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. 2022 Aug 30:10:1004739.
doi: 10.3389/fped.2022.1004739. eCollection 2022.

Risk factors associated with severe disease in respiratory syncytial virus infected children under 5 years of age

Lise Beier Havdal  1   2 , Håkon Bøås  2 , Terese Bekkevold  2 , Anne-Marte Bakken Kran  2   3 , Astrid Elisabeth Rojahn  4 , Ketil Størdal  5   6 , Sara Debes  7 , Henrik Døllner  8   9 , Svein Arne Nordbø  9   10 , Bjørn Barstad  11 , Elisebet Haarr  12 , Liliana Vázquez Fernández  2 , Britt Nakstad  1   6 , Christopher Inchley  1 , Elmira Flem  2
Affiliations

Risk factors associated with severe disease in respiratory syncytial virus infected children under 5 years of age

Lise Beier Havdal et al. Front Pediatr. .

Abstract

Objective: To evaluate risk factors for severe disease in children under 59 months of age hospitalized with respiratory syncytial virus (RSV) infection.

Study design: We prospectively enrolled 1,096 cases of laboratory confirmed RSV infection during three consecutive RSV seasons in 2015-2018. Potential risk factors for severe disease were retrieved through patient questionnaires and linkage to national health registries. Need for respiratory support (invasive ventilation, bi-level positive airway pressure, or continuous positive airway pressure), and length of stay exceeding 72 h were used as measures of disease severity. Associations were investigated using multivariable logistic regression analyses. Multiple imputation was used to avoid bias and inference induced by missing data.

Results: Risk factors associated with a need for respiratory support included age younger than 3 months of age [aOR: 6.73 (95% CI 2.71-16.7)], having siblings [aOR: 1.65 (95% CI 1.05-2.59)] and comorbidity [aOR: 2.40 (95% CI 1.35-4.24)]. The length of hospital stay >72 h was significantly associated with being younger than 3 months of age [aOR: 3.52 (95% CI 1.65-7.54)], having siblings [aOR: 1.45 (95% CI 1.01-2.08)], and comorbidity [aOR: 2.18 (95% CI 1.31-3.61)]. Sub-group analysis of children younger than 6 months of age confirmed the association between both young age and having siblings and the need for respiratory support.

Conclusion: In a large cohort of children <59 months hospitalized with RSV infection, young age, comorbidity, and having siblings were associated with more severe disease.

Keywords: disease severity analysis; pediatric infection; respiratory infection; respiratory syncytial virus (RSV); risk factor (RF).

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Conflict of interest statement

EF was currently employed by Merck & Co., Inc., Kenilworth, New Jersey. The work for the current study was conducted by EF under the previous affiliation. The remaining authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Figures

Figure 1
Figure 1
Univariate logistic regression analysis of risk factors for severe RSV infection in Norwegian children under 5 years of age. (A) Risk factors of need for respiratory support. (B) Risk factors of LOS > 72 h.
See this image and copyright information in PMC

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