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Down syndrome carries increased risk of severe RSV infection

07 Sep 2018

Children with Down syndrome (DS) appear to have an elevated risk of developing severe respiratory syncytial virus (RSV) infection, a study has found.

Researchers performed a systematic review and meta-analysis of 12 studies representing 1,149,171 children, among whom 3,662 had DS, from 10 different countries. The main outcomes investigated were hospital admission and mortality. Secondary outcomes included length of hospital stay, oxygen requirement, ICU admission, need for respiratory support and additional medication use.

Pooled data revealed that DS was associated with increased risks of hospitalization (odds ratio [OR], 8.69; 95 percent CI, 7.33–10.30; I2=11 percent) and mortality (OR, 9.4; 2.26–39.15; I2=38 percent).

Similar results were obtained for the secondary outcomes. The chromosomal disorder was associated with prolonged hospital stay (mean difference, 4.73 days; 2.12–7.33; I2=0 percent), higher likelihood of oxygen requirement (OR, 6.53; 2.22–19.19; I2=0 percent), ICU admission (OR, 2.56; 1.17–5.59; I2=0 percent), need for mechanical ventilation (OR, 2.56; 1.17–5.59; I2=0 percent) and additional medication use (OR for systemic corticosteroids, 2.65; 1.38–5.08; I2=0 percent and OR for antibiotics, 5.82; 2.66–12.69; I2=0 percent).

Researchers pointed out that the present data carry high importance and consequences for public health, given that DS is the most common chromosomal disorder worldwide and that RSV is associated with a substantial percentage of all acute lower respiratory tract infections (LRTIs) and account for considerable LRTI mortality in young children.

For that reason, any potential approach to reduce RSV infection (eg, prophylaxis with monoclonal antibodies or new vaccines) in children with DS could improve morbidity and mortality in this population, researchers added.

The present analysis might be limited by the absence of a subgroup of DS patients with and without CHD or other additional risk factors in some of the included studies.

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