Variation in severity of respiratory syncytial virus infections with subtype
Identifieur interne : 002110 ( Main/Exploration ); précédent : 002109; suivant : 002111Variation in severity of respiratory syncytial virus infections with subtype
Auteurs : Kenneth M. Mcconnochie [États-Unis] ; Caroline B. Hall [États-Unis] ; Edward E. Walsh [États-Unis] ; Klaus J. Roghmann [États-Unis]Source :
- The Journal of Pediatrics [ 0022-3476 ] ; 1990.
English descriptors
- Teeft :
- Admission criteria, Alternative hypothesis, Antibody rise, Antiviral therapy, Apnea, Bivariate analysis, Bronchodilator treatment, Bronchopulmonary dysplasia, Bsubtype infections, Clinical importance, Community attack rates, Community surveillance, Continuous variables, Cutoff points, Cytopathic effect, Data collection, Days sao2, Dichotomized, Direct effects, Discrete multivariate, Discrete multivariate analysis, Equal proportions, Family history, First sample, First winter, Greater severity, High risk, High severity score, High severity scores, Hospital beds, Important implications, Infant, Infection, Influence severity, Intensive care unit admission, Laboratory observations, Lrti, Lrti admissions, Lrti episodes, Massachusetts epidemics, Mechanical ventilation, Multivariate, Multivariate analysis, Normal values, Odds ratio, Odds ratios, Other form, Pco2, Pearson statistic, Pediatr, Pediatrics, Pediatrics july, Preliminary analysis, Premature, Premature birth, Pulmonary dysfunction, Rale, Relative impact, Relative likelihood, Relative risk, Respirations pulse, Respiratory illness, Respiratory syncytial virus, Respiratory syncytial virus infection, Rhonchus, Ribavirin, Ribavirin treatment, Risk factor, Risk factors, Rochester, Sao2, Sao2 measurements, Sao2 values, Second winter, Second winters, Severe illness, Severity, Severity index, Severity indexes, Severity indicators, Severity score, Significant differences, Significant effects, Standard deviation, Strong memorial hospital, Strong relationship, Subtype, Subtypes, Syncytial, Syncytial virus, Tabular analysis, Total visits, Unpublished data, Vaccine, Vaccine development, Virulence, Virulence factors, Virus subtype, West virginia, Yates correction.
Abstract
Two major subtypes of respiratory syncytial virus have been identified. This study assessed the hypothesis that A-subtype infections were more severe than B-subtype infections among the 157 infants hospitalized in two hospitals in Rochester, N.Y., during two winters. Severity was measured both by specific clinical observations and by a severity index that was derived empirically. Among all subjects, several clinical observations suggested that A-subtype infections were more severe. For example, mechanical ventilation was required in 12.6% of those with A-subtype compared with 1.6% of those with B-subtype infection (relative risk=7.88; p=0.01). Among high-risk infants (infants with underlying conditions or age 3 months or less at admission), carbon dioxide tension greater than 45 mm Hg was found in 37.0% of those with A-subtype compared with 12.0% of those with B-subtype infection (relative risk=3.08; p=0.04). In discrete multivariate (logit) analysis, effects of subtype (odds ratio=6.59; p<0.01) on severity remained after adjustment for other statistically significant effects of age less than 3 months, underlying condition, and premature birth. The finding that A-subtype infections were more severe might have important implications for vaccine development, studies of the virulence of respiratory syncytial virus, clinical management (e.g., selection for antiviral therapy), and long-term prognosis.
Url:
DOI: 10.1016/S0022-3476(05)82443-6
Affiliations:
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<term>Alternative hypothesis</term>
<term>Antibody rise</term>
<term>Antiviral therapy</term>
<term>Apnea</term>
<term>Bivariate analysis</term>
<term>Bronchodilator treatment</term>
<term>Bronchopulmonary dysplasia</term>
<term>Bsubtype infections</term>
<term>Clinical importance</term>
<term>Community attack rates</term>
<term>Community surveillance</term>
<term>Continuous variables</term>
<term>Cutoff points</term>
<term>Cytopathic effect</term>
<term>Data collection</term>
<term>Days sao2</term>
<term>Dichotomized</term>
<term>Direct effects</term>
<term>Discrete multivariate</term>
<term>Discrete multivariate analysis</term>
<term>Equal proportions</term>
<term>Family history</term>
<term>First sample</term>
<term>First winter</term>
<term>Greater severity</term>
<term>High risk</term>
<term>High severity score</term>
<term>High severity scores</term>
<term>Hospital beds</term>
<term>Important implications</term>
<term>Infant</term>
<term>Infection</term>
<term>Influence severity</term>
<term>Intensive care unit admission</term>
<term>Laboratory observations</term>
<term>Lrti</term>
<term>Lrti admissions</term>
<term>Lrti episodes</term>
<term>Massachusetts epidemics</term>
<term>Mechanical ventilation</term>
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<term>Multivariate analysis</term>
<term>Normal values</term>
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<term>Odds ratios</term>
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<term>Pediatrics</term>
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<term>Respirations pulse</term>
<term>Respiratory illness</term>
<term>Respiratory syncytial virus</term>
<term>Respiratory syncytial virus infection</term>
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<term>Ribavirin</term>
<term>Ribavirin treatment</term>
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<term>Risk factors</term>
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<term>Sao2 measurements</term>
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<term>Significant effects</term>
<term>Standard deviation</term>
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<front><div type="abstract" xml:lang="en">Two major subtypes of respiratory syncytial virus have been identified. This study assessed the hypothesis that A-subtype infections were more severe than B-subtype infections among the 157 infants hospitalized in two hospitals in Rochester, N.Y., during two winters. Severity was measured both by specific clinical observations and by a severity index that was derived empirically. Among all subjects, several clinical observations suggested that A-subtype infections were more severe. For example, mechanical ventilation was required in 12.6% of those with A-subtype compared with 1.6% of those with B-subtype infection (relative risk=7.88; p=0.01). Among high-risk infants (infants with underlying conditions or age 3 months or less at admission), carbon dioxide tension greater than 45 mm Hg was found in 37.0% of those with A-subtype compared with 12.0% of those with B-subtype infection (relative risk=3.08; p=0.04). In discrete multivariate (logit) analysis, effects of subtype (odds ratio=6.59; p<0.01) on severity remained after adjustment for other statistically significant effects of age less than 3 months, underlying condition, and premature birth. The finding that A-subtype infections were more severe might have important implications for vaccine development, studies of the virulence of respiratory syncytial virus, clinical management (e.g., selection for antiviral therapy), and long-term prognosis.</div>
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