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Respiratory syncytial virus-related death in children with Down Syndrome

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RSV GOLD Study Group (Including: Löwensteyn, Yvette N., Phijffer, Emily W. E. M., Simons, Juliette V. L., Scheltema, Nienke M., Mazur, Natalie I., Nair, Harish and Bont, Louis J.). (2020) Respiratory syncytial virus-related death in children with Down Syndrome. Pediatric Infectious Disease Journal, 39 (8). pp. 665-670. doi:10.1097/INF.0000000000002666

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Official URL: https://doi.org/10.1097/INF.0000000000002666

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Abstract

Background: Respiratory syncytial virus (RSV) is a major cause of mortality in children younger than 5 years worldwide. Systematic reviews have shown that Down syndrome (DS) is an independent risk factor for severe RSV infection. We aimed to describe demographic and clinical characteristics of children with DS who died with RSV infection.

Methods: We performed a retrospective case series in which data were shared by individual researchers, research networks and physicians worldwide as part of the RSV Global Online Database study. We included children with DS who died when younger than 5 years of age with laboratory-confirmed RSV infection.

Results: We included 53 children with DS and RSV-related mortality from 20 countries in 5 continents. Five (9.4%) children were from low-income or lower-middle-income countries. Median age at time of death was 6.0 months [interquartile range (IQR): 3.00-12.0]. Thirteen (24.5%) children were born term and had no other risk factors for severe RSV disease. In total, 36 (67.9%) children had congenital heart disease, 8 (15.1%) had chronic lung disease and 1 (1.9%) had congenital immunodeficiency. Duration of hospitalization was significantly longer for children with DS compared with children without DS [median length of stay, 13 days (IQR: 6.8-21.0) vs. 8 days (IQR: 3.0-18.5), P=0.005].

Conclusions: One-fourth of children with DS and RSV-confirmed death did not have risk factors for severe RSV disease, indicating that DS is an important risk factor for RSV-related mortality. Age distribution at time of death demonstrates that maternal vaccination would not be sufficient to protect children with DS against RSV-related mortality.

Item Type: Journal Article
Subjects: R Medicine > RC Internal medicine
Divisions: Faculty of Science > Life Sciences (2010- )
Library of Congress Subject Headings (LCSH): Respiratory syncytial virus, Respiratory syncytial virus -- Mortality, Children with Down syndrome, Down syndrome, Respiratory infections in children
Journal or Publication Title: Pediatric Infectious Disease Journal
Publisher: Lippincott Williams & Wilkins
ISSN: 0891-3668
Official Date: August 2020
Dates:
DateEvent
August 2020Published
16 February 2020Accepted
Volume: 39
Number: 8
Page Range: pp. 665-670
DOI: 10.1097/INF.0000000000002666
Status: Peer Reviewed
Publication Status: Published
Access rights to Published version: Open Access
RIOXX Funder/Project Grant:
Project/Grant IDRIOXX Funder NameFunder ID
OPP1148988Bill and Melinda Gates Foundationhttp://dx.doi.org/10.13039/100000865
102975Wellcome Trusthttp://dx.doi.org/10.13039/100010269
203077 Wellcome Trusthttp://dx.doi.org/10.13039/100010269
Open Access Version:
  • PubMed Central
Contributors:
ContributionNameContributor ID
ResearcherNokes, D. James35965

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