Respiratory Syncytial Virus Burden in Premature Infants: The Role of Season With and Without RSV Immunoprophylaxis in a Multicenter Study.

IF 2.7 3区医学 Q1 PEDIATRICS

Pediatric Pulmonology Pub Date : 2025-03-01 DOI:10.1002/ppul.71022

Keren Armoni Domany, Avigdor Mandelberg, Nitzan Burrack, Inbal Golan-Tripto, Kamal Masarweh, Michal Gur, Mika Rochman, Moria Be'er, Dario Prais, Merav Mor, Moran Weinberger Opek, Elias Nasrallah, Orli Megged, Rachel Shatzman Steuerman, Michal Stein, Zohar Steinberg, Shereen Shehadeh, Aharona Glatman-Freedman, Diana Tasher

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引用次数: 0

Abstract

Objective: To compare the Respiratory Syncytial Virus (RSV) hospitalization burden among 29-34 weeks gestational age (wGA) preterm infants between seasons with and without routine palivizumab prophylaxis, by utilizing the 2021 off-season RSV surge.

Methods: This multi-center retrospective study was conducted in 11 medical centers across Israel. We included infants > 1 year-old, with wGA data, hospitalized with RSV infection from November 2017-August 2021. National palivizumab compliance data were collected separately. We compared two periods: in-season (November-March) with routine palivizumab prophylaxis as the reference, and off-season (April-October) without prophylaxis as the primary risk factor. The primary outcome was the proportion of RSV hospitalizations in 29-34 wGA infants relative to total RSV admissions, calculated separately for each period. Secondary outcomes included clinical severity parameters.

Results: A total of 3296 infants were admitted during the RSV in-season, and 1044 during the off-season. National palivizumab compliance among eligible infants during the in-season study years was 91%-95%. The proportion of 29-34 wGA infants was significantly higher during the off-season compared to the in-season period (7% vs. 2.1%, p < 0.001). In a multivariable logistic regression model, the odds of hospitalization for 29-34 wGA preemies were 2.6 times higher during the off-season compared to the in-season (95% CI: 1.8-3.9, p < 0.001), independent of demographic covariates. Clinical severity was similar between the two periods.

Conclusions: Our results revealed a significantly higher proportion of 29-34 wGA infants hospitalized during seasons without palivizumab prophylaxis compared to seasons with palivizumab prophylaxis. These findings highlight the importance of including 29-34 wGA infants into future RSV immunoprophylaxis recommendations.

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早产儿呼吸道合胞病毒负担：在一项多中心研究中，有无RSV免疫预防的季节作用

目的：利用2021年呼吸道合胞病毒（RSV）淡季激增，比较29-34周胎龄（wGA）早产儿在使用和不使用常规帕利珠单抗预防的季节之间的呼吸道合胞病毒（RSV）住院负担。方法：这项多中心回顾性研究在以色列的11个医疗中心进行。我们纳入了2017年11月至2021年8月期间因呼吸道合胞病毒感染住院的婴儿，年龄为bb10 - 1岁，具有wGA数据。国家帕利珠单抗依从性数据单独收集。我们比较了两个时期：以常规帕利珠单抗预防为参考的季节（11月至3月）和未预防为主要危险因素的淡季（4月至10月）。主要结局是29-34岁妊娠期婴儿RSV住院率相对于RSV住院总人数的比例，每个时期分别计算。次要结局包括临床严重程度参数。结果：RSV季节共收治3296例患儿，淡季收治1044例患儿。在季节性研究期间，符合条件的婴儿的全国帕利珠单抗依从性为91%-95%。29-34岁wGA婴儿在淡季期间的比例明显高于旺季（7% vs. 2.1%）。结论：我们的研究结果显示，29-34岁wGA婴儿在未使用帕利珠单抗的季节住院的比例明显高于使用帕利珠单抗的季节。这些发现强调了将29-34岁妊娠期婴儿纳入未来RSV免疫预防建议的重要性。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Pediatric Pulmonology 医学-呼吸系统

CiteScore

6.00

自引率

12.90%

发文量

468

审稿时长

3-8 weeks

期刊介绍： Pediatric Pulmonology (PPUL) is the foremost global journal studying the respiratory system in disease and in health as it develops from intrauterine life though adolescence to adulthood. Combining explicit and informative analysis of clinical as well as basic scientific research, PPUL provides a look at the many facets of respiratory system disorders in infants and children, ranging from pathological anatomy, developmental issues, and pathophysiology to infectious disease, asthma, cystic fibrosis, and airborne toxins. Focused attention is given to the reporting of diagnostic and therapeutic methods for neonates, preschool children, and adolescents, the enduring effects of childhood respiratory diseases, and newly described infectious diseases. PPUL concentrates on subject matters of crucial interest to specialists preparing for the Pediatric Subspecialty Examinations in the United States and other countries. With its attentive coverage and extensive clinical data, this journal is a principle source for pediatricians in practice and in training and a must have for all pediatric pulmonologists.