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Published on: December 10, 2013
Does weight influence the course of RSV bronchiolitis in hospitalized infants?
Shelly Tamir1, Inbal Golan-Tripto1,2,3, Itai Hazan1,4
1Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel.
Insights
Underweight infants hospitalized with respiratory syncytial virus (RSV) bronchiolitis face a higher risk of severe outcomes, including pediatric intensive care unit (PICU) admission and prolonged hospital stays. Overweight infants did not show increased severity.
Area of Science:
- Pediatrics
- Infectious Diseases
- Public Health
Background:
- Acute bronchiolitis is a leading cause of infant hospitalizations globally.
- The impact of infant weight on respiratory syncytial virus (RSV) bronchiolitis severity is not well understood.
- Abnormal weight status is linked to increased infectious disease morbidity and mortality.
Purpose of the Study:
- To investigate the association between infant weight status and the severity of RSV bronchiolitis.
- To identify specific risks for underweight and overweight infants hospitalized with RSV bronchiolitis.
Main Methods:
- Retrospective cohort study of 1936 infants under 24 months hospitalized for RSV bronchiolitis (2018-2022).
- Infants categorized into underweight (<5th percentile), normal-weight, and overweight (>85th percentile) based on weight.
- Analysis of pediatric intensive care unit (PICU) admission, length of stay (LOS), and hyponatremia rates.
Main Results:
- Underweight infants showed significantly higher PICU admission rates (9.1% vs. 3.5%) and prolonged LOS (3.13 vs. 2.79 days) compared to normal-weight infants.
- Hyponatremia was more frequent in underweight infants (23% vs. 15%).
- Multivariable analysis confirmed underweight infants had a 2.01-fold increased risk for PICU admission and 1.42-fold increased risk for prolonged LOS. Overweight status was not associated with increased severity.
Conclusions:
- Underweight infants hospitalized with RSV bronchiolitis experience a more severe disease course and higher complication rates.
- This subgroup requires careful attention and monitoring due to their increased risk of PICU admission and prolonged hospitalization.
- Weight status is an independent factor influencing RSV bronchiolitis severity in infants.
Abstract:
Acute bronchiolitis is among the most common causes of hospitalizations in infants worldwide. Associations between weight and severity of respiratory syncytial virus (RSV) bronchiolitis remain unclear. The aim of this study was to evaluate this association. A single-center, retrospective cohort study of infants aged under 24 months, who were hospitalized between 2018 and 2022 for RSV bronchiolitis. Data from computerized medical records were extracted using the MDclone platform. Participants were divided into three groups according to weight percentiles: underweight (below 5th percentile), normal-weight, and overweight (above 85th percentile). A total of 1936 infants (mean age 6.3 months, 55% males) were included, comprising 274 infants who were underweight, 1470 with normal weight, and 192 with overweight. Underweight infants had a higher rate of admission to the pediatric intensive care unit (PICU) (9.1% vs. 3.5%, P < 0.005) and prolonged length of stay (LOS) in the hospital (3.13 vs. 2.79 days P < 0.001) compared to those with normal weight. Hyponatremia was also more common in the underweight group (23% vs. 15%, P < 0.001). A multivariable model accounting for prematurity and birthweight predicted a relative risk of 2.01 (95% CI 1.13-3.48, P = 0.015) for PICU admission and 1.42 (95% CI 1.17-1.7, P < 0.001) for a prolonged LOS. Being overweight was not associated with a more severe disease. Conclusion: Underweight infants, hospitalized for RSV bronchiolitis, had a more severe disease course with a higher complication rate, including PICU admission and prolonged LOS. Thus, careful attention and supervision should be given to this subgroup of infants. What is Known: • Established risk factors for severe bronchiolitis include prematurity, BPD, CHD, and compromised immunity. • Abnormal weight status has been associated with an increased risk for morbidity and mortality from infectious diseases, proposedly due to the effects on endocrine and immunologic systems. What is New: • Underweight infants hospitalized with RSV bronchiolitis face an independent risk of PICU admission and prolonged hospital stay. • Conversely, overweight infants did not display associations with severity measures in our study.
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