Morbidity and outcome of severe respiratory syncytial virus infection

• Published in: Pediatrics international Vol. 55; no. 3; pp. 283 - 288
• Main Authors: El Kholy, Amani A., Mostafa, Nadia A., El-Sherbini, Seham A., Ali, Aliaa A., Ismail, Reem I., Magdy, Rania I., Hamdy, Mona S., Soliman, May S.
• Format: Journal Article
• Language: English
• Published: Australia Blackwell Publishing Ltd 01.06.2013
• Subjects: Child; Child, Preschool; Cohort Studies; Cross-Sectional Studies; Egypt; Female; Humans; Infant; Intensive care; intensive care unit; Intensive Care Units, Pediatric; Length of Stay; Male; Morbidity; mortality; Patient Admission; Pediatrics; prolonged length of stay; Prospective Studies; Respiratory syncytial virus; Respiratory Syncytial Virus Infections - diagnosis; Respiratory Syncytial Virus Infections - mortality; Risk Factors; severe acute respiratory infections; Severe Acute Respiratory Syndrome - diagnosis; Severe Acute Respiratory Syndrome - mortality; Survival Analysis; Egypt
• ISSN: 1328-8067; 1442-200X
• DOI: 10.1111/ped.12051

Background Respiratory syncytial virus (RSV) is the main cause of severe acute respiratory infection (SARI) in infants and young children. This study aimed to identify risk factors for intensive care unit (ICU) admission, prolonged length of stay (PLOS), and mortality in patients hospitalized with SARI caused by RSV. Methods This prospective cohort study included children hospitalized with SARI (according to the World Health Organization definition) and whose laboratory results proved RSV infection during the period from February 2010 to May 2011. Results Out of 240 enrolled patients, 24 patients (10%) were admitted to the ICU, 57 patients (24.3%) had a PLOS of >9 days and 12 patients (5%) died. The presence of cyanosis (P = 0.000; OR, 351.7) and lung consolidation (P = 0.006, OR, 9.3) were independent risk factors associated with ICU admission. The need for ICU admission (P = 0.000; OR, 6.1) and lung consolidation (P = 0.008, OR, 2.46) were independent risk factors associated with PLOS. The presence of an underlying congenital heart disease (P = 0.03, OR, 18.3), thrombocytopenia (P = 0.04, OR, 32.86) and mechanical ventilation (P = 0.000; OR, 449.4) were the only independent risk factors associated with mortality in our study. Conclusions Early recognition of risk factors for complicated RSV disease on admission prompts early interventions and early ICU admissions for these children.