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Severity of respiratory syncytial virus infection is related to virus strain
E E Walsh1, K M McConnochie, C E Long
1Department of Medicine, University of Rochester School of Medicine and Dentistry, New York, USA.
Insights
Respiratory syncytial virus (RSV) group A infection is linked to more severe illness in hospitalized infants compared to group B. Factors like prematurity and young age also increase the risk of severe RSV disease.
Area of Science:
- Pediatrics
- Virology
- Infectious Diseases
Background:
- Respiratory syncytial virus (RSV) is a common cause of infant hospitalization.
- Understanding strain-specific differences in disease severity is crucial for clinical management.
Purpose of the Study:
- To assess the relationship between RSV strain (group A vs. group B) and disease severity in hospitalized infants.
- To identify independent risk factors associated with severe RSV infection.
Main Methods:
- A severity index was developed using clinical and physiological parameters.
- Multivariate analysis was performed on data from 265 hospitalized infants over a 3-year period.
- Infants were categorized by RSV group A (134) or group B (131) infection.
Main Results:
- Group A RSV infection was independently associated with severe disease (Odds Ratio: 3.26).
- Other independent risk factors for severe disease included prematurity (OR: 1.83), underlying medical conditions (OR: 2.84), and age ≤3 months (OR: 4.39).
- Group B RSV infections were associated with significantly lower severity indices and less need for ventilatory support compared to group A.
Conclusions:
- Group A RSV infection leads to greater disease severity in hospitalized infants compared to group B.
- Prematurity, underlying medical conditions, and young age are significant risk factors for severe RSV disease.
Abstract:
The relationship between respiratory syncytial virus (RSV) strain and disease severity was assessed in 265 hospitalized infants over a 3-year period (1988-1991). A severity index of clinical and physiologic parameters was used to grade illness severity. Multivariate analysis of 134 infants infected with group A RSV strains and 131 infants infected with group B strains indicated that prematurity, underlying medical conditions, group A RSV infection, and age < or =3 months were independently associated with severe disease. Odds ratios for severe disease for these risk factors were 1.83, 2.84, 3.26, and 4.39, respectively. Among infants without underlying medical conditions, group B RSV infection rarely required ventilatory support, in contrast to group A infections (1/90 vs. 13/107; P < .006), and had significantly lower severity indices (mean +/- SD, 0.6 +/- 9 vs. 1.3 +/- 1.9; P = .05). Results confirm earlier findings that group A RSV infection results in greater disease severity than group B infection among hospitalized infants.