Abstract
The goal of this study was to define the prevalence of respiratory complications, other than bronchiolitis, such as pneumonia, acute otitis media, and conjunctivitis in children treated in a hospital due to respiratory syncytial virus (RSV) infection, with reference to the plausible risk factors. The study included 111 children, aged up to 22 months (median 3 months). Complications were observed in 68 (61%) children, with 32 (29%) children presenting more than one. The most frequent complication was acute otitis media in 53 (48%), pneumonia in 37 (33%), and conjunctivitis in 12 (11%) out of the 111 children. Children with complications were older than those without complications and had fever that lasted for a significantly longer time, both before and during hospitalization, and the fever was stronger. They also presented a significantly lower breathing rate at admission. The age over 3 months was a single risk factor associated with the development of otitis media (OR = 9.8, 95%CI: 3.6–26.7) and pneumonia (OR = 2.8, 95%CI: 1.1–7.3). Other factors such as prematurity, birth weight below 2500 g, exposure to tobacco smoke during pregnancy, and the cessation of breastfeeding below age 6 months were statistically irrelevant to this end. We conclude that complications are very frequent in hospitalized children with RSV infection and their risk increases with the infant age.
This is a preview of subscription content, log in via an institution.
Buying options
Tax calculation will be finalised at checkout
Purchases are for personal use only
Learn about institutional subscriptionsReferences
Agostoni C, Braegger C, Decsi T, Kolacek S, Koletzko B, Michaelsen KF, Mihatsch W, Moreno LA, Puntis J, Shamir R, Szajewska H, Turck D, van Goudoever J, ESPGHAN Committee on Nutrition (2009) Breast–feeding: a commentary by the ESPGHAN Committee on nutrition. J Pediatr Gastroenterol Nutr 49:112–125
Bamberger E, Srugo I, Abu Raya B, Segal E, Chaim B, Kassis I, Kugelman A, Miron D (2012) What is the clinical relevance of respiratory syncytial virus bronchiolitis? Findings from a multi–center, prospective study. Eur J Clin Microbiol Infect Dis 31:3323–3230
Bitko V, Musiyenko A, Barik S (2007) Viral infection of the lungs through the eye. J Virol 81:783–790
Bruden DJ, Singleton R, Hawk CS, Bulkow LR, Bentley S, Anderson LJ, Herrmann L, Chikoyak L, Hennessy TW (2015) Eighteen years of respiratory syncytial virus surveillance: changes in seasonality and hospitalization rates in southwestern Alaska native children. Pediatr Infect Dis J 34:945–950
Bulkow LR, Singleton RJ, Karron RA, Harrison LH, Alaska RSV Study Group (2002) Risk factors for severe respiratory syncytial virus infection among Alaska native children. Pediatrics 109:210–216
Calvo C, Pozo F, García–García ML, Sanchez M, Lopez–Valero M, Pérez–Breña P, Casas I (2010) Detection of new respiratory viruses in hospitalized infants with bronchiolitis: a three–year prospective study. Acta Paediatr 99:883–887
Chonmaitree T, Revai K, Grady JJ, Clos A, Patel JA, Nair S, Fan J, Henrickson KJ (2008) Viral upper respiratory tract infection and otitis media complication in young children. Clin Infect Dis 46:815–823
European Medicines Agency (2017) Guideline on the clinical evaluation of medicinal products indicated for the prophylaxis or treatment of respiratory syncytial virus (RSV) disease. https://www.ema.europa.eu/en/documents/scientific–guideline/draft–guideline–clinical–evaluation–medicinal–products–indicated–prophylaxis–treatment–respiratory_en.pdf. Accessed on 8 Aug 2019
Fujishima H (2002) Respiratory syncytial virus may be a pathogen in allergic conjunctivitis. Cornea 21(2 Suppl 1):S39–S45
García–García ML, Calvo C, Pozo F, Villadangos PA, Pérez–Breña P, Casas I (2012) Spectrum of respiratory viruses in children with community–acquired pneumonia. Pediatr Infect Dis J 31:808–813
Gentile A, Lucion MF, Juarez MDV, Areso MS, Bakir J, Viegas M, Mistchenko A (2019) Burden of respiratory syncytial virus disease and mortality risk factors in Argentina: 18 years of active surveillance in a children’s hospital. Pediatr Infect Dis J 38:589–594
Gomaa MA, Galal O, Mahmoud MS (2012) Risk of acute otitis media in relation to acute bronchiolitis in children. Int J Pediatr Otorhinolaryngol 76:49–51
Hall CB, Weinberg GA, Iwane MK, Blumkin AK, Edwards KM, Staat MA, Auinger P, Griffin MR, Poehling KA, Erdman D, Grijalva CG, Zhu Y, Szilagyi P (2009) The burden of respiratory syncytial virus infection in young children. N Engl J Med 360:588–598
Heikkinen T, Ojala E, Waris M (2017) Clinical and socioeconomic burden of respiratory syncytial virus infection in children. J Infect Dis 215:17–23
Jain S, Williams DJ, Arnold SR et al (2015) Community–acquired pneumonia requiring hospitalization among U.S. children. N Engl J Med 372:835–845
Mansbach JM, Piedra PA, Teach SJ, Sullivan AF, Forgey T, Clark S, Espinola JA, Camargo CA Jr, MARC–30 Investigators (2012) Prospective multicenter study of viral etiology and hospital length of stay in children with severe bronchiolitis. Arch Pediatr Adolesc Med 166:700–706
Okiro EA, Ngama M, Bett A, Cane PA, Medley GF, James Nokes D (2008) Factors associated with increased risk of progression to respiratory syncytial virus–associated pneumonia in young Kenyan children. Tropical Med Int Health 13:914–926
Paramore LC, Ciuryla V, Ciesla G, Liu L (2004) Economic impact of respiratory syncytial virus–related illness in the US: an analysis of national databases. PharmacoEconomics 22:275–284
Parikh K, Hall M, Mittal V, Montalbano A, Mussman GM, Morse RB, Hain P, Wilson KM, Shah SS (2014) Establishing benchmarks for the hospitalized care of children with asthma, bronchiolitis, and pneumonia. Pediatrics 134:555–562
Ruuskanen O, Arola M, Putto–Laurila A, Mertsola J, Meurman O, Viljanen MK, Halonen P (1989) Acute otitis media and respiratory virus infections. Pediatr Infect Dis J 8:94–99
Shi T, Balsells E, Wastnedge E, Singleton R, Rasmussen ZA, Zar HJ, Rath BA, Madhi SA, Campbell S, Vaccari LC, Bulkow LR, Thomas ED, Barnett W, Hoppe C, Campbell H, Nair H (2015) Risk factors for respiratory syncytial virus associated with acute lower respiratory infection in children under five years: systematic review and meta–analysis. J Glob Health 5:020416
Shi T, McAllister DA, O'Brien KL et al (2017) Global, regional, and national disease burden estimates of acute lower respiratory infections due to respiratory syncytial virus in young children in 2015: a systematic review and modelling study. Lancet 390:946–958
Sigurs N, Gustafsson PM, Bjarnason R, Lundberg F, Schmidt S, Sigurbergsson F, Kjellman B (2005) Severe respiratory syncytial virus bronchiolitis in infancy and asthma and allergy at age 13. Am J Respir Crit Care Med 171:137–141
Souty C, Masse S, Valette M, Behillil S, Bonmarin I, Pino C, Turbelin C, Capai L, Vilcu AM, Lina B, van der Werf S, Blanchon T, Falchi A, Hanslik T (2019) Baseline characteristics and clinical symptoms related to respiratory viruses identified among patients presenting with influenza–like illness in primary care. Clin Microbiol Infect 25(9):1147–1153
Stein RT, Bont LJ, Zar H, Polack FP, Park C, Claxton A, Borok G, Butylkova Y, Wegzyn C (2017) Respiratory syncytial virus hospitalization and mortality: systematic review and meta–analysis. Pediatr Pulmonol 52:556–569
Vesa S, Kleemola M, Blomqvist S, Takala A, Kilpi T, Hovi T (2001) Epidemiology of documented viral respiratory infections and acute otitis media in a cohort of children followed from two to twenty–four months of age. Pediatr Infect Dis J 20:574–581
Weber MW, Milligan P, Hilton S, Lahai G, Whittle H, Mulholland EK, Greenwood BM (1999) Risk factors for severe respiratory syncytial virus infection leading to hospital admission in children in the Western Region of the Gambia. Int J Epidemiol 28:157–162
Welliver RC Sr, Checchia PA, Bauman JH, Fernandes AW, Mahadevia PJ, Hall CB (2010) Fatality rates in published reports of RSV hospitalizations among high–risk and otherwise healthy children. Curr Med Res Opin 26:2175–2181
WHO (2019). https://www.who.int/topics/breastfeeding/en/. Accessed on 2 July 2019
Willson DF, Landrigan CP, Horn SD, Smout RJ (2003) Complications in infants hospitalized for bronchiolitis or respiratory syncytial virus pneumonia. J Pediatr 143(5 Suppl):S142–S149
Acknowledgments
The study was supported by CMKP grant 501-1-020-19-19.
Conflicts of Interest
The authors declare no conflicts of interest in relation to this article.
Ethical Approval
All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. The study was approved by the Ethics Committee of the Center of Postgraduate Medical Education in Warsaw, Poland.
Informed Consent
Written informed consent was obtained from the parents or legal guardians of all the child patients of the study.
Author information
Authors and Affiliations
Corresponding author
Editor information
Editors and Affiliations
Rights and permissions
Copyright information
© 2020 Springer Nature Switzerland AG
About this chapter
Cite this chapter
Wrotek, A. et al. (2020). Respiratory Complications in Children Hospitalized with Respiratory Syncytial Virus Infection. In: Pokorski, M. (eds) Health and Medicine. Advances in Experimental Medicine and Biology(), vol 1279. Springer, Cham. https://doi.org/10.1007/5584_2020_530
Download citation
DOI: https://doi.org/10.1007/5584_2020_530
Published:
Publisher Name: Springer, Cham
Print ISBN: 978-3-030-51120-3
Online ISBN: 978-3-030-51121-0
eBook Packages: Biomedical and Life SciencesBiomedical and Life Sciences (R0)