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Published on: December 10, 2013
Risk Factors for Severe Respiratory Syncytial Virus Infection in Hospitalized Children
Małgorzata Kobiałka1, Teresa Jackowska1,2, August Wrotek1,2
1Department of Pediatrics, Bielanski Hospital, 01-809 Warsaw, Poland.
Insights
Infants under 3 months, premature infants, and those with apnea face higher risks for severe respiratory syncytial virus (RSV) disease, necessitating targeted prevention and management strategies.
Area of Science:
- Pediatrics
- Infectious Diseases
- Public Health
Background:
- Respiratory Syncytial Virus (RSV) is a common cause of hospitalization in infants.
- Understanding risk factors for severe RSV disease is critical for effective public health interventions.
Purpose of the Study:
- To identify key risk factors associated with severe outcomes in laboratory-confirmed RSV hospitalizations.
- To inform clinical practice and public health strategies for RSV prevention.
Main Methods:
- Retrospective analysis of 594 children with laboratory-confirmed RSV hospitalizations.
- Evaluation of factors including pregnancy, birth status, smoke exposure, nutrition, social conditions, and clinical presentation.
- Severe disease defined by need for passive oxygen therapy (pO2Tx), pneumonia, respiratory failure, ICU transfer, or prolonged hospitalization.
Main Results:
- Age under 3 months, prematurity, and apnea were significantly associated with severe RSV outcomes.
- Specific risk factors identified for passive oxygen therapy (pO2Tx), pneumonia, respiratory failure, ICU transfer, and prolonged hospitalization.
- Maternal smoke exposure and dyspnea were linked to pneumonia, while apnea strongly predicted respiratory failure and ICU transfer.
Conclusions:
- Infants aged up to 3 months, premature infants, and those experiencing apnea are at increased risk for severe RSV disease.
- These findings highlight critical demographic and clinical factors for identifying high-risk infants requiring closer monitoring and intervention.
Background:
RSV often leads to hospitalization, and accurate knowledge of risk factors is crucial.
Methods:
We retrospectively analyzed laboratory-confirmed RSV hospitalizations regarding pregnancy factors, birth status, cigarette smoke exposure, nutrition, social conditions, clinical presentation, and severe disease defined as a need for passive oxygen therapy (pO2Tx), the presence of pneumonia, respiratory failure, intensive care unit (ICU) transfer, and prolonged hospitalization.
Results:
A univariate analysis included 594 children (median age 4 months) and revealed a pO2Tx relationship with age ≤ 3 months (OR = 1.56), prematurity (OR = 1.71), being born during RSV season (OR = 1.72), smoke exposure during pregnancy (both parents (OR = 2.41, father (OR = 1.8)), dyspnea (OR = 5.09), and presence of apnea (OR = 5.81). Pneumonia was associated with maternal smoke exposure (OR = 5.01), fever (OR = 3.92), dyspnea (OR = 1.62), history of aspiration (OR = 4.63), and inversely with age ≤ 3 months (OR = 0.45). Respiratory failure was associated with prematurity (OR = 3.13) and apnea (OR = 18.78), while the lower odds were associated with older age (OR = 0.57 per month) and presence of fever (OR = 0.11). ICU transfer was associated with apnea (OR = 17.18), but an inverse association was observed with age (OR = 0.54) and fever (OR = 0.11). A prolonged hospital stay was associated with prematurity (OR = 1.76), low birth weight (OR = 2.89), aspiration (OR = 4.93), and presence of fever (OR = 1.51).
Conclusions:
Age (up to 3 months), prematurity, and presence of apnea are risk factors for a severe RSV course.
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