尼尔塞维马布 预防和呼吸道同胞性病毒 在婴儿中住院的病例
Enrico Cocchi1,2,3, Silvia Bloise4, Aurora Lorefice5
1Department of Medical and Surgical Sciences (DIMEC), Alma Mater Studiorum-University of Bologna, Bologna, Italy.
JAMA network open
|November 20, 2025
概括
尼尔塞维马布预防在婴儿中显著减少了呼吸道同胞病毒 (RSV) 的住院治疗. 然而,像早产儿一样,高风险的婴儿仍然面临风险,这表明需要采取额外的预防策略.
科学领域:
- 儿科 儿科 儿科
- 传染性疾病 传染性疾病
- 公共卫生 公共卫生
背景情况:
- 呼吸道同胞病毒 (RSV) 是婴儿住院的主要原因,特别是在早产婴儿和有大兄弟姐妹的婴儿中.
- 现有的尼尔塞维马布预防建议缺乏高风险婴儿群体的结果数据.
研究的目的:
- 评估nirsevimab预防与RSV相关下呼吸道感染 (LRTI) 住院的风险之间的关联.
- 评估nirsevimab对RSVLRTI在婴儿,包括高风险群体的住院严重程度的影响.
主要方法:
- 一项回顾性,多中心的队列研究比较了在五个意大利新生儿医院普遍实施nirsevimab之前和之后的RSV季节.
- 包括所有活产儿,随访至第一个生日或赛季结束,分析时间到事件数据.
- 使用Cox等级的比例危险回归来调整共变量和季节性,并进行灵敏度分析.
主要成果:
- 尼尔塞维马布预防实现了79.2%的覆盖率,并与RSV住院危险降低了68% (HR,0.32).
- 一个月内分析显示,住院危险的降低甚至更大 (HR,0.11).
- 过早生育和拥有较大的兄弟姐妹仍然是住院治疗的重要风险因素,即使有预防措施.
结论:
- 尼尔塞维马布预防大大降低了RSV住院风险,并减少了医院内严重程度,支持其公共卫生实施.
- 在早产婴儿和家庭中暴露的婴儿中持续存在的风险凸显了补充RSV预防策略的必要性.
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