1
|
Self A, Van Buskirk J, Clark J, Cochrane JE, Knibbs L, Cass-Verco J, Gupta L. Respiratory syncytial virus disease morbidity in Australian infants aged 0 to 6 months: a systematic review with narrative synthesis. BMC Public Health 2023; 23:2560. [PMID: 38129854 PMCID: PMC10740277 DOI: 10.1186/s12889-023-17474-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2023] [Accepted: 12/13/2023] [Indexed: 12/23/2023] Open
Abstract
BACKGROUND A significant proportion of the global respiratory syncytial virus (RSV) associated morbidity is accounted for by infants aged 0 to 6 months, who are particularly vulnerable to severe disease. In 2015, 44% of global hospitalisations in infants in this age group were secondary to RSV. The objective of this systematic review is to appraise and synthesise the local evidence of RSV infection morbidity among Australian infants aged 0 to 6 months and to assess the implications for future immunisation strategies. METHODS Electronic databases (Medline, Embase, Pubmed and Global Health) were searched for full-text articles published between 2000 and 2023 in English language. Studies that examined markers of RSV disease morbidity in infants aged 0 to 6 months in Australia who had laboratory confirmed RSV infection were eligible for inclusion. The outcomes of interest were incidence, prevalence, testing rate, positivity rate, mortality, emergency department visits, community health visits, hospitalisation, intensive care unit admission, supplementary oxygen use, mechanical ventilation, risk factors for disease severity and monoclonal antibody use. RESULTS The database search identified 469 studies. After removal of duplicates and full-text review, 17 articles were eligible for inclusion. This review was reported according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses and Synthesis without meta-analysis guidelines. CONCLUSIONS Qualitative analysis of the included studies showed that Australian infants aged 0 to 6 months have higher rates of RSV testing, positivity and incidence; and more likely to develop severe disease that requires hospitalisation, intensive care unit admission or respiratory support, compared to children and adults of all ages. Aboriginal and Torres Strait Islander infants aged 0 to 6 months demonstrated higher rates of RSV infection and hospitalisation, compared to non-Indigenous infants. Age-related trends persisted in geographic areas with varying seasonal transmission of RSV, and during the SARS-CoV-2 pandemic. Passive immunisation strategies targeting infants in their first 6 months of life, either via vaccination of pregnant women or administration of long-acting monoclonal antibody during infancy, could effectively reduce RSV disease burden in Australia.
Collapse
Affiliation(s)
- Alice Self
- Sydney Local Health District, Sydney, NSW, Australia.
| | - Joseph Van Buskirk
- School of Public Health, The University of Sydney, Sydney, NSW, Australia
- Public Health Research Analytics and Methods for Evidence, Public Health Unit, Sydney Local Health District, Sydney, NSW, Australia
| | - Jayden Clark
- Sydney Local Health District, Sydney, NSW, Australia
| | | | - Luke Knibbs
- School of Public Health, The University of Sydney, Sydney, NSW, Australia
- Public Health Research Analytics and Methods for Evidence, Public Health Unit, Sydney Local Health District, Sydney, NSW, Australia
| | - John Cass-Verco
- Department of Paediatrics, Royal Prince Alfred Hospital, Sydney, NSW, Australia
| | - Leena Gupta
- Sydney Local Health District, Sydney, NSW, Australia
| |
Collapse
|
2
|
El-Atawi K, De Luca D, Ramanathan R, Sanchez Luna M, Alsaedi S, Abdul Wahab MG, Hamdi M, Saleh M. Efficacy and Safety of Palivizumab as a Prophylaxis for Respiratory Syncytial Virus (RSV) Disease: An Updated Systemic Review and Meta-Analysis. Cureus 2023; 15:e51375. [PMID: 38292946 PMCID: PMC10825387 DOI: 10.7759/cureus.51375] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/31/2023] [Indexed: 02/01/2024] Open
Abstract
This systematic review and meta-analysis aimed to summarize the current evidence regarding the efficacy and safety of palivizumab as a prophylaxis for respiratory syncytial virus (RSV) disease. We searched MEDLINE via PubMed, Scopus, Cochrane, Web of Science, Embase, and Science Direct from inception till November 2023. Studies that assessed the efficacy and safety of palivizumab in infants aged between 28 days and three months of age were included. We analyzed the data using Review Manager 5.4 software, with results pooled across studies and expressed as risk ratios (RR) with 95% confidence intervals (CI). A total of 10 studies were included. The effect estimates favored palivizumab over placebo regarding the hospitalization for RSV infection (RR=0.51, 95% CI: 0.40 to 0.65; P<0.00001) and ICU admission (RR=0.49, 95% CI: 0.30 to 0.81; P=0.005). On the other hand, the effect estimate showed no significant difference between palivizumab and placebo regarding all-cause mortality (RR=0.69, 95% CI: 0.42 to 1.15; P=0.16), lower respiratory tract infection (RR=0.42, 95% CI: 0.11 to 1.69; P=0.22), and need for mechanical ventilation (RR=0.75, 95% CI: 0.34 to 1.67; P=0.48). Palivizumab can be considered a prophylaxis for RSV disease in young children as it is safe, well-tolerated, and effective in reducing RSV hospitalizations. However, further research through high-quality randomized controlled trials is required to determine its efficacy as a therapeutic agent for established RSV infections.
Collapse
Affiliation(s)
- Khaled El-Atawi
- Department of Pediatrics, Latifa Women and Children Hospital, Dubai, ARE
| | - Daniele De Luca
- Division of Pediatrics and Neonatal Critical Care, "Antoine Béclère" Hospital, Paris Saclay University Hospitals, APHP (Assistance Publique Hôpitaux de Paris), Paris, FRA
- Physiopathology and Therapeutic Innovation Unit, INSERM (Institut National de la Santé Et de la Recherche Médicale) U999, Paris Saclay University, Paris, FRA
| | - Ranagasamy Ramanathan
- Division of Neonatology, Department of Pediatrics, Los Angeles General Medical Center, Keck School of Medicine of USC (University of Southern California), Los Angeles, USA
| | - Manuel Sanchez Luna
- Department of Neonatology, University Hospital Gregorio Marañón, Madrid, ESP
| | - Saad Alsaedi
- Department of Pediatrics and Neonatology, King Faisal Specialist Hospital & Research Centre, Jeddah, SAU
| | | | - Moataz Hamdi
- Department of Pediatrics, Al Jalila Children's Speciality Hospital, Dubai, ARE
| | - Maysa Saleh
- Department of Pediatrics and Child Health, Al Jalila Children's Speciality Hospital, Dubai, ARE
| |
Collapse
|
3
|
Zekri L, Ruetalo N, Christie M, Walker C, Manz T, Rammensee HG, Salih HR, Schindler M, Jung G. Novel ACE2 fusion protein with adapting activity against SARS-CoV-2 variants in vitro. Front Immunol 2023; 14:1112505. [PMID: 36969164 PMCID: PMC10030959 DOI: 10.3389/fimmu.2023.1112505] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2022] [Accepted: 02/22/2023] [Indexed: 03/29/2023] Open
Abstract
Despite the successful development of vaccines and neutralizing antibodies to limit the spread of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), emerging variants prolong the pandemic and emphasize the persistent need to develop effective antiviral treatment regimens. Recombinant antibodies directed to the original SARS-CoV-2 have been successfully used to treat established viral disease. However, emerging viral variants escape the recognition by those antibodies. Here we report the engineering of an optimized ACE2 fusion protein, designated ACE2-M, which comprises a human IgG1 Fc domain with abrogated Fc-receptor binding linked to a catalytically-inactive ACE2 extracellular domain that displays increased apparent affinity to the B.1 spike protein. The affinity and neutralization capacity of ACE2-M is unaffected or even enhanced by mutations present in the spike protein of viral variants. In contrast, a recombinant neutralizing reference antibody, as well as antibodies present in the sera of vaccinated individuals, lose activity against such variants. With its potential to resist viral immune escape ACE2-M appears to be particularly valuable in the context of pandemic preparedness towards newly emerging coronaviruses.
Collapse
Affiliation(s)
- Latifa Zekri
- Department of Immunology, Institute for Cell Biology, Eberhard Karls Universität Tübingen, Tübingen, Germany
- German Cancer Research Center (DKFZ) Partner Site Tübingen, German Cancer Consortium (DKTK), Tübingen, Germany
- Clinical Collaboration Unit Translational Immunology, Department of Internal Medicine, University Hospital Tübingen, Tübingen, Germany
- Cluster of Excellence iFIT (EXC 2180) “Image-Guided and Functionally Instructed Tumor Therapies”, University of Tübingen, Tübingen, Germany
- *Correspondence: Latifa Zekri,
| | - Natalia Ruetalo
- Institute for Medical Virology and Epidemiology, University Hospital Tübingen, Tübingen, Germany
| | - Mary Christie
- School of Life and Environmental Sciences and School of Life of Medical Sciences, The University of Sydney, Sydney, NSW, Australia
| | - Carolin Walker
- Department of Immunology, Institute for Cell Biology, Eberhard Karls Universität Tübingen, Tübingen, Germany
- German Cancer Research Center (DKFZ) Partner Site Tübingen, German Cancer Consortium (DKTK), Tübingen, Germany
| | - Timo Manz
- Department of Immunology, Institute for Cell Biology, Eberhard Karls Universität Tübingen, Tübingen, Germany
- German Cancer Research Center (DKFZ) Partner Site Tübingen, German Cancer Consortium (DKTK), Tübingen, Germany
| | - Hans-Georg Rammensee
- Department of Immunology, Institute for Cell Biology, Eberhard Karls Universität Tübingen, Tübingen, Germany
- German Cancer Research Center (DKFZ) Partner Site Tübingen, German Cancer Consortium (DKTK), Tübingen, Germany
- Cluster of Excellence iFIT (EXC 2180) “Image-Guided and Functionally Instructed Tumor Therapies”, University of Tübingen, Tübingen, Germany
| | - Helmut R. Salih
- German Cancer Research Center (DKFZ) Partner Site Tübingen, German Cancer Consortium (DKTK), Tübingen, Germany
- Clinical Collaboration Unit Translational Immunology, Department of Internal Medicine, University Hospital Tübingen, Tübingen, Germany
- Cluster of Excellence iFIT (EXC 2180) “Image-Guided and Functionally Instructed Tumor Therapies”, University of Tübingen, Tübingen, Germany
| | - Michael Schindler
- Institute for Medical Virology and Epidemiology, University Hospital Tübingen, Tübingen, Germany
| | - Gundram Jung
- Department of Immunology, Institute for Cell Biology, Eberhard Karls Universität Tübingen, Tübingen, Germany
- German Cancer Research Center (DKFZ) Partner Site Tübingen, German Cancer Consortium (DKTK), Tübingen, Germany
- Cluster of Excellence iFIT (EXC 2180) “Image-Guided and Functionally Instructed Tumor Therapies”, University of Tübingen, Tübingen, Germany
| |
Collapse
|
4
|
Deitchman AN. The Risk of Treating Populations Instead of Patients. CPT-PHARMACOMETRICS & SYSTEMS PHARMACOLOGY 2019; 8:256-258. [PMID: 30884214 PMCID: PMC6539720 DOI: 10.1002/psp4.12402] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 12/11/2018] [Accepted: 02/25/2019] [Indexed: 12/30/2022]
Affiliation(s)
- Amelia N Deitchman
- School of Pharmacy, University of California, San Francisco, San Francisco, California, USA
| |
Collapse
|