Variable morbidity of respiratory syncytial virus infection in patients with underlying lung disease: a review of the PICNIC RSV database. Pediatric Investigators Collaborative Network on Infections in Canada.
OBJECTIVE
We wished to compare outcomes of respiratory syncytial virus (RSV) infection in children with bronchopulmonary dysplasia (BPD) with those with other pulmonary disorders: cystic fibrosis, recurrent aspiration pneumonitis, pulmonary malformation, neurogenic disorders interfering with pulmonary toilet, and tracheoesophageal fistula.


METHODS
Children with RSV infection hospitalized at seven Canadian pediatric tertiary care hospitals in 1993 through 1994 and 9 hospitals in 1994 through 1995 were enrolled and prospectively followed. This study is a secondary analysis of data from this prospective cohort.


RESULTS
Of the 1516 patients enrolled the outcomes of 159 with preexisting lung disorders before RSV lower respiratory tract infection constitute this report. There were no significant differences among the 7 groups (BPD, cystic fibrosis, recurrent aspiration pneumonitis, pulmonary malformation, neurogenic disorders interfering with pulmonary toilet, tracheoesophageal fistula, other) for the morbidity measures: duration of hospitalization, intensive care unit (ICU) admission, duration of ICU stay, mechanical ventilation and duration of mechanical ventilation. Patients using home oxygen were more likely to be admitted to the ICU than those who had never or previously used home oxygen (current 57.1%, past 23.8%, never 33.3%, P = 0.03).


CONCLUSIONS
Children with other underlying diseases have morbidity similar to those with BPD. Prophylactic interventions against RSV should also be studied in these groups.
Arnold
S R
SR
Department of Pediatrics, The Hospital for Sick Children, University of Toronto, Ontario, Canada.
Wang
E E
EE
Law
B J
BJ
Boucher
F D
FD
Stephens
D
D
Robinson
J L
JL
Dobson
S
S
Langley
J M
JM
McDonald
J
J
MacDonald
N E
NE
Mitchell
I
I
D001997:Bronchopulmonary Dysplasia / Q000150:complications / Q000453:epidemiology / Q000821:virology; D002170:Canada; D006760:Hospitalization; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008171:Lung Diseases / Q000150:complications* / Q000453:epidemiology* / Q000821:virology; D009017:Morbidity; D011446:Prospective Studies; D012121:Respiration, Artificial; D018357:Respiratory Syncytial Virus Infections / Q000150:complications* / Q000453:epidemiology*; D018709:Statistics, Nonparametric