Original ArticleChildren with Down Syndrome Are High-Risk for Severe Respiratory Syncytial Virus Disease
Section snippets
Methods
We conducted a retrospective cohort database study of children born between October 1, 2005 and April 30, 2011 within TRICARE, and with minimum continued enrollment beyond 90 days of life (Figure 1; available at www.jpeds.com). The study was approved by our Institutional Review Board and the Human Research Protection Office for the Office of the Assistant Secretary of Defense for Health Affairs/Defense Health Agency. All patient data were deidentified.
TRICARE is the Department of Defense's
Results
A total of 633 200 children younger than 3 years of age and 3 209 378 person-years were studied. With the exception of male sex, the percentages of the individual known risk factors, ie, CLD, HSHD, etc., for RSV hospitalization were different between the cohort of patients with Down syndrome and the cohort of patients without Down syndrome (Table II). In addition, children with Down syndrome were more likely to have one or more concomitant risk factors than the patients without Down syndrome (P
Discussion
Our study demonstrates that children with Down syndrome have a significantly greater absolute and adjusted rate of RSV hospitalization than those without Down syndrome (Table IV). In addition, the overall incidence density rate ratio of children with Down syndrome vs those without Down syndrome was 6.93 (95% CI, 5.57-8.62). Down syndrome was associated more strongly with RSV hospitalization than any other risk factor except immunodeficiency (Table V). Previous studies have shown that nearly
References (35)
- et al.
Palivizumab prophylaxis reduces hospitalization due to respiratory syncytial virus in young children with hemodynamically significant congenital heart disease
J Pediatr
(2003) - et al.
Rehospitalisations for respiratory disease and respiratory syncytial virus infection in preterm infants of 29-36 weeks gestational age
J Infect
(2005) - et al.
Down syndrome and hospitalizations due to respiratory syncytial virus: a population-based study
J Pediatr
(2012) - et al.
Ethnicity, sex, and the incidence of congenital heart defects: a report from the National Down Syndrome Project
Genet Med
(2008) - et al.
Immune evaluation and vaccine responses in Down syndrome: evidence of immunodeficiency?
Vaccine
(2011) - et al.
Respiratory syncytial virus testing during bronchiolitis episodes of care in an integrated health care delivery system: a retrospective cohort study
Clin Ther
(2010) Systematic review of the biology and medical management of respiratory syncytial virus infection
Respir Care
(2003)- et al.
The burden of respiratory syncytial virus infection in young children
N Engl J Med
(2009) - et al.
Respiratory syncytial virus-coded pediatric hospitalizations, 1997 to 1999
Pediatr Infect Dis J
(2002) Respiratory syncytial virus activity - United States, July 2008-December 2009
MMWR Morb Mortal Wkly Rep
(2010)
Population-based surveillance for hospitalizations associated with respiratory syncytial virus, influenza virus, and parainfluenza viruses among young children
Pediatrics
Palivizumab, a humanized respiratory syncytial virus monoclonal antibody, reduces hospitalization from respiratory syncytial virus infection in high-risk infants. The IMpact-RSV Study Group
Pediatrics
Physiologic risk factors for respiratory viral infections and immunoprophylaxis for respiratory syncytial virus in young children with congenital heart disease
Pediatr Infect Dis J
Driscoll Children's Hospital respiratory syncytial virus database: risk factors, treatment and hospital course in 3308 infants and young children, 1991 to 2002
Pediatr Infect Dis J
Hospitalized children with respiratory syncytial virus infection and neuromuscular impairment face an increased risk of a complicated course
Pediatr Infect Dis J
Red Book: 2012 Report of the Committee on Infectious Diseases
Updated guidance for palivizumab prophylaxis among infants and young children at increased risk of hospitalization for respiratory syncytial virus infection
Pediatrics
Cited by (0)
The views expressed in this article are those of the authors and do not reflect the official policy or position of the United States Army, United States Air Force, the Department of Defense, or the U.S. Government. The authors declare no conflicts of interest.