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Observational Study
. 2022 Aug 12;226(Suppl 1):S45-S54.
doi: 10.1093/infdis/jiac163.

Clinical and Viral Factors Associated With Disease Severity and Subsequent Wheezing in Infants With Respiratory Syncytial Virus Infection

Joseph P McGinley  1 , Gu Lung Lin  1 , Deniz Öner  2 , Tanya Golubchik  3 , Daniel O'Connor  1 , Matthew D Snape  1 , Olivier Gruselle  4 , Annefleur C Langedijk  5 , Joanne Wildenbeest  5 , Peter Openshaw  6 , Harish Nair  7 , Jeroen Aerssens  2 , Louis Bont  5 , Federico Martinón-Torres  8 , Simon B Drysdale  9 , Andrew J Pollard  1   10 ; RESCEU Investigators
Collaborators, Affiliations
Observational Study

Clinical and Viral Factors Associated With Disease Severity and Subsequent Wheezing in Infants With Respiratory Syncytial Virus Infection

Joseph P McGinley et al. J Infect Dis. .

Abstract

Respiratory syncytial virus (RSV) causes substantial morbidity and mortality in infants and young children worldwide. Here we evaluated host demographic and viral factors associated with RSV disease severity in 325 RSV-infected infants under 1 year of age from 3 European countries during 2017-2020. Younger infants had a higher clinical severity (ReSViNET) score and were more likely to require hospitalization, intensive care, respiratory support, and/or mechanical ventilation than older infants (<3 months vs 3 to <6 months and 3 to <6 months vs ≥6 months). Older age (≥6 months vs <3 months), higher viral load, and RSV-A were associated with a greater probability of fever. RSV-A and RSV-B caused similar disease severity and had similar viral dynamics. Infants with a more severe RSV infection, demonstrated by having a higher ReSViNET score, fever, and requiring hospitalization and intensive care, were more likely to have developed subsequent wheezing at 1 year of age.

Clinical trials registration: NCT03756766.

Keywords: disease severity; respiratory syncytial virus; subgroup; viral load; wheezing.

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Conflict of interest statement

Potential conflicts of interest. D. Ö. and J. A. are employees of Janssen Pharmaceutica NV. O. G. is an employee of the GSK group of companies. H. N. has received funding from Sanofi and Pfizer; and honoraria from Sanofi, Abbvie, Janssen, ReViral, and Novavax. F. M.-T. has received honoraria from GSK, Pfizer Inc, Sanofi Pasteur, MSD, Seqirus, and Janssen for taking part in advisory boards and expert meetings and for acting as a speaker in congresses outside the scope of the submitted work; has acted as principal investigator in randomized controlled trials of GSK, Pfizer Inc, Sanofi Pasteur, MSD, Seqirus, Janssen, Ablynx, Regeneron, Roche, Abbott, Novavax, and MedImmune, with honoraria paid to his institution; and receives support for his research activities from the Instituto de Salud Carlos III (Proyecto de Investigación en Salud, Acción Estratégica en Salud): Fondo de Investigación Sanitaria (FIS; PI1601569/PI1901090) del Plan Nacional de I + D + I and Fondos FEDER. S. B. D. has been an investigator for clinical trials of vaccines and antimicrobials for pharmaceutical companies including AstraZeneca, Merck, and Janssen; and sits on an RSV advisory board for Sanofi Pasteur. A. J. P. is a NIHR Senior Investigator with funding from the British Research Council. All other authors report no potential conflicts. All authors have submitted the ICMJE Form for Disclosure of Potential Conflicts of Interest. Conflicts that the editors consider relevant to the content of the manuscript have been disclosed.

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