Original ArticleDown Syndrome and Hospitalizations due to Respiratory Syncytial Virus: A Population-Based Study
Section snippets
Methods
Two separate study designs were used. The first used statewide data to calculate population-based rates of RSV hospitalization in Colorado and to describe the clinical features and outcomes of RSV hospitalizations in Colorado children with and without DS. The second, a case-control study, used data from a single major children’s hospital, The Children’s Hospital, Colorado, to define differences in outcomes of children hospitalized with RSV with and without DS. The Colorado Multiple
Population-Based Rates for RSV LRTI Hospitalizations
There were 630 children with DS born in Colorado between 1997 and 2004, an average rate of 12.3 per 10 000 live births/year (95% CI, 11.35-13.25). Among these, there were 85 RSV LRTI hospitalizations within the first 2 years of life with 50 having no concurrent risk factors identified (CHD, PH, CLD, prematurity). The rate for RSV LRTI hospitalization in DS was 67 per 1000 child-years compared with 12 per 1000 child-years in the cohort without DS (OR, 5.99; 95% CI, 5.38-6.68). Comparing
Discussion
Our study shows that children with DS have a 6-fold higher risk of being hospitalized with RSV LRTI in the first 2 years of life than those without DS and an increased severity of disease when hospitalized. This has been reported previously,9, 16 but this study goes further, deriving population-based risk estimates for RSV LRTI in DS and demonstrating increased risk and severity in the absence of other risk factors including CHD. It also demonstrates a gradient in the risk and severity of RSV
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Cited by (57)
Management of acute COVID-19 in the pediatric population and role of antimicrobial therapy
2023, Clinical Management of Pediatric COVID-19: An International Perspective and Practical GuideThe impact of obstructive sleep apnea on bronchiolitis severity in children with Down syndrome
2021, Sleep MedicineCitation Excerpt :However, most publications have proposed descriptive associations without fully addressing DS comorbidities (eg, OSA) that might contribute to the severity of acute bronchiolitis. It is speculated that the increased risk of hospitalization, and length of stay (LOS) among children with DS and acute bronchiolitis is mediated by its neuromuscular or cardiopulmonary comorbidities [13–15]. However, little is known about the impact of OSA on the outcomes of hospitalized children with DS and acute bronchiolitis [16–18], and whether this impact is independent of DS-associated comorbidities.
68 - Respiratory Complications of Down Syndrome
2019, Kendig's Disorders of the Respiratory Tract in ChildrenHospitalization for Respiratory Syncytial Virus in Children with Down Syndrome Less than 2 Years of Age: A Systematic Review and Meta-Analysis
2018, Journal of PediatricsCitation Excerpt :All but 1 study (that by Medrano López et al) was published in English.28 All studies were published between 2004 and 2017 and included 8 retrospective studies,20-26 1 combined retrospective and prospective cohort study,19 1 prospective study,29 and 1 case-control study.27 All children included in the meta-analysis were aged ≤2 years.
Risk factors associated with death in patients with severe respiratory syncytial virus infection
2016, Journal of Microbiology, Immunology and InfectionCitation Excerpt :Children with Down's syndrome have an increased rate of comorbidities with both CHD and pulmonary hypertension, which are two independent risk factors for RSV LRTI.12,13 Patients with Down's syndrome, even without coexisting risk factors such as CHD, still have higher risks of being admitted to hospital for RSV LRTI.14 Other hypothesized mechanisms include hypotonia,15 more injury-prone lungs,16 an abnormal upper respiratory anatomy,15 and altered lung growth.17
Supported by a research grant from MedImmune. The study sponsor was not involved in any of the following: (1) study design; (2) the collection analysis, or interpretation of data; (3) the writing of the report; or (4) the decision to submit the manuscript for publication. E.S. has received research support and honoraria for talks from MedImmune and Abbott Inc. The other authors declare no conflicts of interest.