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. 2020 Nov;14(6):730-738.
doi: 10.1111/irv.12770. Epub 2020 Jun 12.

Cumulative incidence of post-infection asthma or wheezing among young children clinically diagnosed with respiratory syncytial virus infection in the United States: A retrospective database analysis

Jonathan Nguyen-Van-Tam  1 , Veronique Wyffels  2 , Maartje Smulders  3 , Debasish Mazumder  4 , Rohit Tyagi  4 , Nikhil Gupta  4 , Sandra Gavart  2 , Roman Fleischhackl  5
Affiliations

Cumulative incidence of post-infection asthma or wheezing among young children clinically diagnosed with respiratory syncytial virus infection in the United States: A retrospective database analysis

Jonathan Nguyen-Van-Tam et al. Influenza Other Respir Viruses. 2020 Nov.

Abstract

Background: Respiratory syncytial virus (RSV) infection is implicated in subsequent development of asthma/wheezing (AW) among term and pre-term infants. We describe the cumulative incidence of AW among hospitalized and ambulatory neonates/infants/toddlers following RSV infection diagnosis over three independent follow-up periods.

Methods: Between January 1, 2007 and March 31, 2016, patients aged 0-2 years old with first clinical diagnosis of RSV infection were identified using the Optum® integrated electronic health records and claims database. Patients diagnosed with AW ≤ 30 days post-RSV diagnosis were excluded. Three cohorts with 1, 3, and 5 years of follow-up were stratified by presence or absence of specific RSV high-risk factors, including pre-term birth and pre-defined, pre-existing comorbidities. Descriptive statistics and logistic regression results were reported.

Results: Overall, 9811, 4524, and 1788 RSV-infected high-risk factor negative patients were included in 1, 3, and 5-year independent cohorts, respectively. Of these, 6.5%, 6.9%, and 5.8%, respectively had RSV-related hospitalization. By the end of follow-up, 14.9%, 28.2%, and 36.3% had AW events. Overall, 3030, 1378, and 552 RSV-infected high-risk factor positive patients were included in the respective cohorts. Of these, 11.4%, 11.1%, and 11.6%, respectively were hospitalized with initial RSV infection and 18.1%, 32.9%, and 37.9% had subsequent AW events within the follow-up period. Logistic regression confirmed RSV-related hospitalization significantly increased the likelihood of developing AW (P < .05) in high-risk factor positive and negative patients.

Conclusions: In infants diagnosed with RSV infection, RSV-related hospitalization was associated with a significantly increased likelihood of AW development for at least 5 years, compared with non-hospitalized patients.

Keywords: asthma; cumulative incidence; infants; pre-existing high-risk factors; respiratory syncytial virus; wheezing.

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Conflict of interest statement

Jonathan Nguyen‐Van‐Tam declares no conflicts of interests. In particular, he has never received any form of payment from Janssen Pharmaceutica, Belgium or its contractors for his role in this or any other work. He is currently on secondment to the Department of Health and Social Care (DHSC), England. The views expressed in this manuscript are those of the authors and not necessarily those of the DHSC. Maartje Smulders, Debasish Mazumder, Nikhil Gupta, and Rohit Tyagi received research funding from Janssen Pharmaceutica, Belgium. Veronique Wyffels, Sandra Gavart, and Roman Fleischhackl are employed by Janssen Pharmaceutica, a Johnson & Johnson company and may be Johnson & Johnson stockholders.

Figures

FIGURE 1
FIGURE 1
Study design diagram. AW, asthma/wheezing; RSV, respiratory syncytial virus
FIGURE 2
FIGURE 2
Timing of first RSV hospitalization for the cohort of patients with 1 y of follow‐up. RSV, respiratory syncytial virus
FIGURE 3
FIGURE 3
Cumulative incidence of AW among hospitalized/ambulatory neonates/infants/toddlers after RSV/bronchiolitis infection diagnosis in the Optum Integrated Electronic Health Records and claims database. AW, asthma/wheezing; RSV, respiratory syncytial virus
See this image and copyright information in PMC

References

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