A2 Refereed review article in a scientific journal
Respiratory Syncytial Virus-Associated Acute Lower Respiratory Infections in Children With Bronchopulmonary Dysplasia: Systematic Review and Meta-Analysis
Authors: Chaw PS, Hua L, Cunningham S, Campbell H, Mikolajczyk R, Nair H; RESCEU Investigators
Publisher: OXFORD UNIV PRESS INC
Publication year: 2020
Journal: Journal of Infectious Diseases
Journal name in source: JOURNAL OF INFECTIOUS DISEASES
Journal acronym: J INFECT DIS
Volume: 222
Issue: Supplement_7
First page : S620
Last page: S627
Number of pages: 8
ISSN: 0022-1899
eISSN: 1537-6613
DOI: https://doi.org/10.1093/infdis/jiz492
Web address : https://doi.org/10.1093/infdis/jiz492
Abstract
Background. Respiratory syncytial virus (RSV) is among the most important causes of acute lower respiratory tract infection (ALRI) in young children. We assessed the severity of RSV-ALRI in children less than 5 years old with bronchopulmonary dysplasia (BPD).Methods. We searched for studies using EMBASE, Global Health, and MEDLINE. We assessed hospitalization risk, intensive care unit (ICU) admission, need for oxygen supplementation and mechanical ventilation, and in-hospital case fatality (hCFR) among children with BPD compared with those without (non-BPD). We compared the (1) length of hospital stay (LOS) and (2) duration of oxygen supplementation and mechanical ventilation between the groups.Results. Twenty-nine studies fulfilled our inclusion criteria. The case definition for BPD varied substantially in the included studies. Risks were higher among children with BPD compared with non-BPD: RSV hospitalization (odds ratio [OR], 2.6; 95% confidence interval [CI], 1.7-4.2; P <.001), ICU admission (OR, 2.9; 95% CI, 2.3-3.5; P <.001), need for oxygen supplementation (OR, 4.2; 95% CI,.5-33.7; P =.175) and mechanical ventilation (OR, 8.2; 95% CI, 7.6-8.9; P <.001), and hCFR (OR, 12.8; 95% CI, 9.4-17.3; P <.001). Median LOS (range) was 7.2 days (4-23) (BPD) compared with 2.5 days (1-30) (non-BPD). Median duration of oxygen supplementation (range) was 5.5 days (0-21) (BPD) compared with 2.0 days (0-26) (non-BPD). The duration of mechanical ventilation was more often longer (>6 days) in those with BPD compared with non-BPD (OR, 11.9; 95% CI, 1.4-100; P =.02).Conclusions. The risk of severe RSV disease is considerably higher among children with BPD. There is an urgent need to establish standardized BPD case definitions, review the RSV prophylaxis guidelines, and encourage more specific studies on RSV infection in BPD patients, including vaccine development and RSV-specific treatment.
Background. Respiratory syncytial virus (RSV) is among the most important causes of acute lower respiratory tract infection (ALRI) in young children. We assessed the severity of RSV-ALRI in children less than 5 years old with bronchopulmonary dysplasia (BPD).Methods. We searched for studies using EMBASE, Global Health, and MEDLINE. We assessed hospitalization risk, intensive care unit (ICU) admission, need for oxygen supplementation and mechanical ventilation, and in-hospital case fatality (hCFR) among children with BPD compared with those without (non-BPD). We compared the (1) length of hospital stay (LOS) and (2) duration of oxygen supplementation and mechanical ventilation between the groups.Results. Twenty-nine studies fulfilled our inclusion criteria. The case definition for BPD varied substantially in the included studies. Risks were higher among children with BPD compared with non-BPD: RSV hospitalization (odds ratio [OR], 2.6; 95% confidence interval [CI], 1.7-4.2; P <.001), ICU admission (OR, 2.9; 95% CI, 2.3-3.5; P <.001), need for oxygen supplementation (OR, 4.2; 95% CI,.5-33.7; P =.175) and mechanical ventilation (OR, 8.2; 95% CI, 7.6-8.9; P <.001), and hCFR (OR, 12.8; 95% CI, 9.4-17.3; P <.001). Median LOS (range) was 7.2 days (4-23) (BPD) compared with 2.5 days (1-30) (non-BPD). Median duration of oxygen supplementation (range) was 5.5 days (0-21) (BPD) compared with 2.0 days (0-26) (non-BPD). The duration of mechanical ventilation was more often longer (>6 days) in those with BPD compared with non-BPD (OR, 11.9; 95% CI, 1.4-100; P =.02).Conclusions. The risk of severe RSV disease is considerably higher among children with BPD. There is an urgent need to establish standardized BPD case definitions, review the RSV prophylaxis guidelines, and encourage more specific studies on RSV infection in BPD patients, including vaccine development and RSV-specific treatment.
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