Epidemiología y datos clínicos de la infección por el virus respiratorio sincitial en niños mayores de 2 años hospitalizados. Estudio multicéntrico nacional (FIVE)

Abstract

Introduction and objectives: Respiratory syncytial virus (RSV) infections are well characterized in infants. However, few studies are focused in RSV disease in children over 2 of age. Our goal is to analyze the characteristics of children older than 2 hospitalized due to RSV infection in the context of the FIVE study. Patients and methods: This is a substudy of the FIVE study (prospective, observational, and multicenter) performed in 26 hospitals in all Spanish regions, between December 2011 and March 2012. In the FIVE study, children under 5 years of age hospitalized due to RSV infection were analyzed, comparing patients with underlying conditions (clinical cases) with a group of previously healthy children (ratio 1/2). In this occasion, 2-5 year-old children were more widely analyzed. Results: A total of 225 cases and 460 controls were included in the FIVE study. Among those, 70 children were >2 years old (10.2%). The mean age was 35 months (SD= 9), 58% were male and 23% had a history of prematurity. Breathlessness was the cause of hospitalization in 78% of cases. Hypoxemia (SatO2 <92%) was present in 80%. Eight children (11.6%) were admitted to PICU and one of them died. The most common discharge diagnose was recurrent wheezing episode (62%), followed by pneumonia in 30%. 77% of children (54) had an underlying disease (OR= 8.74; 95% CI: 4.8 to 15.7; p <0.0001). The most common underlying diseases observed were respiratory (66%), cardiovascular (20%) and neurologic (11%). The most frequent respiratory disease observed was asthma (59%). Conclusions: Children >2 years hospitalized due to RSV infection are at risk from having underlying disease 8.7 times more than the <2 years. The most common underlying pathology is asthma. The most common diagnosis is an episode of recurrent wheezing and most patients need oxygen therapy.