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. 2020 Nov;14(6):658-670.
doi: 10.1111/irv.12729. Epub 2020 Feb 16.

Risk factors for hospitalized respiratory syncytial virus disease and its severe outcomes

Wei Cai  1   2 , Silke Buda  1 , Ekkehard Schuler  3 , Siddhivinayak Hirve  4 , Wenqing Zhang  4 , Walter Haas  1   2
Affiliations

Risk factors for hospitalized respiratory syncytial virus disease and its severe outcomes

Wei Cai et al. Influenza Other Respir Viruses. 2020 Nov.

Abstract

Introduction: Respiratory syncytial virus (RSV) is a major cause of hospital admission for acute lower respiratory tract infection in young children.

Objectives: We aimed to identify risk factors for hospitalized RSV disease and its severe outcomes.

Methods: We conducted a retrospective cohort study analyzing data of a ICD-10-code-based hospital surveillance for severe acute respiratory infections (SARI). Using univariable and multivariable logistic regression analysis, we assessed age-group, gender, season, and underlying medical conditions as possible risk factors for RSV and its severe outcomes including ICU admission, application of ventilator support, and death, respectively.

Results: Of the 413 552 patients hospitalized with SARI in the database, 8761 were diagnosed with RSV from week 01/2009 to 20/2018 with 97% (8521) aged <5 years. Among children aged <5 years, age-groups 0-5 months (OR: 20.29, 95% CI: 18.37-22.41) and 6 months-1 year (OR: 4.59, 95% CI: 4.16-5.06), and underlying respiratory and cardiovascular disorders specific to the perinatal period (OR: 1.32, 95% CI: 1.11-1.57) were risk factors for being diagnosed with RSV. Age-group 0-5 months (OR: 2.39, 95% CI: 1.45-3.94), low birth weight (OR: 6.77, 95% CI: 1.28-35.71), preterm newborn (OR: 6.71, 95% CI: 2.19-20.61), underlying respiratory and cardiovascular disorders specific to the perinatal period (OR: 4.97, 95% CI: 3.36-7.34), congenital malformation of the heart (OR: 3.65, 95% CI: 1.90-7.02), congenital malformation of the great vessels (OR: 3.50, 95% CI: 1.10-11.18), congenital defect originating in perinatal period (OR: 4.07, 95% CI: 1.71-9.70), cardiovascular disease (OR: 5.19, 95% CI: 2.77-9.72), neurological disorders (OR: 6.48, 95% CI: 3.76-11.18), blood disease (OR: 3.67, 95% CI: 1.98-6.79), and liver disease (OR: 14.99, 95% CI: 1.49-150.82) contributed to ICU admission in RSV cases.

Conclusions: Using ICD-10-based surveillance data allows to identify risk factors for hospitalized RSV disease and its severe outcomes, and quantify the risk in different age-groups.

Keywords: comorbidity; hospitalization; intensive care units; international classification of diseases; logistic models; respiratory syncytial virus; risk factors; ventilation.

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Conflict of interest statement

None.

Figures

Figure 1
Figure 1
Number of SARI cases and RSV cases by age‐group, week 01/2009‐20/2018
Figure 2
Figure 2
Number of SARI cases, RSV cases, ICU‐admitted RSV cases, ventilated RSV cases, and deceased RSV cases ever required ventilator support in ICU
Figure 3
Figure 3
Number of RSV cases and RSV cases with severe outcomes by calendar week, week 01/2015‐20/2018
See this image and copyright information in PMC

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