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BMC Infect Dis. 2018 Mar 6;18(1):111. doi: 10.1186/s12879-018-3002-3.

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

Author information

1
Paediatric Infectious Disease Unit, Division of General Paediatrics, University Hospitals of Geneva & Faculty of Medicine, University of Geneva, Geneva, Switzerland.
2
Department of Paediatrics, Paediatric Infectious Disease Unit, University Hospital of Lausanne, Lausanne, Switzerland.
3
Institute of Social and Preventive Medicine (IUMSP), University of Lausanne, Lausanne, Switzerland.
4
Department of Laboratories, Institute of Microbiology, University Hospital and University of Lausanne, Lausanne, Switzerland.
5
Department of Medicine, Infectious Diseases Service, University Hospital of Lausanne, Lausanne, Switzerland.
6
Department of Surgery, Transplantation Center, University Hospital of Lausanne, Lausanne, Switzerland.
7
Unit of Pulmonary transplantation, Pulmonology Service, University Hospital of Lausanne, Lausanne, Switzerland.
8
Department of Pediatrics, Paediatric Hematology and Oncology Unit, University Hospital of Lausanne, Lausanne, Switzerland.
9
Department of Oncology, Hematology Service, University Hospital of Geneva, Geneva, Switzerland.
10
Paediatric Hematology and Oncology Unit, Division of General Pediatrics, University Hospital of Geneva and Faculty of Medicine, University of Geneva, Geneva, Switzerland.
11
Department of Medicine, Infectious Diseases Service, University Hospital of Geneva and Faculty of Medicine, University of Geneva, Geneva, Switzerland.
12
Department of Genetical and Laboratory Medicine, Virology Laboratory, Laboratory Medicine, University Hospital of Geneva, Geneva, Switzerland.
13
Paediatric Infectious Disease Unit, Division of General Paediatrics, University Hospitals of Geneva & Faculty of Medicine, University of Geneva, Geneva, Switzerland. Sandra.Asner@chuv.ch.
14
Department of Medicine, Infectious Diseases Service, University Hospital of Lausanne, Lausanne, Switzerland. Sandra.Asner@chuv.ch.
15
Department of Pediatrics, Pediatric Infectious Disease Unit, CHUV, Rue du Bugnon 46, 1011, Lausanne, Switzerland. Sandra.Asner@chuv.ch.

Abstract

BACKGROUND:

Respiratory syncytial virus (RSV) is associated with significant mortality rates amongst hematopoietic stem cell transplant (HSCT) recipients, with less known about other immunocompromised patients.

METHODS:

Ten-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.

RESULTS:

From 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.

CONCLUSIONS:

From 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.

PMID:
29510663
PMCID:
PMC5838875
DOI:
10.1186/s12879-018-3002-3
[Indexed for MEDLINE]
Free PMC Article

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