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Published on: December 10, 2013
Characteristics of Children Aged 0 to 23 Months Hospitalized With Respiratory Syncytial Virus
Dennis Wang1,2,3, Huong T Pham1, Shua Chai4,5
1National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia.
Insights
Underlying medical conditions increase severe respiratory syncytial virus (RSV) hospitalization risk in older infants. Conditions like airway abnormalities and Down syndrome are linked to prolonged intensive care unit stays for young children.
Area of Science:
- Pediatric Infectious Diseases
- Respiratory Medicine
- Public Health Surveillance
Background:
- Respiratory syncytial virus (RSV) is a major cause of pediatric hospitalizations.
- Nirsevimab is recommended for infants <8 months and high-risk infants 8-19 months.
- Identifying older infants at high risk for severe RSV is crucial.
Purpose of the Study:
- To identify risk factors for severe RSV disease in children aged 8-19 months.
- To analyze demographics and clinical characteristics of hospitalized children.
- To inform targeted RSV prevention strategies.
Main Methods:
- Utilized the Respiratory Syncytial Virus Hospitalization Surveillance Network data (12 states, 2022-2023).
- Compared hospitalized children aged 0-23 months by age group.
- Analyzed children aged 12-23 months by intensive care unit (ICU) admission severity.
Main Results:
- Hospitalized children aged 12-23 months had higher rates of underlying medical conditions (UMCs) compared to infants aged 0-2 months.
- Prolonged ICU admission (≥3 days) in children 12-23 months was associated with specific UMCs.
- Identified risk factors included airway abnormalities, cardiovascular disease, Down syndrome, and feeding tube dependence.
Conclusions:
- UMCs are more prevalent in older hospitalized infants with RSV.
- Specific UMCs significantly increase the risk of severe outcomes, including prolonged ICU stays.
- Findings aid in refining risk assessment for severe RSV in infants and young children.
Background And Objectives:
Respiratory syncytial virus (RSV) is a leading cause of hospitalization among young children. Nirsevimab is recommended for all infants younger than 8 months and children aged 8 to 19 months who are at increased risk of severe RSV entering their second RSV season. Additional data are necessary to identify children aged 8 to 19 months at increased risk for severe disease.
Methods:
The Respiratory Syncytial Virus Hospitalization Surveillance Network, a population-based surveillance system, captures laboratory-confirmed RSV-associated hospitalizations in 12 states. We compared demographics and clinical characteristics of children aged 0 to 23 months by age category, and of children aged 12 to 23 months by severity (not admitted to the intensive care unit [ICU], admitted to the ICU, or with prolonged [≥3 days] ICU admission) during the 2022-2023 season using χ2 tests and logistic regression.
Results:
Among 3659 randomly sampled hospitalized children in 2022-2023, 31.2%, 40.0%, and 28.9% were aged 0 to 2, 3 to 11, and 12 to 23 months, respectively. Compared with children aged 0 to 2 months, children 3 to 11 and 12 to 23 months were more likely to have at least 1 underlying medical condition (UMC) (3.4%, 12.6%, 23.4%, respectively; P < .05). Children aged 12 to 23 months with prolonged ICU admission were more likely to have airway abnormalities, cardiovascular disease (CVD), Down syndrome (with or without concomitant CVD), and feeding tube dependence than those without ICU admission (P < .05 for all).
Conclusions:
UMCs were more frequently identified among hospitalized children aged 12 to 23 months compared with children 0 to 2 months; prolonged ICU admission was associated with airway abnormalities, CVD, Down syndrome, and feeding tube dependence.
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