Variable morbidity of respiratory syncytial virus (RSV) infection in patients with underlying lung disease; review of PICNIC RSV database † 430

Abstract

Background:Outcome of RSV infection in children with bronchopulmonary dysplasia (BPD) has been well characterized. Objective: We wished to compare outcomes of children with other pulmonary disorders: cystic fibrosis (CF), recurrent aspiration pneumonia(ASP), pulmonary malformation (MAL) and neurogenic disorder interfering with pulmonary toilet (NEU) with those of patients with BPD. Methods: Children with RSV infection hospitalized at seven Canadian pediatric tertiary care hospitals in 1993/94 and nine hospitals in 1994/95 were enrolled and prospectively followed. Of the 1516 patients enrolled, the outcomes of 154 with lung disorders constitute this report. Results: ASP patients and MAL had hospital stay, use of ICU, receipt of ventilation similar to BPD patients (Table). Most patients studied had no previous home oxygen use (104/165). Those currently using home oxygen were more likely to have ICU admission (59% vs. 32%) (p=0.02) and mechanical ventilation (41% vs. 18%) (p=0.01) compared with those who had never or had previously been on home oxygen. Conclusions: Children with other underlying lung diseases have similar or greater morbidity compared with those with BPD. Current home oxygen use is associated with increased ICU admission and mechanical ventilation rates. These groups should also be considered for prophylactic interventions against RSV.Funded by Lederle Praxis Inc.