Children with Down syndrome are more likely to develop severe respiratory syncytial virus, requiring hospitalizations and the use of additional medications and mechanical ventilation, when compared with children without Down syndrome, according to research published in Pediatrics.
“Respiratory infections are the leading cause of hospitalization in children with Down syndrome,” Andrea A. Beckhaus, MD, from the division of pediatrics in the department of pediatrics pulmonology and cardiology at the Pontificia Universidad Católica de Chile, Santiago, and colleagues wrote. “Most individuals who are affected have at least one hospital admission, with multiple hospitalizations being common. A high proportion of these occur during the first year of life and are associated with significant costs.”
The researchers assessed RSV-associated morbidity in children with Down syndrome and compared this rate in those without Down syndrome by reviewing 12 studies conducted in 10 countries. They also examined how long children with Down syndrome are hospitalized, amount of oxygen required for treatment, frequency of ICU admissions, respiratory support needs and any additional medication use.
Those with Down syndrome were at increased risk of RSV-related hospitalization (OR = 8.69; 95% CI, 7.33-10.30) and mortality (OR = 9.4; 95% CI, 2.26-39.15). These children also had longer hospital stays (average difference, 4.73 days; 95% CI, 2.12-7.33), required oxygen (OR = 6.53; 95% CI, 2.22-19.19) and were more likely to be admitted to the ICU (OR = 2.56; 95% CI, 1.17-5.59) when compared with controls.
Furthermore, children with Down syndrome were at greater risk of needing mechanical ventilation (OR = 2.56; 95% CI, 1.17-5.59) or additional medication use, including systemic corticosteroids (OR = 2.65; 95% CI, 1.38-5.08) and antibiotics (OR = 5.82; 95% CI, 2.66-12.69).
“Because Down syndrome is the most common chromosomal disorder worldwide and given that RSV is associated with about 28% of all acute lower respiratory tract infection episodes and 13% to 22% of all acute lower respiratory tract infection mortality in young children, the results of the current study carry high importance and consequences for public health,” Beckhaus and colleagues wrote. “Therefore, any potential strategy to reduce RSV infection, such as prophylaxis with monoclonal antibodies or new vaccines, in children with Down syndrome could decrease their morbidity and mortality.” – by Katherine Bortz
Disclosures: The authors report no relevant financial disclosures.