Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2021 Jan;68(1):e28759.
doi: 10.1002/pbc.28759. Epub 2020 Oct 8.

The burden of respiratory syncytial virus infections among children with sickle cell disease

Christina A Rostad  1   2 , Alexander N Maillis  3 , Kristina Lai  3 , Nitya Bakshi  3   4 , Robert C Jerris  5   6 , Peter A Lane  3   4 , Marianne E Yee  3   4 , Inci Yildirim  1   2   7
Affiliations

The burden of respiratory syncytial virus infections among children with sickle cell disease

Christina A Rostad et al. Pediatr Blood Cancer. 2021 Jan.

Abstract

Background: Although respiratory syncytial virus (RSV) is the leading cause of pediatric lower respiratory tract infections, the burden of RSV in children with sickle cell disease (SCD) is unknown.

Methods: We conducted a retrospective, nested, case-control study of children with SCD <18 years who had respiratory viral panels (RVPs) performed at Children's Healthcare of Atlanta from 2012 to 2019. We abstracted the medical records to describe the demographics, clinical features, and outcomes of children who tested positive for RSV (cases) versus children who tested negative (controls). We calculated the annual incidence of RSV and related hospitalization rates with 95% confidence intervals (CIs) and used multivariate logistic regression to evaluate associations.

Results: We identified 3676 RVP tests performed on 2636 patients over seven respiratory seasons resulting in 219/3676 (6.0%) RSV-positive tests among 160/2636 (6.1%) patients. The average annual incidence of laboratory-confirmed RSV infection among children with SCD was 34.3 (95% CI 18.7-49.8) and 3.8 (95% CI 0.5-7.0) cases per 1000 person-years for those <5 years and 5-18 years, respectively. The RSV-related hospitalization rate for children <5 years was 20.7 (95% CI 8.5-32.8) per 1000 person-years. RSV-positive cases were significantly younger than RSV-negative patients (3.8 years vs 7.6 years, P < .001). Of RSV-positive cases, 22 (13.8%) developed acute chest syndrome and nine (5.6%) required intensive care, which was not significantly different from RSV-negative children with SCD.

Conclusion: RSV infections are common in children with SCD with higher burden in younger patients. RSV is associated with considerable morbidity, including higher rates of hospitalization compared to the general population.

Keywords: acute chest syndrome; respiratory syncytial virus; sickle cell disease.

PubMed Disclaimer

Figures

Figure 1.
Figure 1.. Study enrollment and RSV case status among children with sickle cell disease, Children’s Healthcare of Atlanta, 2012–2019
*Some patients were tested more than once during the seven-year duration of the study. Patients who had a positive RVP test with the same pathogen in the preceding 30 days were only counted once.
Figure 2.
Figure 2.. Incidence of respiratory syncytial virus infection among children with SCD over years by age groups, 2012–2019
See this image and copyright information in PMC

References

    1. Nair H, Nokes DJ, Gessner BD, et al. Global burden of acute lower respiratory infections due to respiratory syncytial virus in young children: a systematic review and meta-analysis. Lancet. 2010;375(9725):1545–1555. - PMC - PubMed
    1. Glezen WP, Taber LH, Frank AL, Kasel JA. Risk of primary infection and reinfection with respiratory syncytial virus. Am J Dis Child. 1986;140(6):543–546. - PubMed
    1. Hall CB, Weinberg GA, Iwane MK, et al. The burden of respiratory syncytial virus infection in young children. N Engl J Med. 2009;360(6):588–598. - PMC - PubMed
    1. American Academy of Pediatrics Committee on Infectious D, American Academy of Pediatrics Bronchiolitis Guidelines C. Updated guidance for palivizumab prophylaxis among infants and young children at increased risk of hospitalization for respiratory syncytial virus infection. Pediatrics. 2014;134(2):415–420. - PubMed
    1. Browne SK, Beeler JA, Roberts JN. Summary of the Vaccines and Related Biological Products Advisory Committee meeting held to consider evaluation of vaccine candidates for the prevention of respiratory syncytial virus disease in RSV-naive infants. Vaccine. 2020;38(2):101–106. - PubMed

Publication types

MeSH terms