A2 Vertaisarvioitu katsausartikkeli tieteellisessä lehdessä
Respiratory Syncytial Virus-Associated Acute Lower Respiratory Infections in Children With Bronchopulmonary Dysplasia: Systematic Review and Meta-Analysis
Tekijät: Chaw PS, Hua L, Cunningham S, Campbell H, Mikolajczyk R, Nair H; RESCEU Investigators
Kustantaja: OXFORD UNIV PRESS INC
Julkaisuvuosi: 2020
Journal: Journal of Infectious Diseases
Tietokannassa oleva lehden nimi: JOURNAL OF INFECTIOUS DISEASES
Lehden akronyymi: J INFECT DIS
Vuosikerta: 222
Numero: Supplement_7
Aloitussivu: S620
Lopetussivu: S627
Sivujen määrä: 8
ISSN: 0022-1899
eISSN: 1537-6613
DOI: https://doi.org/10.1093/infdis/jiz492
Verkko-osoite: https://doi.org/10.1093/infdis/jiz492
Tiivistelmä
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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