Clinical outcomes in outpatient respiratory syncytial virus infection in immunocompromised children

Influenza Other Respir Viruses. 2016 May;10(3):205-10. doi: 10.1111/irv.12375. Epub 2016 Mar 23.

Abstract

Background: Immunocompromised patients are at high risk for morbidity and mortality due to respiratory syncytial virus (RSV) infection. Increasingly, pediatric patients with malignancy or undergoing transplantation are managed primarily as outpatients. Data regarding the clinical presentation and outcomes of RSV in the outpatient pediatric immunocompromised population are limited.

Methods: We performed a retrospective cohort study of children with hematologic malignancy or hematopoietic or solid organ transplant with laboratory-confirmed RSV infection diagnosed as outpatients at an academic medical center between 2008 and 2013.

Results: Of 54 patients with RSV detected while outpatients, 15 (28%) were hospitalized, 7 (13%) received ribavirin, and one (2%) received intravenous immunoglobulin. One (2%) patient was critically ill, but there were no deaths due to RSV infection. Fever (P < 0·01) was associated with increased risk of hospitalization.

Conclusions: Most immunocompromised children with RSV detected while outpatients did not require hospitalization or receive antiviral treatment. Potential studies of RSV therapies should consider inclusion of patients in an ambulatory setting.

Keywords: Hematopoietic stem cell transplant; immunocompromised; outpatient; pediatric; respiratory syncytial virus.

Publication types

  • Research Support, N.I.H., Extramural

MeSH terms

  • Adolescent
  • Antiviral Agents / therapeutic use
  • Child
  • Child, Preschool
  • Cohort Studies
  • Female
  • Hematologic Neoplasms / complications
  • Hematologic Neoplasms / epidemiology
  • Hematologic Neoplasms / virology
  • Humans
  • Immunocompromised Host*
  • Immunoglobulins, Intravenous / therapeutic use
  • Infant
  • Infant, Newborn
  • Male
  • Outpatients
  • Respiratory Syncytial Virus Infections / complications
  • Respiratory Syncytial Virus Infections / drug therapy
  • Respiratory Syncytial Virus Infections / therapy*
  • Respiratory Syncytial Virus Infections / virology
  • Respiratory Syncytial Viruses / isolation & purification
  • Retrospective Studies
  • Ribavirin / therapeutic use
  • Risk Factors
  • Transplantation
  • Treatment Outcome
  • United States
  • Young Adult

Substances

  • Antiviral Agents
  • Immunoglobulins, Intravenous
  • Ribavirin