Anderson Jeremy, Oeum Michelle, Verkolf Eva, Licciardi Paul V, Mulholland Kim, Nguyen Cattram, Chow Kim, Waller Gregory, Costa Anna-Maria, Daley Andrew, Crawford Nigel W, Babl Franz E, Duke Trevor, Do Lien Anh Ha, Wurzel Danielle
Infection and Immunity, Murdoch Children's Research Institute, Parkville, Victoria, Australia
Department of Paediatrics, The University of Melbourne - Parkville Campus, Melbourne, Victoria, Australia.
Arch Dis Child. 2022 Apr;107(4):359-364. doi: 10.1136/archdischild-2021-322435. Epub 2021 Sep 15.
Early recognition of children at risk of severe respiratory syncytial virus (RSV) lower respiratory tract infection is important as it informs management decisions. We aimed to evaluate factors associated with severe disease among young children hospitalised with RSV infection.
We conducted a retrospective cohort study of all children <2 years of age hospitalised for RSV lower respiratory tract infection at a single tertiary paediatric hospital over three RSV seasons (January 2017-December 2019). We classified children as having 'moderate' or 'severe' disease based on the level of respiratory intervention and used univariable and multivariable regression models to determine factors associated with severe disease.
Of 970 hospitalised children, 386 (40%) were classified as having 'severe' and 584 (60%) as having 'moderate' RSV disease. On multivariable analyses, age <2 months (OR: 2.3, 95% CI 1.6 to 3.3, p<0.0001), prematurity (OR: 1.6, 95% CI 1.1 to 2.4, p=0.02) and RSV-parainfluenza virus type 3 (PIV3) codetection (OR: 2.6, 95% CI 1.05 to 6.5, p=0.04) were independently associated with severe disease.
Younger age, prematurity and PIV3 codetection were associated with severe RSV disease in children <2 years of age hospitalised with RSV infection. The association between PIV3 and severe RSV disease is a novel finding and warrants further investigation.
早期识别有患严重呼吸道合胞病毒（RSV）下呼吸道感染风险的儿童很重要，因为这可为管理决策提供依据。我们旨在评估因RSV感染住院的幼儿中与严重疾病相关的因素。
我们对一家三级儿科医院在三个RSV流行季节（2017年1月至2019年12月）因RSV下呼吸道感染住院的所有2岁以下儿童进行了一项回顾性队列研究。我们根据呼吸干预水平将儿童分为“中度”或“重度”疾病，并使用单变量和多变量回归模型来确定与严重疾病相关的因素。
在970名住院儿童中，386名（40%）被分类为患有“重度”RSV疾病，584名（60%）被分类为患有“中度”RSV疾病。多变量分析显示，年龄<2个月（比值比：2.3，95%置信区间1.6至3.3，p<0.0001）、早产（比值比：1.6，95%置信区间1.1至2.4，p=0.02）和RSV与3型副流感病毒（PIV3）共同检测（比值比：2.6，95%置信区间1.05至6.5，p=0.04）与严重疾病独立相关。
年龄较小、早产和PIV3共同检测与因RSV感染住院的2岁以下儿童的严重RSV疾病相关。PIV3与严重RSV疾病之间的关联是一项新发现，值得进一步研究。
