TY - JOUR
T1 - Healthcare-Associated Respiratory Syncytial Virus in Children’s Hospitals
AU - Saiman, Lisa
AU - Coffin, Susan E.
AU - Kociolek, Larry K.
AU - Zerr, Danielle M.
AU - Milstone, Aaron M.
AU - Aldrich, Margaret L.
AU - Vargas, Celibell Y.
AU - Zapata, Giovanny
AU - Zalot, Morgan A.
AU - Reyna, Megan E.
AU - Adler, Amanda
AU - Voskertchian, Annie
AU - Egbert, Emily R.
AU - Alba, Luis
AU - Gollerkeri, Sonia
AU - Ruggieri, Madelyn
AU - Finelli, Lyn
AU - Choi, Yoonyoung
N1 - Publisher Copyright:
© The Author(s) 2023. Published by Oxford University Press on behalf of The Journal of the Pediatric Infectious Diseases Society.
PY - 2023/5/1
Y1 - 2023/5/1
N2 - Background: Outbreaks of healthcare-associated respiratory syncytial virus (HA-RSV) infections in children are well described, but less is known about sporadic HA-RSV infections. We assessed the epidemiology and clinical outcomes associated with sporadic HA-RSV infections. Methods: We retrospectively identified hospitalized children ≤18 years old with HA-RSV infections in six children’s hospitals in the United States during the respiratory viral seasons October–April in 2016–2017, 2017–2018, and 2018–2019 and prospectively from October 2020 through November 2021. We evaluated outcomes temporally associated with HA-RSV infections including escalation of respiratory support, transfer to the pediatric intensive care unit (PICU), and in-hospital mortality. We assessed demographic characteristics and comorbid conditions associated with escalation of respiratory support. Results: We identified 122 children (median age 16.0 months [IQR 6, 60 months]) with HA-RSV. The median onset of HA-RSV infections was hospital day 14 (IQR 7, 34 days). Overall, 78 (63.9%) children had two or more comorbid conditions; cardiovascular, gastrointestinal, neurologic/neuromuscular, respiratory, and premature/ neonatal comorbidities were most common. Fifty-five (45.1%) children required escalation of respiratory support and 18 (14.8%) were transferred to the PICU. Five (4.1%) died during hospitalization. In the multivariable analysis, respiratory comorbidities (aOR: 3.36 [CI95 1.41, 8.01]) were associated with increased odds of escalation of respiratory support. Conclusions: HA-RSV infections cause preventable morbidity and increase healthcare resource utilization. Further study of effective mitigation strategies for HA-respiratory viral infections should be prioritized; this priority is further supported by the impact of the COVID-19 pandemic on seasonal viral infections. We identified 122 children with healthcare-associated (HA) respiratory syncytial virus infections; 55 (45%) required escalation of respiratory support and 18 (15%) were transferred to the Pediatric ICU. Further study of effective mitigation strategies for HA-respiratory viral infections should be prioritized.
AB - Background: Outbreaks of healthcare-associated respiratory syncytial virus (HA-RSV) infections in children are well described, but less is known about sporadic HA-RSV infections. We assessed the epidemiology and clinical outcomes associated with sporadic HA-RSV infections. Methods: We retrospectively identified hospitalized children ≤18 years old with HA-RSV infections in six children’s hospitals in the United States during the respiratory viral seasons October–April in 2016–2017, 2017–2018, and 2018–2019 and prospectively from October 2020 through November 2021. We evaluated outcomes temporally associated with HA-RSV infections including escalation of respiratory support, transfer to the pediatric intensive care unit (PICU), and in-hospital mortality. We assessed demographic characteristics and comorbid conditions associated with escalation of respiratory support. Results: We identified 122 children (median age 16.0 months [IQR 6, 60 months]) with HA-RSV. The median onset of HA-RSV infections was hospital day 14 (IQR 7, 34 days). Overall, 78 (63.9%) children had two or more comorbid conditions; cardiovascular, gastrointestinal, neurologic/neuromuscular, respiratory, and premature/ neonatal comorbidities were most common. Fifty-five (45.1%) children required escalation of respiratory support and 18 (14.8%) were transferred to the PICU. Five (4.1%) died during hospitalization. In the multivariable analysis, respiratory comorbidities (aOR: 3.36 [CI95 1.41, 8.01]) were associated with increased odds of escalation of respiratory support. Conclusions: HA-RSV infections cause preventable morbidity and increase healthcare resource utilization. Further study of effective mitigation strategies for HA-respiratory viral infections should be prioritized; this priority is further supported by the impact of the COVID-19 pandemic on seasonal viral infections. We identified 122 children with healthcare-associated (HA) respiratory syncytial virus infections; 55 (45%) required escalation of respiratory support and 18 (15%) were transferred to the Pediatric ICU. Further study of effective mitigation strategies for HA-respiratory viral infections should be prioritized.
KW - escalation of respiratory support
KW - healthcare-associated RSV
KW - surveillance definitions
KW - transmission index
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U2 - 10.1093/jpids/piad030
DO - 10.1093/jpids/piad030
M3 - Article
C2 - 37144945
AN - SCOPUS:85161716891
SN - 2048-7193
VL - 12
SP - 265
EP - 272
JO - Journal of the Pediatric Infectious Diseases Society
JF - Journal of the Pediatric Infectious Diseases Society
IS - 5
ER -