV LRTI versus influenza LRTI.
- To identify key differences in clinical presentation and outcomes between RSV and influenza infections.
Main Methods:
- Retrospective cohort study of children under 2 years admitted with confirmed RSV or influenza LRTI (2016-2019).
- Complex hospital course defined as ICU admission, respiratory support, nasogastric tube feeding, prolonged stay, or death.
- Statistical analysis included regression models and time-to-event analysis.
Main Results:
- RSV admissions (89%) were more frequent than influenza admissions (11%).
- RSV admissions were significantly more likely to experience a complex hospital course (aOR=3.5) and require respiratory support (aHR=3.2).
- Influenza patients were older and more likely to present with abnormal heart rate and fever.
Conclusions:
- RSV LRTI is associated with a substantially higher risk of complex hospital course and need for respiratory support compared to influenza LRTI in young children.
- Findings can inform hospital resource allocation and clinical management strategies for pediatric respiratory infections.
Introduction:
Both respiratory syncytial virus (RSV) and influenza-associated lower respiratory tract infections (LRTI) cause serious respiratory infections in infants and toddlers. We aimed to assess the frequency of complex hospital courses among patients admitted with influenza versus RSV LRTI.
Methods:
A retrospective cohort study was performed on admissions of children <2 years who were admitted for LRTI and tested positive for influenza or RSV from 2016 to 2019. The primary outcome, complex hospital course, was a composite including: intensive care unit admission, respiratory support, nasogastric tube feeds, prolonged length of stay, and death. Secondary outcomes included 7-day readmission and time to respiratory support. Differences between RSV and influenza groups were assessed and unadjusted and adjusted regression models and competing risks time to event models were developed.
Results:
There were 1094 (89%) RSV admissions and 134 (11%) influenza admissions. Children admitted for influenza were significantly older (336 vs. 165 days, p < 0.001), more likely to present with an abnormal heart rate for age (84.3% vs. 73.5%, p < 0.01) and a fever (27.6% vs. 18.9%, p = 0.02). Admissions with RSV were significantly more likely to experience a complex hospital course (ORadj = 3.5, 95% CI: 2.2-5.6). In time to event analysis, RSV admissions had a significantly higher rate of respiratory support (HRadj = 3.2, 95% CI: 2.0, 5.2). Readmission rates were similar.
Conclusions:
RSV admissions were associated with a higher risk for a complex hospital course and required higher rates of respiratory support than influenza admissions. This information may help in evaluating hospital resources and admissions.
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