Risk Factors for Severe Disease Among Children Hospitalized With Respiratory Syncytial Virus
Notice bibliographique
Résumé
Importance: A resurgence of respiratory syncytial virus (RSV)-associated acute respiratory tract infection (ARI) was observed in 2022 and 2023 after the COVID-19 pandemic. Changes in the demographic characteristics, disease severity, and outcomes of patients were observed, which could impact the identification of risk groups for interventions aimed at reducing the severity of RSV disease. Objectives: To identify factors associated with severe clinical outcomes among children hospitalized with RSV-associated ARIs in 2022 and 2023. Design, Setting, and Participants: This observational cohort study, conducted at 2 large, Canadian, tertiary-level pediatric hospitals, comprised all 709 cases of RSV-associated ARI among children younger than 18 years who were admitted to the hospital or intensive care unit (ICU) from July 1, 2022, to June 30, 2023. Exposure: Diagnosis of RSV-associated ARI. Main Outcomes and Measures: The primary outcome of severe disease was defined as requiring noninvasive or invasive ventilation or death. Risk factors for severe disease and ICU admission (secondary outcome) were assessed using multivariable Poisson regression, and results were reported as adjusted risk ratios (ARRs) with 95% CIs, with age-stratified models (<2 years and ≥2 years). Results: A total of 709 cases (median age, 13.1 months [IQR, 2.0-36.6 months]; 442 boys [62.3%]) were admitted with RSV-associated ARI; 452 (63.8%) were younger than 2 years, and 257 (36.2%) were aged 2 years or older. Severe disease was documented for 204 cases (28.8%). Patients with severe disease were younger than those with nonsevere disease (median age, 2.6 months [IQR, 1.3-16.0 months] vs 18.6 months [IQR, 4.5-39.1 months]; P < .001). Pulmonary disease and use of home oxygen (ARR, 2.47 [95% CI, 1.30-4.68]) and neurologic, neuromuscular, and developmental conditions (ARR, 1.89 [95% CI, 1.03-3.49]) were associated with severe disease among children aged 2 years or older. Among children younger than 2 years, age younger than 3 months (ARR, 2.34 [95% CI, 1.43-3.84]), age 3 to less than 6 months (ARR, 2.79 [95% CI, 1.65-4.70]), and prematurity (ARR, 1.40 [95% CI, 1.03-1.89]) were associated with severe disease. Conclusions and Relevance: In this cohort study of children hospitalized with RSV in 2022 and 2023, severe RSV disease was more likely among those aged 2 years or older with pulmonary and neurologic, neuromuscular, or developmental conditions. For children younger than 2 years, age younger than 6 months and prematurity were the main risk factors. These findings support prevention strategies for all younger children, including premature infants, with potential benefit for children aged 2 years or older in specific high-risk groups.
Récupéré en direct depuis OpenAlex et désinversé. Les résumés ne sont pas conservés dans cette base de données : les index inversés représentent 8,6 Go des 9,3 Go de texte de la base, et le serveur dispose de 13 Go libres.
Comment cette classification a été obtenuedéplier
Prédiction distillée sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Apprise à partir de 10 348 étiquettes directes de Codex et de 10 348 étiquettes directes de Gemma. Le mode candidate est l'union des têtes enseignantes seuillées; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont ni des étiquettes humaines ni des étiquettes directes de modèles de pointe.
Scores Codex et Gemma par catégorie
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,001 | 0,001 |
| Méta-épidémiologie (sens strict) | 0,000 | 0,000 |
| Méta-épidémiologie (sens large) | 0,001 | 0,000 |
| Bibliométrie | 0,000 | 0,001 |
| Études des sciences et des technologies | 0,001 | 0,000 |
| Communication savante | 0,000 | 0,001 |
| Science ouverte | 0,001 | 0,000 |
| Intégrité de la recherche | 0,000 | 0,001 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,000 | 0,000 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule tête enseignante, pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».