Newborns with congenital disease prone to severe RSV infection

Infants aged <1.5 months with cardiovascular or congenital/genetic diseases are at higher risk of severe respiratory syncytial virus (RSV) infection, according to a Taiwan study. Use of RSV monoclonal antibody (mAb) prophylaxis appears beneficial in these children.

This cohort study was carried out at National Taiwan University Hospital and determined the rate of severe outcomes among children hospitalized due to RSV infection from 2008 to 2018. After adjusting for age, sex, and birth cohorts born before and after RSV mAb endorsement, the authors then identified the predictors of severe RSV infection, which was characterized by the use of invasive ventilator support.

A total of 1,985 admissions due to RSV infections were identified. Of these, 66 patients (3.3 percent) had a severe disease. Notably, an RSV mAb endorsement resulted in a significant decrease in the proportion of severe RSV infections.

In multivariable analysis, children with severe RSV infections tended to be young (<1.5 months of age) or have cardiovascular or congenital/genetic diseases. Moreover, bacterial coinfections, elevated creatinine levels, and initial abnormal chest radiograph findings were predictive of severe RSV infection.

“RSV is a common cause of bronchiolitis and pneumonia in infants and young children,” the authors said. “Starting in December 2010, RSV mAb was endorsed by Taiwan National Health Insurance and given to children with prematurity and/or congenital heart diseases, which are considered high-risk factors for severe RSV diseases.”