title: Down's syndrome is a risk factor for severe lower respiratory tract infection due to respiratory syncytial virus.
abstract: OBJECTIVE
  Previous studies have suggested that Down's syndrome is an independent risk factor for severe respiratory infection due to respiratory syncytial virus (RSV). We compared the clinical characteristics of children with and without Down's syndrome hospitalised due to RSV.
  
  
  METHODS
  This retrospective cohort study compared data from hospitalisations due to RSV lower respiratory tract infections (LRTI) in children under 14 years of age with (n = 58) and without (n = 58) Down's syndrome.
  
  
  RESULTS
  The Down's group had longer hospital stays than the controls of six versus four days (p < 0.0001), even after adjusting for age, weeks of gestation at birth, presence of asthma, bronchopulmonary dysplasia, haemodynamically significant and nonsignificant congenital heart disease. This difference increased when only children under one year of age were analysed to 11 versus five days (p < 0.0001). Children with Down's syndrome were more likely to be admitted to intensive care unit (43.1% versus 22.4%, p = 0.017), need noninvasive mechanical ventilation (36.2% versus 13.7%, p = 0.005) and be prescribed antibiotics and steroids.
  
  
  CONCLUSIONS
  Children with Down's syndrome hospitalised due to RSV LRTI had longer hospital stays and worse clinical courses than controls, highlighting the need for RSV prophylaxis for children with Down's syndrome, especially under one year of age.
authors.affiliation: Division of Paediatrics, School of Medicine, Pontificia Universidad Católica de Chile, Santiago, Chile.
authors.forename: Constanza
authors.initials: C
authors.lastname: Galleguillos
authors.affiliation: Department of Traumatology, School of Medicine, Universidad de Chile, Santiago, Chile.
authors.forename: Bárbara
authors.initials: B
authors.lastname: Galleguillos
authors.affiliation: Division of Paediatrics, School of Medicine, Pontificia Universidad Católica de Chile, Santiago, Chile.
authors.forename: Guillermo
authors.initials: G
authors.lastname: Larios
authors.affiliation: Division of Paediatrics, Hospital Dr. Sótero del Río, School of Medicine, Pontificia Universidad Católica de Chile, Santiago, Chile.
authors.forename: Gonzalo
authors.initials: G
authors.lastname: Menchaca
authors.affiliation: University Medical Center-Utrecht, Utrecht, The Netherlands.
authors.forename: Louis
authors.initials: L
authors.lastname: Bont
authors.affiliation: Division of Paediatrics, School of Medicine, Pontificia Universidad Católica de Chile, Santiago, Chile. jacastro17@homail.com.
authors.forename: Jose A
authors.initials: JA
authors.lastname: Castro-Rodriguez
mesh_terms: D002648:Child; D002675:Child, Preschool; D002677:Chile / Q000453:epidemiology; D015897:Comorbidity; D004314:Down Syndrome / Q000150:complications* / Q000453:epidemiology / Q000276:immunology; D005260:Female; D017052:Hospital Mortality; D006801:Humans; D007223:Infant; D007297:Inpatients / Q000706:statistics & numerical data*; D015278:Intensive Care Units, Pediatric / Q000706:statistics & numerical data; D007902:Length of Stay / Q000706:statistics & numerical data; D008297:Male; D012121:Respiration, Artificial / Q000706:statistics & numerical data; D018357:Respiratory Syncytial Virus Infections / Q000453:epidemiology / Q000401:mortality*; D012189:Retrospective Studies; D012307:Risk Factors; D012720:Severity of Illness Index
keywords: Congenital heart disease; Down's syndrome; Palivizumab; Respiratory syncytial virus; Risk factors