Abstract / Description of output
Background
Respiratory syncytial virus (RSV) is a major cause of mortality in children younger than 5 years worldwide. Systematic reviews have shown that Down syndrome (DS) is an independent risk factor for severe RSV infection. We aimed to describe demographic and clinical characteristics of children with DS who died with RSV infection.
Methods
We performed a retrospective case series in which data were shared by individual researchers, research networks and physicians worldwide as part of the RSV GOLD study. We included children with DS who died when younger than 5 years of age with laboratory-confirmed RSV-infection.
Results
We included 53 children with DS and RSV-related in-hospital mortality from 20 countries in 5 continents. Thirty-two (60.4%) children were from low and middle-income countries. Median age at time of death was 6.0 months (IQR: 3.0-12.0). Thirteen (24.5%) children were born term and had no other risk factors for severe RSV disease. In total, 36 (67.9%) children had congenital heart disease,
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8 (15.1%) had chronic lung disease and 1 (1.9%) had congenital immunodeficiency. Duration of hospitalization was significantly longer for children with DS compared to children without DS (median length of stay 13 days (IQR 6.8-21.0) versus 8 days (IQR 3.0-18.5), p=0.005).
Conclusions
One-fourth of children with DS and RSV-confirmed death did not have risk factors for severe RSV disease, indicating that DS is an important risk factor for RSV-related mortality. Age distribution at time of death demonstrates that maternal vaccination would not be sufficient to protect children with DS against RSV-related mortality.
Respiratory syncytial virus (RSV) is a major cause of mortality in children younger than 5 years worldwide. Systematic reviews have shown that Down syndrome (DS) is an independent risk factor for severe RSV infection. We aimed to describe demographic and clinical characteristics of children with DS who died with RSV infection.
Methods
We performed a retrospective case series in which data were shared by individual researchers, research networks and physicians worldwide as part of the RSV GOLD study. We included children with DS who died when younger than 5 years of age with laboratory-confirmed RSV-infection.
Results
We included 53 children with DS and RSV-related in-hospital mortality from 20 countries in 5 continents. Thirty-two (60.4%) children were from low and middle-income countries. Median age at time of death was 6.0 months (IQR: 3.0-12.0). Thirteen (24.5%) children were born term and had no other risk factors for severe RSV disease. In total, 36 (67.9%) children had congenital heart disease,
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8 (15.1%) had chronic lung disease and 1 (1.9%) had congenital immunodeficiency. Duration of hospitalization was significantly longer for children with DS compared to children without DS (median length of stay 13 days (IQR 6.8-21.0) versus 8 days (IQR 3.0-18.5), p=0.005).
Conclusions
One-fourth of children with DS and RSV-confirmed death did not have risk factors for severe RSV disease, indicating that DS is an important risk factor for RSV-related mortality. Age distribution at time of death demonstrates that maternal vaccination would not be sufficient to protect children with DS against RSV-related mortality.
| Original language | English |
|---|---|
| Journal | The Pediatric Infectious Disease Journal |
| Early online date | 23 Apr 2020 |
| DOIs | |
| Publication status | E-pub ahead of print - 23 Apr 2020 |