Preterm infants hospitalized for RSV face increased risk for ICU admission
BALTIMORE — Recent data from the SENTINEL1 study showed that preterm infants hospitalized for respiratory syncytial virus are at increased risk for ICU admission and other adverse outcomes, according to a presentation at the Pediatric Academic Societies Meeting.
“Our findings presented at this year’s PAS now pertain to the 212 study-eligible infants 29 to 35 weeks gestational age with community-acquired RSV who were enrolled for further characterization of their RSV-confirmed hospitalization [in the SENTINEL1 study],” Leonard R. Krilov, MD, FAAP, FIDSA, of the Winthrop University Hospital and an Infectious Diseases in Children Editorial Board member, said in an interview.
Leonard R. Krilov
“The SENTINEL1 [study] demonstrated that RSV disease severity is greater in infants born at earlier gestational ages,” Krilov said. “Initial results demonstrated that among these preterm infants, RSV illness can be severe, often resulting in ICU admission and need for [invasive mechanical ventilation], particularly during the first 6 months of life.”
To characterize RSV hospitalizations among preterm infants with RSV, the researchers studied 709 preterm infants with RSV, hospitalized at 43 centers during the 2014/2015 RSV season. Participants were enrolled if they had laboratory-confirmed RSV, hospital stays lasting longer than 24 hours and did not receive RSV immunoprophylaxis within 35 days before symptom onset. The researchers collected data related to birth at gestational age, birth month, length of hospital stay, ICU admission, mechanical ventilation use and mortality.
According to Krilov, there was a significant risk for severe RSV disease in preterm infants born at 29 to 35 weeks’ gestational age.
Data demonstrated that among infants <3 months of age at time of admission, 68% of children born at 29 to 32 weeks’ gestational age, 52% of children born at 33 to 34 weeks and 37% of children born at 35 weeks were admitted to the ICU after community-acquired RSV infection. In addition, among infants <3 months of age, a significant proportion of preterm infants with community-acquired RSV required mechanical ventilation, including 44% of infants at 29 to 32 weeks’ gestational age, 25% of infants at 33 to 34 weeks’ gestational age and 17% of children born at 35 weeks.
Krilov and colleagues observed that 9% of infants exhibited a serious clinical outcome that significantly impacted their health, with one infant death reported during the study.
“These data further demonstrate the real and significantly higher risk of severe RSV disease in preterm infants born at 29 to 35 weeks’ gestational age,” Krilov said, “and I believe that health care professionals should continue to review the newest data to guide their practice for caring for preterm infants.” – by David Costill
Krilov LR, et al. Abstract 378. Presented at: Pediatric Academic Societies 2016; April 30 - May 3, 2016; Baltimore.
Disclosure: This study was funded by AstraZeneca.