Burden of severe RSV disease among immunocompromised children and adults: a 10 year retrospective study View Full Text


Ontology type: schema:ScholarlyArticle      Open Access: True


Article Info

DATE

2018-03-06

AUTHORS

Olga Chatzis, Stephanie Darbre, Jérôme Pasquier, Pascal Meylan, Oriol Manuel, John David Aubert, Maja Beck-Popovic, Stavroula Masouridi-Levrat, Marc Ansari, Laurent Kaiser, Klara M. Posfay-Barbe, Sandra A. Asner

ABSTRACT

BackgroundRespiratory syncytial virus (RSV) is associated with significant mortality rates amongst hematopoietic stem cell transplant (HSCT) recipients, with less known about other immunocompromised patients.MethodsTen-year retrospective cohort study of immunocompromised patients presenting with RSV disease documented at University Hospitals of Lausanne and Geneva. Severe RSV-related outcomes referred to RSV documented respiratory conditions requiring hospital admission, presenting as lower respiratory tract infection (LRTI) or pneumonia. We used multivariable logistic regression to assess clinical and laboratory correlates of severe RSV disease.ResultsFrom 239 RSV-positive immunocompromised in and out-patients 175 were adults and 64 children of whom 111 (47.8%) presented with LRTI, which resulted in a 38% (89/239) admission rate to hospital. While immunocompromised children were more likely to be admitted to hospital compared to adults (75% vs 62.9%, p = 0.090), inpatients admitted to the intensive care unit (17/19) or those who died (11/11) were mainly adults. From multivariable analyses, adults with solid tumors (OR 5.2; 95% CI: 1.4–20.9 P = 0.015) or those requiring chronic immunosuppressive treatments mainly for rheumatologic conditions (OR 4.1; 95% CI: 1.1–16.0; P = 0.034) were significantly more likely to be admitted to hospital compared to hematopoietic stem cell (HSCT) recipients. Bacterial co-infection was significantly and consistently associated with viral LRTI and pneumonia.ConclusionsFrom our findings, RSV-related disease results in a significant burden among adults requiring chronic immunosuppressive treatments for rheumatological conditions and those with solid tumors. As such, systematic screening for respiratory viruses, should be extended to other immunocompromised populations than HSCT recipients. More... »

PAGES

111

Journal

TITLE

BMC Infectious Diseases

ISSUE

1

VOLUME

18

Identifiers

URI

http://scigraph.springernature.com/pub.10.1186/s12879-018-3002-3

DOI

http://dx.doi.org/10.1186/s12879-018-3002-3

DIMENSIONS

https://app.dimensions.ai/details/publication/pub.1101355467

PUBMED

https://www.ncbi.nlm.nih.gov/pubmed/29510663


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27 schema:description BackgroundRespiratory syncytial virus (RSV) is associated with significant mortality rates amongst hematopoietic stem cell transplant (HSCT) recipients, with less known about other immunocompromised patients.MethodsTen-year retrospective cohort study of immunocompromised patients presenting with RSV disease documented at University Hospitals of Lausanne and Geneva. Severe RSV-related outcomes referred to RSV documented respiratory conditions requiring hospital admission, presenting as lower respiratory tract infection (LRTI) or pneumonia. We used multivariable logistic regression to assess clinical and laboratory correlates of severe RSV disease.ResultsFrom 239 RSV-positive immunocompromised in and out-patients 175 were adults and 64 children of whom 111 (47.8%) presented with LRTI, which resulted in a 38% (89/239) admission rate to hospital. While immunocompromised children were more likely to be admitted to hospital compared to adults (75% vs 62.9%, p = 0.090), inpatients admitted to the intensive care unit (17/19) or those who died (11/11) were mainly adults. From multivariable analyses, adults with solid tumors (OR 5.2; 95% CI: 1.4–20.9 P = 0.015) or those requiring chronic immunosuppressive treatments mainly for rheumatologic conditions (OR 4.1; 95% CI: 1.1–16.0; P = 0.034) were significantly more likely to be admitted to hospital compared to hematopoietic stem cell (HSCT) recipients. Bacterial co-infection was significantly and consistently associated with viral LRTI and pneumonia.ConclusionsFrom our findings, RSV-related disease results in a significant burden among adults requiring chronic immunosuppressive treatments for rheumatological conditions and those with solid tumors. As such, systematic screening for respiratory viruses, should be extended to other immunocompromised populations than HSCT recipients.
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33 schema:keywords BackgroundRespiratory syncytial virus
34 ConclusionsFrom
35 Geneva
36 HSCT recipients
37 Lausanne
38 RSV
39 RSV disease
40 University Hospital
41 admission
42 admission rates
43 adults
44 analysis
45 burden
46 care unit
47 cell recipients
48 cell transplant recipients
49 children
50 chronic immunosuppressive treatment
51 cohort study
52 conditions
53 correlates
54 disease
55 disease results
56 findings
57 hematopoietic stem cell recipients
58 hematopoietic stem cell transplant recipients
59 hospital
60 hospital admission
61 immunocompromised children
62 immunocompromised populations
63 immunosuppressive treatment
64 infection
65 inpatients
66 intensive care unit
67 laboratory correlates
68 logistic regression
69 lower respiratory tract infections
70 mortality rate
71 multivariable analysis
72 multivariable logistic regression
73 outcomes
74 patients
75 pneumonia
76 population
77 rate
78 recipients
79 regression
80 respiratory conditions
81 respiratory tract infections
82 respiratory viruses
83 results
84 retrospective cohort study
85 retrospective study
86 rheumatologic conditions
87 rheumatological conditions
88 screening
89 severe RSV disease
90 significant burden
91 significant mortality rate
92 solid tumors
93 stem cell recipients
94 stem cell transplant recipients
95 study
96 syncytial virus
97 systematic screening
98 tract infections
99 transplant recipients
100 treatment
101 tumors
102 units
103 viral lower respiratory tract infections
104 virus
105 year retrospective study
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