Mortality due to Respiratory Syncytial Virus. Burden and Risk Factors
Respiratory syncytial virus (RSV) is the most frequent cause of hospitalization and an important cause of death in infants in the developing world. The relative contribution of social, biologic, and clinical risk factors to RSV mortality in low-income regions is unclear. To determine the burden and...
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| Published in: | American journal of respiratory and critical care medicine Vol. 195; no. 1; pp. 96 - 103 |
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| Main Authors: | , , , , , , , , , , , , , , , , , , , , , , , , , , |
| Format: | Journal Article |
| Language: | English |
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United States
American Thoracic Society
01.01.2017
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| ISSN: | 1073-449X, 1535-4970 |
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| Abstract | Respiratory syncytial virus (RSV) is the most frequent cause of hospitalization and an important cause of death in infants in the developing world. The relative contribution of social, biologic, and clinical risk factors to RSV mortality in low-income regions is unclear.
To determine the burden and risk factors for mortality due to RSV in a low-income population of 84,840 infants.
This was a prospective, population-based, cross-sectional, multicenter study conducted between 2011 and 2013. Hospitalizations and deaths due to severe lower respiratory tract illness (LRTI) were recorded during the RSV season. All-cause hospital deaths and community deaths were monitored. Risk factors for respiratory failure (RF) and mortality due to RSV were assessed using a hierarchical, logistic regression model.
A total of 2,588 (65.5%) infants with severe LRTI were infected with RSV. A total of 157 infants (148 postneonatal) experienced RF or died with RSV. RSV LRTI accounted for 57% fatal LRTI tested for the virus. A diagnosis of sepsis (odds ratio [OR], 17.03; 95% confidence interval [CI], 13.14-21.16 for RF) (OR, 119.39; 95% CI, 50.98-273.34 for death) and pneumothorax (OR, 17.15; 95% CI, 13.07-21.01 for RF) (OR, 65.49; 95% CI, 28.90-139.17 for death) were the main determinants of poor outcomes.
RSV was the most frequent cause of mortality in low-income postneonatal infants. RF and death due to RSV LRTI, almost exclusively associated with prematurity and cardiopulmonary diseases in industrialized countries, primarily affect term infants in a developing world environment. Poor outcomes at hospitals are frequent and associated with the cooccurrence of bacterial sepsis and clinically significant pneumothoraxes. |
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| AbstractList | Respiratory syncytial virus (RSV) is the most frequent cause of hospitalization and an important cause of death in infants in the developing world. The relative contribution of social, biologic, and clinical risk factors to RSV mortality in low-income regions is unclear.
To determine the burden and risk factors for mortality due to RSV in a low-income population of 84,840 infants.
This was a prospective, population-based, cross-sectional, multicenter study conducted between 2011 and 2013. Hospitalizations and deaths due to severe lower respiratory tract illness (LRTI) were recorded during the RSV season. All-cause hospital deaths and community deaths were monitored. Risk factors for respiratory failure (RF) and mortality due to RSV were assessed using a hierarchical, logistic regression model.
A total of 2,588 (65.5%) infants with severe LRTI were infected with RSV. A total of 157 infants (148 postneonatal) experienced RF or died with RSV. RSV LRTI accounted for 57% fatal LRTI tested for the virus. A diagnosis of sepsis (odds ratio [OR], 17.03; 95% confidence interval [CI], 13.14-21.16 for RF) (OR, 119.39; 95% CI, 50.98-273.34 for death) and pneumothorax (OR, 17.15; 95% CI, 13.07-21.01 for RF) (OR, 65.49; 95% CI, 28.90-139.17 for death) were the main determinants of poor outcomes.
RSV was the most frequent cause of mortality in low-income postneonatal infants. RF and death due to RSV LRTI, almost exclusively associated with prematurity and cardiopulmonary diseases in industrialized countries, primarily affect term infants in a developing world environment. Poor outcomes at hospitals are frequent and associated with the cooccurrence of bacterial sepsis and clinically significant pneumothoraxes. RATIONALERespiratory syncytial virus (RSV) is the most frequent cause of hospitalization and an important cause of death in infants in the developing world. The relative contribution of social, biologic, and clinical risk factors to RSV mortality in low-income regions is unclear.OBJECTIVESTo determine the burden and risk factors for mortality due to RSV in a low-income population of 84,840 infants.METHODSThis was a prospective, population-based, cross-sectional, multicenter study conducted between 2011 and 2013. Hospitalizations and deaths due to severe lower respiratory tract illness (LRTI) were recorded during the RSV season. All-cause hospital deaths and community deaths were monitored. Risk factors for respiratory failure (RF) and mortality due to RSV were assessed using a hierarchical, logistic regression model.MEASUREMENTS AND MAIN RESULTSA total of 2,588 (65.5%) infants with severe LRTI were infected with RSV. A total of 157 infants (148 postneonatal) experienced RF or died with RSV. RSV LRTI accounted for 57% fatal LRTI tested for the virus. A diagnosis of sepsis (odds ratio [OR], 17.03; 95% confidence interval [CI], 13.14-21.16 for RF) (OR, 119.39; 95% CI, 50.98-273.34 for death) and pneumothorax (OR, 17.15; 95% CI, 13.07-21.01 for RF) (OR, 65.49; 95% CI, 28.90-139.17 for death) were the main determinants of poor outcomes.CONCLUSIONSRSV was the most frequent cause of mortality in low-income postneonatal infants. RF and death due to RSV LRTI, almost exclusively associated with prematurity and cardiopulmonary diseases in industrialized countries, primarily affect term infants in a developing world environment. Poor outcomes at hospitals are frequent and associated with the cooccurrence of bacterial sepsis and clinically significant pneumothoraxes. |
| Author | Nocito, Celina Geoghegan, Sarah Polack, Fernando P. Grimaldi, Luciano Alva Libster, Romina Karron, Ruth A. Barboza, Edgar Zanone, Stella M. Sastre, Gustavo Acosta, Patricio L. Flamenco, Edgardo Bianchi, Alejandra Erviti, Anabella Dueñas, Karina Ferrero, Fernando Ferretti, Adrian Gago, Guadalupe Fernández Rebec, Beatriz Caballero, Mauricio T. Perez, Alberto Rodriguez Bergel, Eduardo Ferolla, F. Martin Vallone, Fernando Rodriguez, Andrea Talarico, Laura B. Sancilio, Andrea Losada, Juan Ves |
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| SubjectTerms | Argentina - epidemiology Cost of Illness Cross-Sectional Studies Female Hospitalization - statistics & numerical data Humans Infant Logistic Models Male Pneumothorax - etiology Pneumothorax - mortality Prospective Studies Respiratory Syncytial Virus Infections - complications Respiratory Syncytial Virus Infections - diagnosis Respiratory Syncytial Virus Infections - mortality Respiratory Syncytial Viruses Risk Factors Sepsis - etiology Sepsis - mortality Sex Factors Socioeconomic Factors |
| Title | Mortality due to Respiratory Syncytial Virus. Burden and Risk Factors |
| URI | https://www.ncbi.nlm.nih.gov/pubmed/27331632 https://www.proquest.com/docview/1857759889 https://www.proquest.com/docview/1826705868 |
| Volume | 195 |
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