Resch B, Kurath-Koller S, Hahn J, Raith W, Köstenberger M, Gamillscheg A
Division of Neonatology, Department of Pediatrics and Adolescent Medicine, Medical University of Graz, Auenbruggerplatz 34/2, 8036, Graz, Austria.
Research Unit for Neonatal Infectious Diseases and Epidemiology, Medical University of Graz, Graz, Austria.
Eur J Clin Microbiol Infect Dis. 2016 Jul;35(7):1165-9. doi: 10.1007/s10096-016-2649-1. Epub 2016 Apr 28.
The purpose of this investigation was to analyze the burden of respiratory syncytial virus (RSV)-related hospitalizations in infants and children with congenital heart disease (CHD) over three consecutive RSV seasons. Retrospectively, all children with hemodynamically significant (HS-CHD) and not significant (HNS-CHD) CHD born between 2004 and 2008 at a tertiary care university hospital and identified by ICD-10 diagnoses were included. Data on RSV-related hospitalizations over the first three years of life covering at least three RSV seasons (November-April) were analyzed. The overall incidence of RSV-related hospitalization was 9.6 % (58/602), without a statistically significant difference between HS-CHD and HNS-CHD (7.3 % vs. 10.4 %; p = 0.258). Recommendation of palivizumab prophylaxis did not influence the RSV hospitalization rates between groups. Patients with HS-CHD and early surgery were significantly less often hospitalized due to RSV compared to those with delayed surgery (1.3 % vs. 14.3 %; p = 0.003). The median duration of hospitalization was 8.5 days (HS-CHD: 14 vs.
HNS-CHD: 7 days; p = 0.003). Thirteen patients (22.4 %) were admitted to the intensive care unit (ICU), for a median of 10 days. The median age at admission was 2 months, with a significant difference between HS-CHD and HNS-CHD (6 vs. 2 months; p = 0.001). The majority (97 %) of RSV-related hospitalizations occurred before 12 months of age. Patients with HS-CHD had a significantly more severe course of RSV disease and were older at the time of hospitalization. Early surgery seemed to significantly reduce the risk of RSV hospitalization during the first RSV season.
本研究的目的是分析连续三个呼吸道合胞病毒（RSV）流行季节中，先天性心脏病（CHD）患儿RSV相关住院负担。回顾性纳入2004年至2008年在一家三级大学附属医院出生、经ICD - 10诊断确定的所有有血流动力学显著意义（HS - CHD）和无显著意义（HNS - CHD）的CHD患儿。分析涵盖至少三个RSV季节（11月至4月）的生命前三年中RSV相关住院数据。RSV相关住院的总体发生率为9.6%（58/602），HS - CHD和HNS - CHD之间无统计学显著差异（7.3%对10.4%；p = 0.258）。帕利珠单抗预防性用药的推荐未影响组间RSV住院率。与手术延迟的患儿相比，HS - CHD且早期手术的患儿因RSV住院的频率显著更低（1.3%对14.3%；p = 0.003）。住院中位时长为8.5天（HS - CHD：14天对HNS - CHD：7天；p = 0.003）。13名患者（22.4%）入住重症监护病房（ICU），中位时长为10天。入院中位年龄为2个月，HS - CHD和HNS - CHD之间有显著差异（6个月对2个月；p = 0.001）。大多数（97%）RSV相关住院发生在12个月龄之前。HS - CHD患者的RSV疾病病程显著更严重，且住院时年龄更大。早期手术似乎能显著降低首个RSV季节中RSV住院的风险。
