Risk factors for disease severity and increased medical resource utilization in respiratory syncytial virus (+) hospitalized children: A descriptive study conducted in four Belgian hospitals
We aimed to provide regional data on clinical symptoms, medical resource utilization (MRU), and risk factors for increased MRU in hospitalized respiratory syncytial virus (RSV)-infected Belgian pediatric population. This prospective, multicenter study enrolled RSV (+) hospitalized children (aged ≤5y...
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| Published in: | PloS one Vol. 17; no. 6; p. e0268532 |
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| Format: | Journal Article |
| Language: | English |
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06-06-2022
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| Abstract | We aimed to provide regional data on clinical symptoms, medical resource utilization (MRU), and risk factors for increased MRU in hospitalized respiratory syncytial virus (RSV)-infected Belgian pediatric population.
This prospective, multicenter study enrolled RSV (+) hospitalized children (aged ≤5y) during the 2013-2015 RSV seasons. RSV was diagnosed within 24h of hospitalization. Disease severity of RSV (+) patients was assessed until discharge or up to maximum six days using a Physical Examination Score (PES) and a derived score based on ability to feed, dyspnea and respiratory effort (PES3). MRU (concomitant medications, length of hospitalization [LOH], and oxygen supplementation) was evaluated. Kaplan-Meier survival analysis was performed to compare MRU by age and presence of risk factors for severe disease. Association between baseline covariates and MRU was analyzed using Cox regression models.
In total, 75 children were included, Median (range) age was 4 (0-41) months, risk factors were present in 18.7%, and early hospitalization (≤3 days of symptom onset) was observed in 57.3% of patients. Cough (100%), feeding problems (82.2%), nasal discharge (87.8%), and rales and rhonchi (82.2%) were frequently observed. Median (range) LOH and oxygen supplementation was 5 (2-7) and 3 (1-7) days. Oxygen supplementation, bronchodilators, and antibiotics were administered to 58.7%, 64.0%, and 41.3% of the patients, respectively. Age <3 months and baseline total PES3 score were associated with probability and the duration of receiving oxygen supplementation. LOH was not associated with any covariate.
RSV is associated with high disease burden and MRU in hospitalized children. Oxygen supplementation but not length of hospitalization was associated with very young age and the PES3 score. These results warrant further assessment of the PES3 score as a predictor for the probability of receiving and length of oxygen supplementation in RSV hospitalized children.
NCT02133092. |
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| AbstractList | We aimed to provide regional data on clinical symptoms, medical resource utilization (MRU), and risk factors for increased MRU in hospitalized respiratory syncytial virus (RSV)-infected Belgian pediatric population.
This prospective, multicenter study enrolled RSV (+) hospitalized children (aged ≤5y) during the 2013-2015 RSV seasons. RSV was diagnosed within 24h of hospitalization. Disease severity of RSV (+) patients was assessed until discharge or up to maximum six days using a Physical Examination Score (PES) and a derived score based on ability to feed, dyspnea and respiratory effort (PES3). MRU (concomitant medications, length of hospitalization [LOH], and oxygen supplementation) was evaluated. Kaplan-Meier survival analysis was performed to compare MRU by age and presence of risk factors for severe disease. Association between baseline covariates and MRU was analyzed using Cox regression models.
In total, 75 children were included, Median (range) age was 4 (0-41) months, risk factors were present in 18.7%, and early hospitalization (≤3 days of symptom onset) was observed in 57.3% of patients. Cough (100%), feeding problems (82.2%), nasal discharge (87.8%), and rales and rhonchi (82.2%) were frequently observed. Median (range) LOH and oxygen supplementation was 5 (2-7) and 3 (1-7) days. Oxygen supplementation, bronchodilators, and antibiotics were administered to 58.7%, 64.0%, and 41.3% of the patients, respectively. Age <3 months and baseline total PES3 score were associated with probability and the duration of receiving oxygen supplementation. LOH was not associated with any covariate.
RSV is associated with high disease burden and MRU in hospitalized children. Oxygen supplementation but not length of hospitalization was associated with very young age and the PES3 score. These results warrant further assessment of the PES3 score as a predictor for the probability of receiving and length of oxygen supplementation in RSV hospitalized children.
NCT02133092. Background We aimed to provide regional data on clinical symptoms, medical resource utilization (MRU), and risk factors for increased MRU in hospitalized respiratory syncytial virus (RSV)-infected Belgian pediatric population. Methods This prospective, multicenter study enrolled RSV (+) hospitalized children (aged ≤5y) during the 2013–2015 RSV seasons. RSV was diagnosed within 24h of hospitalization. Disease severity of RSV (+) patients was assessed until discharge or up to maximum six days using a Physical Examination Score (PES) and a derived score based on ability to feed, dyspnea and respiratory effort (PES3). MRU (concomitant medications, length of hospitalization [LOH], and oxygen supplementation) was evaluated. Kaplan-Meier survival analysis was performed to compare MRU by age and presence of risk factors for severe disease. Association between baseline covariates and MRU was analyzed using Cox regression models. Results In total, 75 children were included, Median (range) age was 4 (0–41) months, risk factors were present in 18.7%, and early hospitalization (≤3 days of symptom onset) was observed in 57.3% of patients. Cough (100%), feeding problems (82.2%), nasal discharge (87.8%), and rales and rhonchi (82.2%) were frequently observed. Median (range) LOH and oxygen supplementation was 5 (2–7) and 3 (1–7) days. Oxygen supplementation, bronchodilators, and antibiotics were administered to 58.7%, 64.0%, and 41.3% of the patients, respectively. Age <3 months and baseline total PES3 score were associated with probability and the duration of receiving oxygen supplementation. LOH was not associated with any covariate. Conclusion RSV is associated with high disease burden and MRU in hospitalized children. Oxygen supplementation but not length of hospitalization was associated with very young age and the PES3 score. These results warrant further assessment of the PES3 score as a predictor for the probability of receiving and length of oxygen supplementation in RSV hospitalized children. Registration NCT02133092 BACKGROUNDWe aimed to provide regional data on clinical symptoms, medical resource utilization (MRU), and risk factors for increased MRU in hospitalized respiratory syncytial virus (RSV)-infected Belgian pediatric population. METHODSThis prospective, multicenter study enrolled RSV (+) hospitalized children (aged ≤5y) during the 2013-2015 RSV seasons. RSV was diagnosed within 24h of hospitalization. Disease severity of RSV (+) patients was assessed until discharge or up to maximum six days using a Physical Examination Score (PES) and a derived score based on ability to feed, dyspnea and respiratory effort (PES3). MRU (concomitant medications, length of hospitalization [LOH], and oxygen supplementation) was evaluated. Kaplan-Meier survival analysis was performed to compare MRU by age and presence of risk factors for severe disease. Association between baseline covariates and MRU was analyzed using Cox regression models. RESULTSIn total, 75 children were included, Median (range) age was 4 (0-41) months, risk factors were present in 18.7%, and early hospitalization (≤3 days of symptom onset) was observed in 57.3% of patients. Cough (100%), feeding problems (82.2%), nasal discharge (87.8%), and rales and rhonchi (82.2%) were frequently observed. Median (range) LOH and oxygen supplementation was 5 (2-7) and 3 (1-7) days. Oxygen supplementation, bronchodilators, and antibiotics were administered to 58.7%, 64.0%, and 41.3% of the patients, respectively. Age <3 months and baseline total PES3 score were associated with probability and the duration of receiving oxygen supplementation. LOH was not associated with any covariate. CONCLUSIONRSV is associated with high disease burden and MRU in hospitalized children. Oxygen supplementation but not length of hospitalization was associated with very young age and the PES3 score. These results warrant further assessment of the PES3 score as a predictor for the probability of receiving and length of oxygen supplementation in RSV hospitalized children. REGISTRATIONNCT02133092. Background We aimed to provide regional data on clinical symptoms, medical resource utilization (MRU), and risk factors for increased MRU in hospitalized respiratory syncytial virus (RSV)-infected Belgian pediatric population. Methods This prospective, multicenter study enrolled RSV (+) hospitalized children (aged [less than or equal to]5y) during the 2013-2015 RSV seasons. RSV was diagnosed within 24h of hospitalization. Disease severity of RSV (+) patients was assessed until discharge or up to maximum six days using a Physical Examination Score (PES) and a derived score based on ability to feed, dyspnea and respiratory effort (PES3). MRU (concomitant medications, length of hospitalization [LOH], and oxygen supplementation) was evaluated. Kaplan-Meier survival analysis was performed to compare MRU by age and presence of risk factors for severe disease. Association between baseline covariates and MRU was analyzed using Cox regression models. Results In total, 75 children were included, Median (range) age was 4 (0-41) months, risk factors were present in 18.7%, and early hospitalization ([less than or equal to]3 days of symptom onset) was observed in 57.3% of patients. Cough (100%), feeding problems (82.2%), nasal discharge (87.8%), and rales and rhonchi (82.2%) were frequently observed. Median (range) LOH and oxygen supplementation was 5 (2-7) and 3 (1-7) days. Oxygen supplementation, bronchodilators, and antibiotics were administered to 58.7%, 64.0%, and 41.3% of the patients, respectively. Age <3 months and baseline total PES3 score were associated with probability and the duration of receiving oxygen supplementation. LOH was not associated with any covariate. Conclusion RSV is associated with high disease burden and MRU in hospitalized children. Oxygen supplementation but not length of hospitalization was associated with very young age and the PES3 score. These results warrant further assessment of the PES3 score as a predictor for the probability of receiving and length of oxygen supplementation in RSV hospitalized children. Registration NCT02133092 Background We aimed to provide regional data on clinical symptoms, medical resource utilization (MRU), and risk factors for increased MRU in hospitalized respiratory syncytial virus (RSV)-infected Belgian pediatric population. Methods This prospective, multicenter study enrolled RSV (+) hospitalized children (aged ≤5y) during the 2013–2015 RSV seasons. RSV was diagnosed within 24h of hospitalization. Disease severity of RSV (+) patients was assessed until discharge or up to maximum six days using a Physical Examination Score (PES) and a derived score based on ability to feed, dyspnea and respiratory effort (PES3). MRU (concomitant medications, length of hospitalization [LOH], and oxygen supplementation) was evaluated. Kaplan-Meier survival analysis was performed to compare MRU by age and presence of risk factors for severe disease. Association between baseline covariates and MRU was analyzed using Cox regression models. Results In total, 75 children were included, Median (range) age was 4 (0–41) months, risk factors were present in 18.7%, and early hospitalization (≤3 days of symptom onset) was observed in 57.3% of patients. Cough (100%), feeding problems (82.2%), nasal discharge (87.8%), and rales and rhonchi (82.2%) were frequently observed. Median (range) LOH and oxygen supplementation was 5 (2–7) and 3 (1–7) days. Oxygen supplementation, bronchodilators, and antibiotics were administered to 58.7%, 64.0%, and 41.3% of the patients, respectively. Age <3 months and baseline total PES3 score were associated with probability and the duration of receiving oxygen supplementation. LOH was not associated with any covariate. Conclusion RSV is associated with high disease burden and MRU in hospitalized children. Oxygen supplementation but not length of hospitalization was associated with very young age and the PES3 score. These results warrant further assessment of the PES3 score as a predictor for the probability of receiving and length of oxygen supplementation in RSV hospitalized children. Registration NCT02133092 We aimed to provide regional data on clinical symptoms, medical resource utilization (MRU), and risk factors for increased MRU in hospitalized respiratory syncytial virus (RSV)-infected Belgian pediatric population. This prospective, multicenter study enrolled RSV (+) hospitalized children (aged [less than or equal to]5y) during the 2013-2015 RSV seasons. RSV was diagnosed within 24h of hospitalization. Disease severity of RSV (+) patients was assessed until discharge or up to maximum six days using a Physical Examination Score (PES) and a derived score based on ability to feed, dyspnea and respiratory effort (PES3). MRU (concomitant medications, length of hospitalization [LOH], and oxygen supplementation) was evaluated. Kaplan-Meier survival analysis was performed to compare MRU by age and presence of risk factors for severe disease. Association between baseline covariates and MRU was analyzed using Cox regression models. In total, 75 children were included, Median (range) age was 4 (0-41) months, risk factors were present in 18.7%, and early hospitalization ([less than or equal to]3 days of symptom onset) was observed in 57.3% of patients. Cough (100%), feeding problems (82.2%), nasal discharge (87.8%), and rales and rhonchi (82.2%) were frequently observed. Median (range) LOH and oxygen supplementation was 5 (2-7) and 3 (1-7) days. Oxygen supplementation, bronchodilators, and antibiotics were administered to 58.7%, 64.0%, and 41.3% of the patients, respectively. Age <3 months and baseline total PES3 score were associated with probability and the duration of receiving oxygen supplementation. LOH was not associated with any covariate. RSV is associated with high disease burden and MRU in hospitalized children. Oxygen supplementation but not length of hospitalization was associated with very young age and the PES3 score. These results warrant further assessment of the PES3 score as a predictor for the probability of receiving and length of oxygen supplementation in RSV hospitalized children. |
| Audience | Academic |
| Author | Reynders, Marijke Ispas, Gabriela Garmyn, Kristien Vandendijck, Yannick Bollekens, Jacques Fleischhackl, Roman Laffut, Wim Rector, Annabel Sauer, Kate Verschelde, Ann Vermeulen, Francois Keyaerts, Els Proesmans, Marijke |
| AuthorAffiliation | 6 Department of Pediatrics, AZ Sint-Jan Brugge–Oostende, Campus Henri Serruys, Oostende, Belgium 8 Department of Pediatrics, Heilig-Hartziekenhuis, Lier, Belgium 9 Janssen-Cilag Austria, Vienna, Austria 2 KU Leuven Department of Microbiology, Immunology and Transplantation, Rega Institute, Laboratory of Clinical and Epidemiological Virology, Leuven, Belgium 4 Department of Pediatrics, AZ Sint-Jan Brugge—Oostende, Campus Brugge, Brugge, Belgium 5 Department of Microbiology, AZ Sint-Jan Brugge—Oostende, Campus Brugge, Brugge, Belgium 1 Department of Pediatrics, University Hospitals Leuven, Leuven, Belgium 7 Department of Microbiology, Heilig-Hartziekenhuis, Lier, Belgium University of Cape Town, SOUTH AFRICA 3 Janssen Pharmaceutica, Beerse, Belgium |
| AuthorAffiliation_xml | – name: 4 Department of Pediatrics, AZ Sint-Jan Brugge—Oostende, Campus Brugge, Brugge, Belgium – name: 2 KU Leuven Department of Microbiology, Immunology and Transplantation, Rega Institute, Laboratory of Clinical and Epidemiological Virology, Leuven, Belgium – name: 6 Department of Pediatrics, AZ Sint-Jan Brugge–Oostende, Campus Henri Serruys, Oostende, Belgium – name: 5 Department of Microbiology, AZ Sint-Jan Brugge—Oostende, Campus Brugge, Brugge, Belgium – name: 3 Janssen Pharmaceutica, Beerse, Belgium – name: 9 Janssen-Cilag Austria, Vienna, Austria – name: University of Cape Town, SOUTH AFRICA – name: 7 Department of Microbiology, Heilig-Hartziekenhuis, Lier, Belgium – name: 8 Department of Pediatrics, Heilig-Hartziekenhuis, Lier, Belgium – name: 1 Department of Pediatrics, University Hospitals Leuven, Leuven, Belgium |
| Author_xml | – sequence: 1 givenname: Marijke surname: Proesmans fullname: Proesmans, Marijke organization: Department of Pediatrics, University Hospitals Leuven, Leuven, Belgium – sequence: 2 givenname: Annabel surname: Rector fullname: Rector, Annabel organization: KU Leuven Department of Microbiology, Immunology and Transplantation, Rega Institute, Laboratory of Clinical and Epidemiological Virology, Leuven, Belgium – sequence: 3 givenname: Els surname: Keyaerts fullname: Keyaerts, Els organization: KU Leuven Department of Microbiology, Immunology and Transplantation, Rega Institute, Laboratory of Clinical and Epidemiological Virology, Leuven, Belgium – sequence: 4 givenname: Yannick surname: Vandendijck fullname: Vandendijck, Yannick organization: Janssen Pharmaceutica, Beerse, Belgium – sequence: 5 givenname: Francois surname: Vermeulen fullname: Vermeulen, Francois organization: Department of Pediatrics, University Hospitals Leuven, Leuven, Belgium – sequence: 6 givenname: Kate orcidid: 0000-0002-4523-7832 surname: Sauer fullname: Sauer, Kate organization: Department of Pediatrics, AZ Sint-Jan Brugge-Oostende, Campus Brugge, Brugge, Belgium – sequence: 7 givenname: Marijke orcidid: 0000-0003-2079-1279 surname: Reynders fullname: Reynders, Marijke organization: Department of Microbiology, AZ Sint-Jan Brugge-Oostende, Campus Brugge, Brugge, Belgium – sequence: 8 givenname: Ann surname: Verschelde fullname: Verschelde, Ann organization: Department of Pediatrics, AZ Sint-Jan Brugge-Oostende, Campus Henri Serruys, Oostende, Belgium – sequence: 9 givenname: Wim surname: Laffut fullname: Laffut, Wim organization: Department of Microbiology, Heilig-Hartziekenhuis, Lier, Belgium – sequence: 10 givenname: Kristien surname: Garmyn fullname: Garmyn, Kristien organization: Department of Pediatrics, Heilig-Hartziekenhuis, Lier, Belgium – sequence: 11 givenname: Roman surname: Fleischhackl fullname: Fleischhackl, Roman organization: Janssen-Cilag Austria, Vienna, Austria – sequence: 12 givenname: Jacques surname: Bollekens fullname: Bollekens, Jacques organization: Janssen Pharmaceutica, Beerse, Belgium – sequence: 13 givenname: Gabriela orcidid: 0000-0002-2720-8157 surname: Ispas fullname: Ispas, Gabriela organization: Janssen Pharmaceutica, Beerse, Belgium |
| BackLink | https://www.ncbi.nlm.nih.gov/pubmed/35666728$$D View this record in MEDLINE/PubMed |
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| CitedBy_id | crossref_primary_10_1002_jmv_28541 crossref_primary_10_1186_s12889_023_17474_x crossref_primary_10_3390_antiox11081453 crossref_primary_10_12688_f1000research_146540_1 crossref_primary_10_12688_f1000research_146540_2 |
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| Copyright | COPYRIGHT 2022 Public Library of Science 2022 Proesmans et al. This is an open access article distributed under the terms of the Creative Commons Attribution License: http://creativecommons.org/licenses/by/4.0/ (the “License”), which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License. 2022 Proesmans et al 2022 Proesmans et al |
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| License | This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. Creative Commons Attribution License |
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| Notes | ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-2 content type line 23 Competing Interests: I have read the journal’s policy and the authors of this manuscript have the following competing interests: YV, RF, JB, and GI are employees of Janssen Pharmaceutica NV and may own stock in Johnson & Johnson. MP, AR, EK, FV, KS, MR, AV, WL, and KG have no conflict of interest. |
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