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Infection & Chemotherapy Mar 2024We aimed to evaluate the clinical features of respiratory syncytial virus (RSV) infection and risk factors for severe RSV disease among Korean children in 2022/2023. A...
We aimed to evaluate the clinical features of respiratory syncytial virus (RSV) infection and risk factors for severe RSV disease among Korean children in 2022/2023. A total of 235 children were identified, and 84.3% were hospitalized. Patients under 3 months and 2 years of age accounted for 20.9% and 54.5%, respectively. Pneumonia was diagnosed in 40.9% of children and bronchiolitis in 23.8%. Respiratory support and intensive care were required in 43.4% and 7.7% of patients, respectively. nasopharyngeal colonization and the presence of underlying disease showed a significant correlation with severity indicators. The clinical impact of RSV infection was high on infants and toddlers, even those having no underlying disease or not being indicated for palivizumab.
PubMed: 38527782
DOI: 10.3947/ic.2023.0076 -
Pathogens (Basel, Switzerland) Jun 2024Nirsevimab is approved in the US for the prevention of respiratory syncytial virus (RSV) lower respiratory tract disease in neonates and infants during their first RSV...
BACKGROUND
Nirsevimab is approved in the US for the prevention of respiratory syncytial virus (RSV) lower respiratory tract disease in neonates and infants during their first RSV season and in children aged ≤24 months who remain vulnerable to severe RSV disease through their second RSV season. We summarize a pre-specified analysis of nirsevimab safety data from three randomized controlled trials: Phase 2b (NCT02878330; healthy infants born ≥29 to <35 weeks' gestational age [wGA]); Phase 3 MELODY (NCT03979313; healthy infants born ≥35 wGA); and Phase 2/3 MEDLEY (NCT03959488; infants with congenital heart disease [CHD] and/or chronic lung disease of prematurity [CLD] or born ≤35 wGA).
METHODS
Participants (randomized 2:1) received a single intramuscular dose of nirsevimab or comparator (placebo, Phase 2b/MELODY; 5× once-monthly palivizumab, MEDLEY) before their first RSV season (recipients < 5 kg, nirsevimab 50 mg; ≥5 kg, nirsevimab 100 mg). In MEDLEY, children with CHD/CLD continued to a second RSV season: first-season nirsevimab recipients received nirsevimab 200 mg; first-season palivizumab recipients were re-randomized 1:1 to receive nirsevimab 200 mg or 5× once-monthly palivizumab.
RESULTS
The incidence, severity, and nature of AEs were similar across treatments (nirsevimab, = 3184; placebo, = 1284; palivizumab, = 304). Most AEs were mild to moderate in severity, with ≥98% unrelated to treatment. AEs of special interest occurred infrequently (<1%): no anaphylaxis or thrombocytopenia were treatment-related, and no immune complex disease was reported. Deaths (incidence < 1.0%) were all unrelated to treatment.
CONCLUSIONS
A single dose per season of nirsevimab for the prevention of RSV disease had a favorable safety profile, irrespective of wGA or comorbidities.
PubMed: 38921800
DOI: 10.3390/pathogens13060503 -
Hong Kong Medical Journal = Xianggang... Dec 2023
Topics: Child; Humans; Infant; Palivizumab; Cost-Benefit Analysis; Hong Kong; Antiviral Agents; Respiratory Syncytial Virus Infections; Hospitalization
PubMed: 38148655
DOI: No ID Found -
Cureus Feb 2024Background The predominant source of respiratory infections in Northern Canada stems from RSV, leading to potentially life-threatening lower respiratory tract infections...
Background The predominant source of respiratory infections in Northern Canada stems from RSV, leading to potentially life-threatening lower respiratory tract infections in children below the age of 2. Typically, RSV begins to appear in November or December and persists until April or May. Synagis® (Palivizumab), a monoclonal antibody, is employed to mitigate or reduce the effects of RSV. Past research indicated a reduction in hospitalizations with the use of Synagis®. Aim The aim is to estimate the cost-benefit analysis by comparing the health services cost with Synagis program cost. Also evaluate the association of identified risk factors with the severity of RSV infection. Material and methods The dependent variable is categorized as: "Mild-Medium" cases that didn't undergo intubation or require medical evacuation; "Severe" cases that underwent intubation, required medical evacuation, and intensive care unit facilities. We also calculate the cost of health services and Synagis of each year. Results It has been found that babies who exclusively breastfed and regularly took vitamin D did not develop severe forms of infection. Prenatal smoking and shared and crowded accommodations contribute to the spreading of RSV. The average cost of health services per participant was higher than that of the Synagis program. Conclusion They are promoting the Synagis® program during the season. Standardize the regulations prohibiting smoking around small children since they are more vulnerable to infection. Practice breastfeeding up to 24-month-old babies.
PubMed: 38435208
DOI: 10.7759/cureus.53378 -
Open Forum Infectious Diseases Mar 2024Currently, there are no available tools to identify infants at the highest risk of significant morbidity and mortality from respiratory syncytial virus (RSV) lower...
BACKGROUND
Currently, there are no available tools to identify infants at the highest risk of significant morbidity and mortality from respiratory syncytial virus (RSV) lower respiratory tract infection (LRTI) who would benefit most from RSV prevention products. The objective was to develop and internally validate a personalized risk prediction tool for use among all newborns that uses readily available birth/postnatal data to predict RSV LRTI requiring intensive care unit (ICU) admission.
METHODS
We conducted a population-based birth cohort study of infants born from 1995 to 2007, insured by the Tennessee Medicaid Program, and who did not receive RSV immunoprophylaxis during the first year of life. The primary outcome was severe RSV LRTI requiring ICU admission during the first year of life. We built a multivariable logistic regression model including demographic and clinical variables available at or shortly after birth to predict the primary outcome.
RESULTS
In a population-based sample of 429 365 infants, 713 (0.2%) had severe RSV LRTI requiring ICU admission. The median age of admission was 66 days (interquartile range, 37-120). Our tool, including 19 variables, demonstrated good predictive accuracy (area under the curve, 0.78; 95% confidence interval, 0.77-0.80) and identified infants who did not qualify for palivizumab, based on American Academy of Pediatrics guidelines, but had higher predicted risk levels than infants who qualified (27% of noneligible infants with >0.16% predicted probabilities [lower quartile for eligible infants]).
CONCLUSIONS
We developed a personalized tool that identified infants at increased risk for severe RSV LRTI requiring ICU admission, expected to benefit most from immunoprophylaxis.
PubMed: 38481426
DOI: 10.1093/ofid/ofae077 -
Frontiers in Public Health 2024[This corrects the article DOI: 10.3389/fpubh.2023.1261165.].
[This corrects the article DOI: 10.3389/fpubh.2023.1261165.].
PubMed: 38333738
DOI: 10.3389/fpubh.2024.1354693 -
Frontiers in Pediatrics 2024
PubMed: 38283631
DOI: 10.3389/fped.2024.1343960