Exploring respiratory syncytial virus prophylaxis for children with all grades of bronchopulmonary dysplasia.

Abstract

Bronchopulmonary dysplasia (BPD) is an independent risk factor for respiratory syncytial virus (RSV) hospitalisation in children who have not received prophylaxis. It is associated with an RSV hospitalisation rate of 12%-21%, which is up to 10 times higher than term-born infants and other high-risk groups without comorbidities, even up to three years of age.1 A meta-analysis has confirmed that hospitalised children with BPD experience significant morbidity compared to non BPD subjects including a median hospital length of stay of 7.2 days versus 2.5 days. They also need higher intensive care admissions, with an odds ratio (OR) of 2.9 and 95% confidence interval (CI) of 2.3-3.5 (p < 0.001), have a greater need for mechanical ventilation (OR 8.2, 95% CI, 7.6-8.9, p < 0.001) and experience a higher case-fatality (OR 12.8, 95% CI 9.4-17.3, p< 0.001).2 In 2012, expenditure for children hospitalised with RSV and BPD, in the USA, was 1.7-fold higher than children hospitalised with congenital heart disease and airway anomalies.