Risk Factors of Very Severe RSV Infections in a Multicenter Cohort of Very Preterm and Extreme Preterm Babies Receiving or Not Palivizumab

Frontiers in Pediatrics

article

Gwenaelle Mulot¹  Mehdi Benchaib¹  Frank Plaisant¹  Dominique Ploin¹  Yves Gillet¹  Etienne Javouhey¹  Olivier Claris¹  Jean-Charles Picaud⁶  Jean-Sebastien Casalegno³  Marine Butin¹ 

[1] Hospices Civils de Lyon, Hôpital Femme Mère Enfant;UMR CNRS 5558 – LBBE;Centre International de Recherche en Infectiologie ,(CIRI), Team VirPatH, INSERM U1111, CNRS UMR5308, Ecole Normale Supérieure de Lyon, Université Claude Bernard Lyon 1;Centre International de Recherche en Infectiologie, Team Staphylococcal Pathogenesis, INSERM U1111, CNRS UMR5308, Ecole Normale Supérieure de Lyon, Université Claude Bernard Lyon 1;EA 4129, Université Claude Bernard Lyon 1;Hospices Civils de Lyon, Hôpital de la Croix Rousse;CarMeN, INSERM U1060, INRA U1397, Université Claude Bernard Lyon 1;Institut des Agents Infectieux, Hôpital de la Croix Rousse

关键词: cohort study;    RSV;    bronchiolitis;    preterm;    palivizumab;    LRTI;   

DOI  :  10.3389/fped.2022.884120

学科分类：社会科学、人文和艺术（综合）

来源: Frontiers

【 摘 要 】

Introduction Preterm infants are at risk of lower respiratory tract infections (LRTI), including Respiratory Syncytial Virus (RSV) associated bronchiolitis, for which palivizumab prophylaxis can be proposed. Our aim was to determine risk factors of very severe RSV disease in children born before 34 weeks of gestation. Methods Among 2,101 infants born before 34 weeks of gestation in 3 maternity wards between 2012 and 2017, the laboratory confirmed RSV-infected patients requiring hospitalization before 12 months of corrected age were retrospectively included. We collected data about the neonatal period, the palivizumab prophylaxis and the hospitalization for a RSV-related LRTI. LRTI was considered as very severe (VS-LRTI) when patients required invasive or non-invasive positive pressure ventilation. Results Among 86 included patients, 31 met the criteria of VS-LRTI. The VS-LRTI patients had a higher birth gestational age and weight but less heart disease and bronchopulmonary dysplasia. They received palivizumab prophylaxis less frequently than the other patients but the difference was not significant. At the onset of infection, VS-LRTI patients had a younger corrected age for prematurity and presented more frequently with apnea, bradycardia, life-threatening event, hemodynamic failure, hypercapnia. Using logistic regression, the main factor associated with VS-LRTI was a younger corrected age for prematurity at the onset of infection [Odd ratio for each month of corrected age = 0.77 (0.62; 0.93), p = 0.012]. Conclusion Infants at the highest risk of VS-LRTI were infants with a younger corrected age for prematurity. Therefore, a better targeting of infants requiring palivizumab prophylaxis and early interventions at hospital discharge could limit VS-LRTI in these infants.

【 授权许可】

CC BY