Respiratory syncytial virus prophylaxis in infants with congenital airway anomalies compared to standard indications and complex medical disorders

被引:7
作者
Paes, Bosco [1 ,18 ]
Kim, Doyoung [2 ]
Saleem, Mahwesh [2 ]
Wong, Sophie [2 ]
Mitchell, Ian [3 ,4 ]
Lanctot, Krista L. [2 ]
Bjornson, Candice [4 ]
Mitchell, Ian [3 ,4 ]
Chilvers, Mark [5 ]
Caouette, Georges [6 ]
Lebel, Marc [7 ]
Dumas, Mario Eddy [8 ]
Hui, Charles [9 ]
Bayliss, Ann [10 ]
DiGravio, Bruno [11 ]
Doray, Jean-Pierre [12 ]
Stinson, Dora [13 ]
Papageorgiou, Apostolos [14 ]
Mitchell, Marianna [15 ]
Lee, David [16 ]
Price, April [16 ]
Chiu, Aaron [17 ]
Paes, Bosco [1 ,18 ]
Canning, Roderick [19 ]
Canakis, Anne-Marie [20 ]
Papenburg, Jesse [20 ]
O'Brien, Karel [21 ]
Chang, Karen [22 ]
Sankaran, Koravangattu [23 ]
Ho, Vincent [24 ]
Chang, Larry [25 ]
Ojah, Cecil [26 ]
Avdic, Sanja [27 ]
Allen, Upton [28 ]
Majaesic, Carina [29 ]
Blayney, Marc [30 ]
Simmons, Brian [31 ]
Tang, Kiang [32 ]
Popovic, Jelena [32 ]
Jagdis, Frank [33 ]
Margolis, Ivor [34 ]
Bacheyie, Godfrey [35 ]
机构
[1] McMaster Univ, Dept Pediat, HSC 3A,1280 Main St West, Hamilton, ON L8S 4K1, Canada
[2] Univ Toronto, Sunnybrook Hlth Sci Ctr, Med Outcomes & Res Econ MORE Res Grp, Toronto, ON, Canada
[3] Univ Calgary, Dept Pediat, Calgary, AB, Canada
[4] Alberta Childrens Prov Gen Hosp, Calgary, AB, Canada
[5] BC Childrens Hosp, Vancouver, BC, Canada
[6] CHU Laval, Quebec City, PQ, Canada
[7] CHU St Justine, Montreal, PQ, Canada
[8] CHU Sherbrooke, Sherbrooke, PQ, Canada
[9] Childrens Hosp Eastern Ontario, Ottawa, ON, Canada
[10] Credit Valley Hosp, Mississauga, ON, Canada
[11] Grand River Hosp, Kitchener, ON, Canada
[12] Hop Charles LeMoyne, Longueuil, PQ, Canada
[13] IWK Hlth Ctr, Halifax, NS, Canada
[14] Jewish Gen Hosp, Montreal, PQ, Canada
[15] Lakeridge Hlth Oshawa, Oshawa, ON, Canada
[16] London Hlth Sci Ctr, London, ON, Canada
[17] Manitoba Inst Child Hlth, Winnipeg, MB, Canada
[18] McMaster Childrens Hosp, Hamilton, ON, Canada
[19] Moncton Hosp, Moncton, NB, Canada
[20] Montreal Childrens Hosp, Montreal, PQ, Canada
[21] Mt Sinai Hosp, Toronto, ON, Canada
[22] Rouge Valley Hosp, Toronto, ON, Canada
[23] Royal Univ Hosp, Saskatoon, SK, Canada
[24] Royal Victoria Hosp, Montreal, PQ, Canada
[25] Southlake Reg Hlth Ctr, Newmarket, ON, Canada
[26] St Johns Hosp, St John, NB, Canada
[27] St Josephs Hlth Ctr, Toronto, ON, Canada
[28] Sick Kids Hosp, Toronto, ON, Canada
[29] Stollery Childrens Hosp, Edmonton, AB, Canada
[30] Sudbury Reg Hosp, Sudbury, ON, Canada
[31] Sunnybrook Hlth Sci Ctr, Toronto, ON, Canada
[32] Toronto East Gen Hosp, Toronto, ON, Canada
[33] Victoria Gen Hosp, Victoria, BC, Canada
[34] William Osler Hlth Ctr, Brampton, ON, Canada
[35] Windsor Reg Hosp, Windsor, ON, Canada
关键词
Congenital airway anomalies; Respiratory syncytial virus; Palivizumab; Outcomes; YOUNG-CHILDREN; PALIVIZUMAB PROPHYLAXIS; MONOCLONAL-ANTIBODY; RISK-FACTORS; DISEASE; HOSPITALIZATIONS; INFECTION; PHARMACOKINETICS; MALFORMATIONS; MANAGEMENT;
D O I
10.1007/s00431-018-03308-1
中图分类号
R72 [儿科学];
学科分类号
100202 ;
摘要
An observational study was conducted of children <2years who received 1 dose of palivizumab in 32 Canadian institutions from 2005 to 2017. We compared respiratory illness (RIH) and respiratory syncytial virus-related hospitalization (RSVH) hazards in children with a congenital airway anomaly (CAA) versus those prophylaxed for standard indications (SI) and serious medical disorders (SMD). Data were assembled on neonatal course, demographics, palivizumab utilization and adherence, and respiratory illness events, and analyzed using ANOVA, chi-square tests and Cox proportional hazards. Twenty-five thousand three children (1219 CAA, 3538 SMD, and 20,246 SI) were enrolled. Palivizumab adherence was 74.8% overall and similar across groups. For 2054 respiratory-related events, 1724 children were hospitalized. RIH rates were 13.6% (CAA), 9.6% (SMD), and 6.0% (SI). RSVH rates were 2.4% (CAA), 1.6% (SMD), and 1.5% (SI). After adjustment for demographic and neonatal differences, children with a CAA had a significantly increased RIH and RSVH hazard relative to SI (RIH, HR=1.6, 95% CI 1.2-2.2, p=0.002; RSVH, HR=2.1, 95% CI 1.0-4.4, p=0.037) but similar to SMD (RIH, HR=1.3, 95% CI 0.9-1.9, p=0.190; RSVH, HR=1.7, 95% CI 0.7-4.1, p=0.277).Conclusion: Children with a CAA experience higher RIH risk. RSVH hazard was similar between CAA and SMD but higher for CAA compared to SI, implying that this population requires surveillance for RSV prophylaxis.
引用
收藏
页码:377 / 385
页数:9
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