Burden of respiratory syncytial virus disease and mortality risk factors in Argentina: 18 years of active surveillance in a children's hospital

Autores
Gentile, Angela; Lucion, Maria Florencia; Juarez, Maria del Valle; Areso, María Soledad; Bakir, Julia; Viegas, Mariana; Mistchenko, Alicia Susana
Año de publicación
2019
Idioma
inglés
Tipo de recurso
artículo
Estado
versión publicada
Descripción
Background: Respiratory syncytial virus is the leading cause of acute lower respiratory infection in children. We aimed to describe the clinical-epidemiologic pattern and risk factors for mortality associated with RSV infection. Methods: This is a prospective, cross-sectional study of acute lower respiratory infection in children admitted to the Children’s Hospital during 2000 to 2017. Viral diagnosis was made by fluorescent antibody techniques or real-time-polymerase chain reaction. We compared clinical-epidemiologic characteristics of RSV infection in nonfatal versus fatal cases. Multiple logistic regression was used to identify independent predictors of mortality. Results: Of 15,451 patients with acute lower respiratory infection, 13,033 were tested for respiratory viruses and 5831 (45%) were positive: RSV 81.3% (4738), influenza 7.6% (440), parainfluenza 6.9% (402) and adenovirus 4.3% (251). RSV had a seasonal epidemic pattern coinciding with months of lowest average temperature. RSV cases show a case fatality rate of 1.7% (82/4687). Fatal cases had a higher proportion of prematurity (P < 0.01), perinatal respiratory history (P < 0.01), malnourishment (P < 0.01), congenital heart disease (P < 0.01), chronic neurologic disease (P < 0.01) and pneumonia at clinical presentation (P = 0.014). No significant difference between genders was observed. Most deaths occurred among children who had complications: respiratory distress (80.5%), nosocomial infections (45.7%), sepsis (31.7%) and atelectasis (13.4%). Independent predictors of RSV mortality were moderate-to-severe malnourishment, odds ratio (OR): 3.69 [95% confidence interval (CI): 1.98–6.87; P < 0.0001]; chronic neurologic disease, OR: 4.14 (95% CI: 2.12–8.08; P < 0.0001); congenital heart disease, OR: 4.18 (95% CI: 2.39–7.32; P< 0.0001); and the age less than 6 months, OR: 1.99 (95% CI: 1.24–3.18; P = 0.004). Conclusions: RSV showed an epidemic pattern affecting mostly young children. Malnourishment, chronic neurologic disease, congenital heart disease and the age less than 6 months were the independent risk factors for RSV mortality.
Fil: Gentile, Angela. Gobierno de la Ciudad de Buenos Aires. Hospital General de Niños "Ricardo Gutiérrez"; Argentina
Fil: Lucion, Maria Florencia. Gobierno de la Ciudad de Buenos Aires. Hospital General de Niños "Ricardo Gutiérrez"; Argentina
Fil: Juarez, Maria del Valle. Gobierno de la Ciudad de Buenos Aires. Hospital General de Niños "Ricardo Gutiérrez"; Argentina
Fil: Areso, María Soledad. Gobierno de la Ciudad de Buenos Aires. Hospital General de Niños "Ricardo Gutiérrez"; Argentina
Fil: Bakir, Julia. Gobierno de la Ciudad de Buenos Aires. Hospital General de Niños "Ricardo Gutiérrez"; Argentina
Fil: Viegas, Mariana. Gobierno de la Ciudad de Buenos Aires. Hospital General de Niños "Ricardo Gutiérrez". Laboratorio de Virología; Argentina. Consejo Nacional de Investigaciones Científicas y Técnicas; Argentina
Fil: Mistchenko, Alicia Susana. Gobierno de la Ciudad de Buenos Aires. Hospital General de Niños "Ricardo Gutiérrez". Laboratorio de Virología; Argentina
Materia
BRONCHIOLITIS
CASE FATALITY RATE
EPIDEMIOLOGY
PEDIATRICS
RESPIRATORY SYNCYTIAL VIRUS
Nivel de accesibilidad
acceso abierto
Condiciones de uso
https://creativecommons.org/licenses/by-nc-sa/2.5/ar/
Repositorio
CONICET Digital (CONICET)
Institución
Consejo Nacional de Investigaciones Científicas y Técnicas
OAI Identificador
oai:ri.conicet.gov.ar:11336/117294
Acceder
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oai_identifier_str oai:ri.conicet.gov.ar:11336/117294
network_acronym_str CONICETDig
repository_id_str 3498
network_name_str CONICET Digital (CONICET)
spelling Burden of respiratory syncytial virus disease and mortality risk factors in Argentina: 18 years of active surveillance in a children's hospitalGentile, AngelaLucion, Maria FlorenciaJuarez, Maria del ValleAreso, María SoledadBakir, JuliaViegas, MarianaMistchenko, Alicia SusanaBRONCHIOLITISCASE FATALITY RATEEPIDEMIOLOGYPEDIATRICSRESPIRATORY SYNCYTIAL VIRUShttps://purl.org/becyt/ford/1.6https://purl.org/becyt/ford/1Background: Respiratory syncytial virus is the leading cause of acute lower respiratory infection in children. We aimed to describe the clinical-epidemiologic pattern and risk factors for mortality associated with RSV infection. Methods: This is a prospective, cross-sectional study of acute lower respiratory infection in children admitted to the Children’s Hospital during 2000 to 2017. Viral diagnosis was made by fluorescent antibody techniques or real-time-polymerase chain reaction. We compared clinical-epidemiologic characteristics of RSV infection in nonfatal versus fatal cases. Multiple logistic regression was used to identify independent predictors of mortality. Results: Of 15,451 patients with acute lower respiratory infection, 13,033 were tested for respiratory viruses and 5831 (45%) were positive: RSV 81.3% (4738), influenza 7.6% (440), parainfluenza 6.9% (402) and adenovirus 4.3% (251). RSV had a seasonal epidemic pattern coinciding with months of lowest average temperature. RSV cases show a case fatality rate of 1.7% (82/4687). Fatal cases had a higher proportion of prematurity (P < 0.01), perinatal respiratory history (P < 0.01), malnourishment (P < 0.01), congenital heart disease (P < 0.01), chronic neurologic disease (P < 0.01) and pneumonia at clinical presentation (P = 0.014). No significant difference between genders was observed. Most deaths occurred among children who had complications: respiratory distress (80.5%), nosocomial infections (45.7%), sepsis (31.7%) and atelectasis (13.4%). Independent predictors of RSV mortality were moderate-to-severe malnourishment, odds ratio (OR): 3.69 [95% confidence interval (CI): 1.98–6.87; P < 0.0001]; chronic neurologic disease, OR: 4.14 (95% CI: 2.12–8.08; P < 0.0001); congenital heart disease, OR: 4.18 (95% CI: 2.39–7.32; P< 0.0001); and the age less than 6 months, OR: 1.99 (95% CI: 1.24–3.18; P = 0.004). Conclusions: RSV showed an epidemic pattern affecting mostly young children. Malnourishment, chronic neurologic disease, congenital heart disease and the age less than 6 months were the independent risk factors for RSV mortality.Fil: Gentile, Angela. Gobierno de la Ciudad de Buenos Aires. Hospital General de Niños "Ricardo Gutiérrez"; ArgentinaFil: Lucion, Maria Florencia. Gobierno de la Ciudad de Buenos Aires. Hospital General de Niños "Ricardo Gutiérrez"; ArgentinaFil: Juarez, Maria del Valle. Gobierno de la Ciudad de Buenos Aires. Hospital General de Niños "Ricardo Gutiérrez"; ArgentinaFil: Areso, María Soledad. Gobierno de la Ciudad de Buenos Aires. Hospital General de Niños "Ricardo Gutiérrez"; ArgentinaFil: Bakir, Julia. Gobierno de la Ciudad de Buenos Aires. Hospital General de Niños "Ricardo Gutiérrez"; ArgentinaFil: Viegas, Mariana. Gobierno de la Ciudad de Buenos Aires. Hospital General de Niños "Ricardo Gutiérrez". Laboratorio de Virología; Argentina. Consejo Nacional de Investigaciones Científicas y Técnicas; ArgentinaFil: Mistchenko, Alicia Susana. Gobierno de la Ciudad de Buenos Aires. Hospital General de Niños "Ricardo Gutiérrez". Laboratorio de Virología; ArgentinaLippincott Williams2019-01info:eu-repo/semantics/articleinfo:eu-repo/semantics/publishedVersionhttp://purl.org/coar/resource_type/c_6501info:ar-repo/semantics/articuloapplication/pdfapplication/pdfhttp://hdl.handle.net/11336/117294Gentile, Angela; Lucion, Maria Florencia; Juarez, Maria del Valle; Areso, María Soledad; Bakir, Julia; et al.; Burden of respiratory syncytial virus disease and mortality risk factors in Argentina: 18 years of active surveillance in a children's hospital; Lippincott Williams; Pediatric Infectious Disease Journal; 38; 6; 1-2019; 589-5940891-3668CONICET DigitalCONICETenginfo:eu-repo/semantics/altIdentifier/doi/10.1097/INF.0000000000002271info:eu-repo/semantics/altIdentifier/url/https://journals.lww.com/pidj/Abstract/2019/06000/Burden_of_Respiratory_Syncytial_Virus_Disease_and.8.aspxinfo:eu-repo/semantics/openAccesshttps://creativecommons.org/licenses/by-nc-sa/2.5/ar/reponame:CONICET Digital (CONICET)instname:Consejo Nacional de Investigaciones Científicas y Técnicas2025-09-03T09:55:05Zoai:ri.conicet.gov.ar:11336/117294instacron:CONICETInstitucionalhttp://ri.conicet.gov.ar/Organismo científico-tecnológicoNo correspondehttp://ri.conicet.gov.ar/oai/requestdasensio@conicet.gov.ar; lcarlino@conicet.gov.arArgentinaNo correspondeNo correspondeNo correspondeopendoar:34982025-09-03 09:55:06.038CONICET Digital (CONICET) - Consejo Nacional de Investigaciones Científicas y Técnicasfalse
dc.title.none.fl_str_mv Burden of respiratory syncytial virus disease and mortality risk factors in Argentina: 18 years of active surveillance in a children's hospital
title Burden of respiratory syncytial virus disease and mortality risk factors in Argentina: 18 years of active surveillance in a children's hospital
spellingShingle Burden of respiratory syncytial virus disease and mortality risk factors in Argentina: 18 years of active surveillance in a children's hospital
Gentile, Angela
BRONCHIOLITIS
CASE FATALITY RATE
EPIDEMIOLOGY
PEDIATRICS
RESPIRATORY SYNCYTIAL VIRUS
title_short Burden of respiratory syncytial virus disease and mortality risk factors in Argentina: 18 years of active surveillance in a children's hospital
title_full Burden of respiratory syncytial virus disease and mortality risk factors in Argentina: 18 years of active surveillance in a children's hospital
title_fullStr Burden of respiratory syncytial virus disease and mortality risk factors in Argentina: 18 years of active surveillance in a children's hospital
title_full_unstemmed Burden of respiratory syncytial virus disease and mortality risk factors in Argentina: 18 years of active surveillance in a children's hospital
title_sort Burden of respiratory syncytial virus disease and mortality risk factors in Argentina: 18 years of active surveillance in a children's hospital
dc.creator.none.fl_str_mv Gentile, Angela
Lucion, Maria Florencia
Juarez, Maria del Valle
Areso, María Soledad
Bakir, Julia
Viegas, Mariana
Mistchenko, Alicia Susana
author Gentile, Angela
author_facet Gentile, Angela
Lucion, Maria Florencia
Juarez, Maria del Valle
Areso, María Soledad
Bakir, Julia
Viegas, Mariana
Mistchenko, Alicia Susana
author_role author
author2 Lucion, Maria Florencia
Juarez, Maria del Valle
Areso, María Soledad
Bakir, Julia
Viegas, Mariana
Mistchenko, Alicia Susana
author2_role author
author
author
author
author
author
dc.subject.none.fl_str_mv BRONCHIOLITIS
CASE FATALITY RATE
EPIDEMIOLOGY
PEDIATRICS
RESPIRATORY SYNCYTIAL VIRUS
topic BRONCHIOLITIS
CASE FATALITY RATE
EPIDEMIOLOGY
PEDIATRICS
RESPIRATORY SYNCYTIAL VIRUS
purl_subject.fl_str_mv https://purl.org/becyt/ford/1.6
https://purl.org/becyt/ford/1
dc.description.none.fl_txt_mv Background: Respiratory syncytial virus is the leading cause of acute lower respiratory infection in children. We aimed to describe the clinical-epidemiologic pattern and risk factors for mortality associated with RSV infection. Methods: This is a prospective, cross-sectional study of acute lower respiratory infection in children admitted to the Children’s Hospital during 2000 to 2017. Viral diagnosis was made by fluorescent antibody techniques or real-time-polymerase chain reaction. We compared clinical-epidemiologic characteristics of RSV infection in nonfatal versus fatal cases. Multiple logistic regression was used to identify independent predictors of mortality. Results: Of 15,451 patients with acute lower respiratory infection, 13,033 were tested for respiratory viruses and 5831 (45%) were positive: RSV 81.3% (4738), influenza 7.6% (440), parainfluenza 6.9% (402) and adenovirus 4.3% (251). RSV had a seasonal epidemic pattern coinciding with months of lowest average temperature. RSV cases show a case fatality rate of 1.7% (82/4687). Fatal cases had a higher proportion of prematurity (P < 0.01), perinatal respiratory history (P < 0.01), malnourishment (P < 0.01), congenital heart disease (P < 0.01), chronic neurologic disease (P < 0.01) and pneumonia at clinical presentation (P = 0.014). No significant difference between genders was observed. Most deaths occurred among children who had complications: respiratory distress (80.5%), nosocomial infections (45.7%), sepsis (31.7%) and atelectasis (13.4%). Independent predictors of RSV mortality were moderate-to-severe malnourishment, odds ratio (OR): 3.69 [95% confidence interval (CI): 1.98–6.87; P < 0.0001]; chronic neurologic disease, OR: 4.14 (95% CI: 2.12–8.08; P < 0.0001); congenital heart disease, OR: 4.18 (95% CI: 2.39–7.32; P< 0.0001); and the age less than 6 months, OR: 1.99 (95% CI: 1.24–3.18; P = 0.004). Conclusions: RSV showed an epidemic pattern affecting mostly young children. Malnourishment, chronic neurologic disease, congenital heart disease and the age less than 6 months were the independent risk factors for RSV mortality.
Fil: Gentile, Angela. Gobierno de la Ciudad de Buenos Aires. Hospital General de Niños "Ricardo Gutiérrez"; Argentina
Fil: Lucion, Maria Florencia. Gobierno de la Ciudad de Buenos Aires. Hospital General de Niños "Ricardo Gutiérrez"; Argentina
Fil: Juarez, Maria del Valle. Gobierno de la Ciudad de Buenos Aires. Hospital General de Niños "Ricardo Gutiérrez"; Argentina
Fil: Areso, María Soledad. Gobierno de la Ciudad de Buenos Aires. Hospital General de Niños "Ricardo Gutiérrez"; Argentina
Fil: Bakir, Julia. Gobierno de la Ciudad de Buenos Aires. Hospital General de Niños "Ricardo Gutiérrez"; Argentina
Fil: Viegas, Mariana. Gobierno de la Ciudad de Buenos Aires. Hospital General de Niños "Ricardo Gutiérrez". Laboratorio de Virología; Argentina. Consejo Nacional de Investigaciones Científicas y Técnicas; Argentina
Fil: Mistchenko, Alicia Susana. Gobierno de la Ciudad de Buenos Aires. Hospital General de Niños "Ricardo Gutiérrez". Laboratorio de Virología; Argentina
description Background: Respiratory syncytial virus is the leading cause of acute lower respiratory infection in children. We aimed to describe the clinical-epidemiologic pattern and risk factors for mortality associated with RSV infection. Methods: This is a prospective, cross-sectional study of acute lower respiratory infection in children admitted to the Children’s Hospital during 2000 to 2017. Viral diagnosis was made by fluorescent antibody techniques or real-time-polymerase chain reaction. We compared clinical-epidemiologic characteristics of RSV infection in nonfatal versus fatal cases. Multiple logistic regression was used to identify independent predictors of mortality. Results: Of 15,451 patients with acute lower respiratory infection, 13,033 were tested for respiratory viruses and 5831 (45%) were positive: RSV 81.3% (4738), influenza 7.6% (440), parainfluenza 6.9% (402) and adenovirus 4.3% (251). RSV had a seasonal epidemic pattern coinciding with months of lowest average temperature. RSV cases show a case fatality rate of 1.7% (82/4687). Fatal cases had a higher proportion of prematurity (P < 0.01), perinatal respiratory history (P < 0.01), malnourishment (P < 0.01), congenital heart disease (P < 0.01), chronic neurologic disease (P < 0.01) and pneumonia at clinical presentation (P = 0.014). No significant difference between genders was observed. Most deaths occurred among children who had complications: respiratory distress (80.5%), nosocomial infections (45.7%), sepsis (31.7%) and atelectasis (13.4%). Independent predictors of RSV mortality were moderate-to-severe malnourishment, odds ratio (OR): 3.69 [95% confidence interval (CI): 1.98–6.87; P < 0.0001]; chronic neurologic disease, OR: 4.14 (95% CI: 2.12–8.08; P < 0.0001); congenital heart disease, OR: 4.18 (95% CI: 2.39–7.32; P< 0.0001); and the age less than 6 months, OR: 1.99 (95% CI: 1.24–3.18; P = 0.004). Conclusions: RSV showed an epidemic pattern affecting mostly young children. Malnourishment, chronic neurologic disease, congenital heart disease and the age less than 6 months were the independent risk factors for RSV mortality.
publishDate 2019
dc.date.none.fl_str_mv 2019-01
dc.type.none.fl_str_mv info:eu-repo/semantics/article
info:eu-repo/semantics/publishedVersion
http://purl.org/coar/resource_type/c_6501
info:ar-repo/semantics/articulo
format article
status_str publishedVersion
dc.identifier.none.fl_str_mv http://hdl.handle.net/11336/117294
Gentile, Angela; Lucion, Maria Florencia; Juarez, Maria del Valle; Areso, María Soledad; Bakir, Julia; et al.; Burden of respiratory syncytial virus disease and mortality risk factors in Argentina: 18 years of active surveillance in a children's hospital; Lippincott Williams; Pediatric Infectious Disease Journal; 38; 6; 1-2019; 589-594
0891-3668
CONICET Digital
CONICET
url http://hdl.handle.net/11336/117294
identifier_str_mv Gentile, Angela; Lucion, Maria Florencia; Juarez, Maria del Valle; Areso, María Soledad; Bakir, Julia; et al.; Burden of respiratory syncytial virus disease and mortality risk factors in Argentina: 18 years of active surveillance in a children's hospital; Lippincott Williams; Pediatric Infectious Disease Journal; 38; 6; 1-2019; 589-594
0891-3668
CONICET Digital
CONICET
dc.language.none.fl_str_mv eng
language eng
dc.relation.none.fl_str_mv info:eu-repo/semantics/altIdentifier/doi/10.1097/INF.0000000000002271
info:eu-repo/semantics/altIdentifier/url/https://journals.lww.com/pidj/Abstract/2019/06000/Burden_of_Respiratory_Syncytial_Virus_Disease_and.8.aspx
dc.rights.none.fl_str_mv info:eu-repo/semantics/openAccess
https://creativecommons.org/licenses/by-nc-sa/2.5/ar/
eu_rights_str_mv openAccess
rights_invalid_str_mv https://creativecommons.org/licenses/by-nc-sa/2.5/ar/
dc.format.none.fl_str_mv application/pdf
application/pdf
dc.publisher.none.fl_str_mv Lippincott Williams
publisher.none.fl_str_mv Lippincott Williams
dc.source.none.fl_str_mv reponame:CONICET Digital (CONICET)
instname:Consejo Nacional de Investigaciones Científicas y Técnicas
reponame_str CONICET Digital (CONICET)
collection CONICET Digital (CONICET)
instname_str Consejo Nacional de Investigaciones Científicas y Técnicas
repository.name.fl_str_mv CONICET Digital (CONICET) - Consejo Nacional de Investigaciones Científicas y Técnicas
repository.mail.fl_str_mv dasensio@conicet.gov.ar; lcarlino@conicet.gov.ar
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score 13.13397

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