From the Discipline of Child and Adolescent Health, University of Sydney.
National Centre for Immunisation Research and Surveillance.
Pediatr Infect Dis J. 2022 Mar 1;41(3):186-191. doi: 10.1097/INF.0000000000003398.
Respiratory syncytial virus (RSV) is a leading cause of acute lower respiratory tract infection and an important contributor to child mortality. In this study, we estimated the frequency and described the clinical features of RSV-attributable deaths in Australian children.
We conducted a retrospective observational study of RSV-associated deaths in hospitalized children <16 years of age over a 21-year period (1998-2018) in a pediatric tertiary/quaternary referral hospital in New South Wales (NSW), Australia. RSV-associated deaths were identified, reviewed, and classified according to RSV contribution to death. For 'RSV-attributable' deaths, we estimated frequency, case fatality ratio (CFR), and population death rate. We described demographic and clinical features of cases.
There were 20 RSV-attributable deaths. RSV was considered the primary cause of death for five cases and a contributory cause for 15 cases. The CFR among hospitalized cases was 0.2% (20/9779). The annual death rate was 0.6 per 10,000 hospitalized children. The population death rate was 1.2 (95% confidence interval 0.5-2.7) per million children <16 years of age in NSW. The median age at death was 28.7 months (interquartile range 8.8-75.0). All children had at least one medical comorbidity. Over half the deaths occurred in children ≥2 years of age (11, 55%). RSV healthcare-associated infection (RSV-HAI) was common (11, 55%).
RSV-attributable death is infrequent in this setting. Deaths occurred exclusively in children with medical comorbidity and a high proportion were RSV-HAI. Children with medical comorbidity, including those ≥2 years of age, should be prioritized for targeted prevention of RSV disease.
呼吸道合胞病毒（RSV）是急性下呼吸道感染的主要原因，也是导致儿童死亡的重要因素。在这项研究中，我们估计了澳大利亚儿童中 RSV 相关死亡的频率，并描述了其临床特征。
我们对新南威尔士州（NSW）一家儿科三级/四级转诊医院 21 年来（1998-2018 年）住院的<16 岁儿童中与 RSV 相关的死亡病例进行了回顾性观察研究。根据 RSV 对死亡的贡献，确定、审查并分类与 RSV 相关的死亡。对于“RSV 归因”死亡，我们估计了频率、病死率（CFR）和人群死亡率。我们描述了病例的人口统计学和临床特征。
共有 20 例 RSV 归因死亡。RSV 被认为是 5 例死亡的主要原因，15 例死亡的次要原因。住院病例的 CFR 为 0.2%（20/9779）。每年每 10000 名住院儿童的死亡率为 0.6 例。在 NSW，每 100 万<16 岁儿童的人口死亡率为 1.2（95%置信区间 0.5-2.7）。死亡时的中位年龄为 28.7 个月（四分位距 8.8-75.0）。所有儿童均至少有一种合并症。超过一半的死亡发生在≥2 岁的儿童（11，55%）。RSV 与医疗保健相关的感染（RSV-HAI）很常见（11，55%）。
在这种情况下，RSV 归因死亡很少见。死亡仅发生在有合并症的儿童中，其中很大一部分是 RSV-HAI。患有合并症的儿童，包括≥2 岁的儿童，应优先考虑针对 RSV 疾病的靶向预防。
