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Geoghegan S, Erviti A, Caballero MT, Vallone F, Zanone SM, Losada JV, Bianchi A, Acosta PL, Talarico LB, Ferretti A, Grimaldi LA, Sancilio A, Dueñas K, Sastre G, Rodriguez A, Ferrero F, Barboza E, Gago GF, Nocito C, Flamenco E, Perez AR, Rebec B, Ferolla FM, Libster R, Karron RA, Bergel E, Polack FP. Mortality due to Respiratory Syncytial Virus. Burden and Risk Factors. Am J Respir Crit Care Med 2017; 195:96-103. [PMID: 27331632 DOI: 10.1164/rccm.201603-0658oc] [Citation(s) in RCA: 100] [Impact Index Per Article: 14.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023] Open
Abstract
RATIONALE Respiratory syncytial virus (RSV) is the most frequent cause of hospitalization and an important cause of death in infants in the developing world. The relative contribution of social, biologic, and clinical risk factors to RSV mortality in low-income regions is unclear. OBJECTIVES To determine the burden and risk factors for mortality due to RSV in a low-income population of 84,840 infants. METHODS This was a prospective, population-based, cross-sectional, multicenter study conducted between 2011 and 2013. Hospitalizations and deaths due to severe lower respiratory tract illness (LRTI) were recorded during the RSV season. All-cause hospital deaths and community deaths were monitored. Risk factors for respiratory failure (RF) and mortality due to RSV were assessed using a hierarchical, logistic regression model. MEASUREMENTS AND MAIN RESULTS A total of 2,588 (65.5%) infants with severe LRTI were infected with RSV. A total of 157 infants (148 postneonatal) experienced RF or died with RSV. RSV LRTI accounted for 57% fatal LRTI tested for the virus. A diagnosis of sepsis (odds ratio [OR], 17.03; 95% confidence interval [CI], 13.14-21.16 for RF) (OR, 119.39; 95% CI, 50.98-273.34 for death) and pneumothorax (OR, 17.15; 95% CI, 13.07-21.01 for RF) (OR, 65.49; 95% CI, 28.90-139.17 for death) were the main determinants of poor outcomes. CONCLUSIONS RSV was the most frequent cause of mortality in low-income postneonatal infants. RF and death due to RSV LRTI, almost exclusively associated with prematurity and cardiopulmonary diseases in industrialized countries, primarily affect term infants in a developing world environment. Poor outcomes at hospitals are frequent and associated with the cooccurrence of bacterial sepsis and clinically significant pneumothoraxes.
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Affiliation(s)
| | | | | | | | | | - Juan Ves Losada
- 3 Hospital de Alta Complejidad El Cruce "Dr. Néstor Kirchner," Florencio Varela, Argentina
| | | | | | | | | | | | - Andrea Sancilio
- 5 Hospital Interzonal General de Agudos "Evita," Lanús, Argentina
| | - Karina Dueñas
- 5 Hospital Interzonal General de Agudos "Evita," Lanús, Argentina
| | - Gustavo Sastre
- 6 Hospital Zonal General de Agudos Descentralizado "Evita Pueblo," Berazategui, Argentina
| | - Andrea Rodriguez
- 6 Hospital Zonal General de Agudos Descentralizado "Evita Pueblo," Berazategui, Argentina
| | - Fernando Ferrero
- 7 Hospital General de Niños "Pedro de Elizalde," Buenos Aires, Argentina
| | - Edgar Barboza
- 8 Hospital Zonal General de Agudos "Dr. Narciso López," Lanús, Argentina
| | - Guadalupe Fernández Gago
- 9 Institute for Development and Research in Pediatrics "Prof. Dr. Fernando E. Viteri," Children's Hospital of La Plata (Min Sal/CIC-PBA), La Plata, Argentina
| | - Celina Nocito
- 10 Hospital Interzonal General de Agudos "Dr. Pedro Fiorito," Avellaneda, Argentina
| | - Edgardo Flamenco
- 11 Hospital Zonal General de Agudos "Dr. Arturo Oñativia," Rafael Calzada, Argentina
| | | | - Beatriz Rebec
- 13 Hospital Interzonal General de Agudos "Presidente Perón," Avellaneda, Argentina
| | | | | | - Ruth A Karron
- 14 Johns Hopkins University, Baltimore, Maryland; and
| | | | - Fernando P Polack
- 1 Fundación INFANT, Buenos Aires, Argentina.,15 Vanderbilt University, Nashville, Tennessee
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Ferolla FM, Hijano DR, Acosta PL, Rodríguez A, Dueñas K, Sancilio A, Barboza E, Caría A, Gago GF, Almeida RE, Castro L, Pozzolo C, Martínez MV, Grimaldi LA, Rebec B, Calvo M, Henrichsen J, Nocito C, González M, Barbero G, Losada JV, Caballero MT, Zurankovas V, Raggio M, Schavlovsky G, Kobylarz A, Wimmenauer V, Bugna J, Williams JV, Sastre G, Flamenco E, Pérez AR, Ferrero F, Libster R, Grijalva CG, Polack FP. Macronutrients during Pregnancy and Life-Threatening Respiratory Syncytial Virus Infections in Children. Am J Respir Crit Care Med 2013; 187:983-90. [DOI: 10.1164/rccm.201301-0016oc] [Citation(s) in RCA: 40] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
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