The Journal of Infectious Diseases最新文献

{"title":"Respiratory Syncytial Virus Disease in Young Children and Older Adults in Europe: A Burden and Economic Perspective.","authors":"Eric A F Simões","doi":"10.1093/infdis/jiac252","DOIUrl":"https://doi.org/10.1093/infdis/jiac252","url":null,"abstract":"","PeriodicalId":509652,"journal":{"name":"The Journal of Infectious Diseases","volume":" ","pages":"S1-S9"},"PeriodicalIF":6.4,"publicationDate":"2022-08-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40498620","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Performance Assessment of a Rapid Molecular Respiratory Syncytial Virus Point-of-Care Test: A Prospective Community Study in Older Adults.","authors":"Roy P Zuurbier,&nbsp;Koos Korsten,&nbsp;Theo J M Verheij,&nbsp;Chris Butler,&nbsp;Niels Adriaenssens,&nbsp;Samuel Coenen,&nbsp;Olivier Gruselle,&nbsp;Valerie Vantomme,&nbsp;Marlies A van Houten,&nbsp;Louis J Bont,&nbsp;Joanne G Wildenbeest","doi":"10.1093/infdis/jiab600","DOIUrl":"https://doi.org/10.1093/infdis/jiab600","url":null,"abstract":"<p><strong>Background: </strong>Respiratory syncytial virus (RSV) causes a substantial burden in older adults. Viral load in RSV-infected adults is generally lower compared to young children, which could result in suboptimal sensitivity of RSV diagnostics. Although the Xpert® Xpress Flu/RSV assay has been used in routine clinical care, its sensitivity to diagnose RSV infection in older adults is largely unknown. We aimed to compare the performance of the Xpert® Xpress Flu/RSV assay with real-time reverse-transcription polymerase chain reaction (RT-PCR) in home-dwelling older adults (≥60 years of age).</p><p><strong>Methods: </strong>Nasopharyngeal swabs were tested with Xpert® Xpress Flu/RSV and compared to RSV RT-PCR in older adults with acute respiratory tract infections with different levels of disease severity.</p><p><strong>Results: </strong>We studied 758 respiratory samples from 561 older adults from 2 consecutive RSV seasons. Thirty-five (4.6%) samples tested positive for RSV by at least 1 of the assays, of which 2 samples were negative by Xpert® Xpress Flu/RSV and 3 samples by real-time RT-PCR. The positive percentage agreement (PPA) was 90.9% (95% confidence interval [CI], 76.4%-96.8%) and negative percentage agreement was 99.7% (95% CI, 99.0%-99.9%). Viral loads were low (≤103 copies/mL or cycle threshold value ≥34) in all cases with discordant results for the 2 assays.</p><p><strong>Conclusions: </strong>The PPA of Xpert® Xpress Flu/RSV compared to routine RT-PCR is high for RSV detection in home-dwelling older adults. The assay is fast and easy to use at the point of care.</p><p><strong>Clinical trials registration: </strong>NCT03621930.</p>","PeriodicalId":509652,"journal":{"name":"The Journal of Infectious Diseases","volume":" ","pages":"S63-S70"},"PeriodicalIF":6.4,"publicationDate":"2022-08-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/7a/43/jiab600.PMC9374508.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39900449","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Age-Specific Estimates of Respiratory Syncytial Virus-Associated Hospitalizations in 6 European Countries: A Time Series Analysis.","authors":"Caroline K Johannesen,&nbsp;Maarten van Wijhe,&nbsp;Sabine Tong,&nbsp;Liliana V Fernández,&nbsp;Terho Heikkinen,&nbsp;Michiel van Boven,&nbsp;Xin Wang,&nbsp;Håkon Bøås,&nbsp;You Li,&nbsp;Harry Campbell,&nbsp;John Paget,&nbsp;Luca Stona,&nbsp;Anne Teirlinck,&nbsp;Toni Lehtonen,&nbsp;Hanna Nohynek,&nbsp;Mathieu Bangert,&nbsp;Thea K Fischer","doi":"10.1093/infdis/jiac150","DOIUrl":"https://doi.org/10.1093/infdis/jiac150","url":null,"abstract":"<p><strong>Background: </strong>Knowledge on age-specific hospitalizations associated with RSV infection is limited due to limited testing, especially in older children and adults in whom RSV infections are not expected to be severe. Burden estimates based on RSV coding of hospital admissions are known to underestimate the burden of RSV. We aimed to provide robust and reliable age-specific burden estimates of RSV-associated hospital admissions based on data on respiratory infections from national health registers and laboratory-confirmed cases of RSV.</p><p><strong>Methods: </strong>We conducted multiseason regression analysis of weekly hospitalizations with respiratory infection and weekly laboratory-confirmed cases of RSV and influenza as covariates, based on national health registers and laboratory databases across 6 European countries. The burden of RSV-associated hospitalizations was estimated by age group, clinical diagnosis, and presence of underlying medical conditions.</p><p><strong>Results: </strong>Across the 6 European countries, hospitalizations of children with respiratory infections were clearly associated with RSV, with associated proportions ranging from 28% to 60% in children younger than 3 months and we found substantial proportions of admissions to hospital with respiratory infections associated with RSV in children younger than 3 years. Associated proportions were highest among hospitalizations with ICD-10 codes of \"bronchitis and bronchiolitis.\" In all 6 countries, annual incidence of RSV-associated hospitalizations was >40 per 1000 persons in the age group 0-2 months. In age group 1-2 years the incidence rate ranged from 1.3 to 10.5 hospitalizations per 1000. Adults older than 85 years had hospitalizations with respiratory infection associated to RSV in all 6 countries although incidence rates were low.</p><p><strong>Conclusions: </strong>Our findings highlight the substantial proportion of RSV infections among hospital admissions across different ages and may help public health professionals and policy makers when planning prevention and control strategies. In addition, our findings provide valuable insights for health care professionals attending to both children and adults presenting with symptoms of viral respiratory infections.</p>","PeriodicalId":509652,"journal":{"name":"The Journal of Infectious Diseases","volume":" ","pages":"S29-S37"},"PeriodicalIF":6.4,"publicationDate":"2022-08-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40396611","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Risk Factors for Poor Outcome or Death in Young Children With Respiratory Syncytial Virus-Associated Acute Lower Respiratory Tract Infection: A Systematic Review and Meta-Analysis.","authors":"Ting Shi,&nbsp;Sophie Vennard,&nbsp;Sara Mahdy,&nbsp;Harish Nair","doi":"10.1093/infdis/jiaa751","DOIUrl":"https://doi.org/10.1093/infdis/jiaa751","url":null,"abstract":"<p><strong>Background: </strong>Respiratory syncytial virus (RSV)-associated acute lower respiratory tract infection (RSV-ALRTI) constitutes a substantial disease burden in young children. We aimed to identify all studies investigating the risk factors for RSV-ALRTI poor outcome or death in young children.</p><p><strong>Methods: </strong>We carried out a systematic literature review across 7 databases with data from studies published from January 1995 to December 2019. We defined poor outcome as need for prolonged hospital stay, oxygen supplementation, mechanical ventilation, or intensive care unit admission. The quality of all eligible studies was assessed according to modified Grading of Recommendations, Assessment, Development and Evaluations (GRADE) criteria. We conducted meta-analyses to estimate odds ratios (ORs) with 95% confidence intervals (CIs) for individual risk factors.</p><p><strong>Results: </strong>We identified 27 eligible studies, which investigated 20 risk factors for RSV-ALRTI poor outcome and/or death in children <5 years old, compared with children with RSV-ALRTI who did not have poor outcome or who did not die. Among the risk factors, 6 were significantly associated with RSV-ALRTI poor outcome: any comorbid condition (OR, 2.69; 95% CI, 1.89-3.83), congenital heart disease (3.40; 2.14-5.40), prematurity with gestational age (GA) <37 weeks (1.75 (1.31-2.36), prematurity with GA ≤32 weeks (2.68; 1.43-5.04), age <3 months (4.91; 1.64-14.71), and age <6 months (2.02; 1.73-2.35). The meta-estimate ORs for all risk factors other than age <3 months were based on studies using multivariable analysis. For death, only prematurity with GA <37 weeks had a significant meta-estimated OR-3.81 (95% CI, 1.68-8.63)-based on univariable analysis.</p><p><strong>Conclusions: </strong>This study represents a comprehensive report of the association between various risk factors and RSV-ALRTI poor outcome or death in young children. More research should be carried out to elucidate risk factors associated with poor outcome or death using multivariable analysis.</p>","PeriodicalId":509652,"journal":{"name":"The Journal of Infectious Diseases","volume":" ","pages":"S10-S16"},"PeriodicalIF":6.4,"publicationDate":"2022-08-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1093/infdis/jiaa751","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"25362381","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"World Health Organization Influenza-Like Illness Underestimates the Burden of Respiratory Syncytial Virus Infection in Community-Dwelling Older Adults.","authors":"Koos Korsten,&nbsp;Niels Adriaenssens,&nbsp;Samuel Coenen,&nbsp;Chris C Butler,&nbsp;Theo J M Verheij,&nbsp;Louis J Bont,&nbsp;Joanne G Wildenbeest","doi":"10.1093/infdis/jiab452","DOIUrl":"https://doi.org/10.1093/infdis/jiab452","url":null,"abstract":"<p><strong>Background: </strong>Respiratory syncytial virus (RSV) surveillance is heavily dependent on the influenza-like illness (ILI) case definition from the World Health Organization (WHO). Because ILI includes fever in its syndromic case definition, its ability to accurately identify acute respiratory tract infections (ARTI) caused by RSV in older adults is uncertain.</p><p><strong>Methods: </strong>The accuracy of the WHO ILI and a modified ILI (requiring only self-reported fever) case definitions in identifying patients with PCR-confirmed RSV-ARTI was evaluated in community-dwelling older adults (≥60 years) from the prospective European RESCEU cohort study.</p><p><strong>Results: </strong>Among 1040 participants, 750 ARTI episodes were analyzed including 36 confirmed RSV-ARTI. Due to a general lack of fever, sensitivity for RSV-ARTI was 33% for modified ILI and 11% for ILI. The area under the curve for both ILI definitions was 0.52 indicating poor discrimination for RSV. RSV-ARTI could not be distinguished from all other ARTI based on clinical symptoms.</p><p><strong>Conclusions: </strong>The use of ILI underestimated the occurrence of RSV-ARTI in community-dwelling older adults up to 9-fold (11% sensitivity). Because worldwide RSV surveillance depends largely on ILI, there is an urgent need for a better approach to measure the occurrence of RSV disease and the impact of future RSV vaccine introduction. Clinical Trials Registration. NCT03621930.</p>","PeriodicalId":509652,"journal":{"name":"The Journal of Infectious Diseases","volume":" ","pages":"S71-S78"},"PeriodicalIF":6.4,"publicationDate":"2022-08-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/fc/2a/jiab452.PMC9374507.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39722699","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Systematic Review of European Clinical Practice Guidelines for Respiratory Syncytial Virus Prophylaxis.","authors":"Rachel M Reeves,&nbsp;Maarten van Wijhe,&nbsp;Toni Lehtonen,&nbsp;Luca Stona,&nbsp;Anne C Teirlinck,&nbsp;Liliana Vazquez Fernandez,&nbsp;You Li,&nbsp;Richard Osei-Yeboah,&nbsp;Thea K Fischer,&nbsp;Terho Heikkinen,&nbsp;Michiel van Boven,&nbsp;Håkon Bøås,&nbsp;Daniele Donà,&nbsp;Elisa Barbieri,&nbsp;Harry Campbell","doi":"10.1093/infdis/jiac059","DOIUrl":"https://doi.org/10.1093/infdis/jiac059","url":null,"abstract":"<p><strong>Background: </strong>Since the widespread adoption of palivizumab prophylaxis in Europe, there have been a number of clinical practice guidelines (CPGs) published for the prevention of respiratory syncytial virus (RSV) infection in children. The aim of this systematic review was to identify CPGs for the prevention of RSV infection across Europe.</p><p><strong>Methods: </strong>We performed a systematic literature search and contacted European influenza and respiratory virus networks and public health institutions, to identify national CPGs for the prevention of RSV infection. The Reporting Items for practice Guidelines in Healthcare (RIGHT) Statement checklist was applied to extract data and review the quality of reporting.</p><p><strong>Results: </strong>A total of 20 national CPGs were identified, all published between 2000 and 2018. The greatest discrepancy between guidelines was the recommendations for palivizumab prophylaxis for premature infants, with recommendations varying by gestational age. All guidelines recommended or considered the use of palivizumab in infants with bronchopulmonary dysplasia, 85% (n = 17) in children with congenital heart disease (CHD), and 60% (n = 12) in children with severe combined immunodeficiency.</p><p><strong>Conclusions: </strong>We recommend that agencies publishing RSV prevention guidelines adopt the RIGHT reporting requirements when updating these guidelines to improve the presentation of the evidence-base for decisions.</p>","PeriodicalId":509652,"journal":{"name":"The Journal of Infectious Diseases","volume":" ","pages":"S110-S116"},"PeriodicalIF":6.4,"publicationDate":"2022-08-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40327600","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Influenza A(H1N1)pdm09 But Not A(H3N2) Virus Infection Induces Durable Seroprotection: Results From the Ha Nam Cohort.","authors":"Le Nguyen Minh Hoa,&nbsp;Sheena G Sullivan,&nbsp;Le Quynh Mai,&nbsp;Arseniy Khvorov,&nbsp;Hoang Vu Mai Phuong,&nbsp;Nguyen Le Khanh Hang,&nbsp;Pham Quang Thai,&nbsp;Le Thi Thanh,&nbsp;Louise Carolan,&nbsp;Dang Duc Anh,&nbsp;Tran Nhu Duong,&nbsp;Juliet E Bryant,&nbsp;H Rogier van Doorn,&nbsp;Heiman F L Wertheim,&nbsp;Peter Horby,&nbsp;Annette Fox","doi":"10.1093/infdis/jiaa293","DOIUrl":"https://doi.org/10.1093/infdis/jiaa293","url":null,"abstract":"<p><strong>Background: </strong>The extent to which influenza recurrence depends upon waning immunity from prior infection is undefined. We used antibody titers of Ha-Nam cohort participants to estimate protection curves and decay trajectories.</p><p><strong>Methods: </strong>Households (270) participated in influenza-like-illness (ILI) surveillance and provided blood at intervals spanning laboratory-confirmed virus transmission. Sera were tested in hemagglutination inhibition assay. Infection was defined as influenza virus-positive ILI and/or seroconversion. Median protective titers were estimated using scaled-logistic regression to model pretransmission titer against infection status in that season, limiting analysis to households with infection(s). Titers were modelled against month since infection using mixed-effects linear regression to estimate decay and when titers fell below protection thresholds.</p><p><strong>Results: </strong>From December 2008-2012, 295 and 314 participants were infected with H1N1pdm09-like and A/Perth/16/09-like (H3N2Pe09) viruses, respectively. The proportion protected rose more steeply with titer for H1N1pdm09 than for H3N2Pe09, and estimated 50% protection titers were 19.6 and 37.3, respectively. Postinfection titers started higher against H3N2Pe09 but decayed more steeply than against H1N1pdm09. Seroprotection was estimated to be sustained against H1N1pdm09 but to wane by 8-months for H3N2Pe09.</p><p><strong>Conclusions: </strong>Estimates indicate that infection induces durable seroprotection against H1N1pdm09 but not H3N2Pe09, which could in part account for the younger age of A(H1N1) versus A(H3N2) cases.</p>","PeriodicalId":509652,"journal":{"name":"The Journal of Infectious Diseases","volume":" ","pages":"59-69"},"PeriodicalIF":6.4,"publicationDate":"2022-08-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1093/infdis/jiaa293","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38002435","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effect of Influenza Vaccination on Risk of Coronavirus Disease 2019: A Prospective Cohort Study of 46 000 Healthcare Workers.","authors":"Jonas Henrik Kristensen,&nbsp;Rasmus Bo Hasselbalch,&nbsp;Mia Pries-Heje,&nbsp;Pernille Brok Nielsen,&nbsp;Andreas Dehlbæk Knudsen,&nbsp;Kamille Fogh,&nbsp;Jakob Boesgaard Norsk,&nbsp;Aleksander Eiken,&nbsp;Ove Andersen,&nbsp;Thea Kølsen Fischer,&nbsp;Claus Antonio Juul Jensen,&nbsp;Christian Torp-Pedersen,&nbsp;Jørgen Rungby,&nbsp;Sisse Bolm Ditlev,&nbsp;Ida Hageman,&nbsp;Rasmus Møgelvang,&nbsp;Mikkel Gybel-Brask,&nbsp;Ram Benny Dessau,&nbsp;Erik Sørensen,&nbsp;Lene Harritshøj,&nbsp;Fredrik Folke,&nbsp;Maria Elizabeth Engel Møller,&nbsp;Thomas Benfield,&nbsp;Henrik Ullum,&nbsp;Charlotte Sværke Jørgensen,&nbsp;Sisse Rye Ostrowski,&nbsp;Susanne Dam Nielsen,&nbsp;Henning Bundgaard,&nbsp;Kasper Iversen","doi":"10.1093/infdis/jiac001","DOIUrl":"https://doi.org/10.1093/infdis/jiac001","url":null,"abstract":"<p><strong>Background: </strong>The purpose of this study was to assess whether influenza vaccination has an impact on the risk of coronavirus disease 2019 (COVID-19).</p><p><strong>Methods: </strong>A cohort of 46 112 healthcare workers were tested for antibodies against severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and filled in a survey on COVID-19 symptoms, hospitalization, and influenza vaccination.</p><p><strong>Results: </strong>The risk ratio of hospitalization due to SARS-CoV-2 for influenza vaccinated compared with unvaccinated participants was 1.00 for the seasonal vaccination in 2019/2020 (confidence interval, .56-1.78, P = 1.00). Likewise, no clinical effect of influenza vaccination on development of antibodies against SARS-CoV-2 was found.</p><p><strong>Conclusions: </strong>The present findings indicate that influenza vaccination does not affect the risk of SARS-CoV-2 infection or COVID-19.</p>","PeriodicalId":509652,"journal":{"name":"The Journal of Infectious Diseases","volume":" ","pages":"6-10"},"PeriodicalIF":6.4,"publicationDate":"2022-08-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8755365/pdf/jiac001.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39791374","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Serological Evidence of Human Infection With Avian Influenza A(H7N9) Virus: A Systematic Review and Meta-analysis.","authors":"Wei Wang,&nbsp;Xinhua Chen,&nbsp;Yan Wang,&nbsp;Shengjie Lai,&nbsp;Juan Yang,&nbsp;Benjamin J Cowling,&nbsp;Peter W Horby,&nbsp;Timothy M Uyeki,&nbsp;Hongjie Yu","doi":"10.1093/infdis/jiaa679","DOIUrl":"https://doi.org/10.1093/infdis/jiaa679","url":null,"abstract":"<p><strong>Background: </strong>The extent of human infections with avian influenza A(H7N9) virus, including mild and asymptomatic infections, is uncertain.</p><p><strong>Methods: </strong>We performed a systematic review and meta-analysis of serosurveys for avian influenza A(H7N9) virus infections in humans published during 2013-2020. Three seropositive definitions were assessed to estimate pooled seroprevalence, seroconversion rate, and seroincidence by types of exposures. We applied a scoring system to assess the quality of included studies.</p><p><strong>Results: </strong>Of 31 included studies, pooled seroprevalence of A(H7N9) virus antibodies from all participants was 0.02%, with poultry workers, close contacts, and general populations having seroprevalence of 0.1%, 0.2%, and 0.02%, respectively, based on the World Health Organization (WHO)-recommended definition. Although most infections were asymptomatic, evidence of infection was highest in poultry workers (5% seroconversion, 19.1% seroincidence per 100 person-years). Use of different virus clades did not significantly affect seroprevalence estimates. Most serological studies were of low to moderate quality and did not follow standardized seroepidemiological protocols or WHO-recommended laboratory methods.</p><p><strong>Conclusions: </strong>Human infections with avian influenza A(H7N9) virus have been uncommon, especially for general populations. Workers with occupational exposures to poultry and close contacts of A(H7N9) human cases had low risks of infection.</p>","PeriodicalId":509652,"journal":{"name":"The Journal of Infectious Diseases","volume":" ","pages":"70-82"},"PeriodicalIF":6.4,"publicationDate":"2022-08-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1093/infdis/jiaa679","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38645563","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Time-Varying Association Between Severe Respiratory Syncytial Virus Infections and Subsequent Severe Asthma and Wheeze and Influences of Age at the Infection.","authors":"Xin Wang,&nbsp;You Li,&nbsp;Harish Nair,&nbsp;Harry Campbell","doi":"10.1093/infdis/jiab308","DOIUrl":"https://doi.org/10.1093/infdis/jiab308","url":null,"abstract":"<p><strong>Background: </strong>Early-life severe respiratory syncytial virus (RSV) infection has been associated with subsequent risk of asthma and recurrent wheeze. However, changes in the association over time and the interaction effect of the age at first RSV infection are less well understood. We aimed to assess the time-varying association between RSV and subsequent asthma and wheeze admission and explore how the association was affected by the age at RSV infection.</p><p><strong>Methods: </strong>We retrospectively followed up a cohort of 23 365 children for a median of 6.9 years using Scottish health databases. Children who were born between 2001 and 2013 and had RSV-associated respiratory tract infection (RTI) admissions under 2 years were in the exposed group; those with unintentional accident admissions under 2 years comprised the control group. The Cox proportional-hazards model was used to report adjusted hazard ratios (HRs) of RSV admissions on subsequent asthma and wheeze admissions. We did subgroup analyses by follow-up years. We also explored how this association was affected by the age at first RSV admission.</p><p><strong>Results: </strong>The association was strongest in the first 2 years of follow-up and decreased over time. The association persisted for 6 years in children whose first RSV-RTI admission occurred at 6-23 months of age, with an adjusted HR of 3.9 (95% confidence interval [CI], 3.1-4.9) for the first 2 years, 2.3 (95% CI, 1.6-3.2) for 2 to <4 years, and 1.9 (95% CI, 1.2-2.9) for 4 to <6 years of follow-up. In contrast, the association was only significant for the first 2 years after first RSV-RTI admissions occurring at 0-5 months.</p><p><strong>Conclusions: </strong>We found a more persistent association for subsequent asthma and wheeze in children whose first severe RSV infection occurred at 6-23 months compared to those whose first severe RSV infection occurred at 0-6 months. This provides new evidence for further assessment of the association and RSV intervention programs.</p>","PeriodicalId":509652,"journal":{"name":"The Journal of Infectious Diseases","volume":" ","pages":"S38-S44"},"PeriodicalIF":6.4,"publicationDate":"2022-08-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39419208","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}