Global respiratory syncytial virus-associated mortality in young children (RSV GOLD): a retrospective case series.
Global respiratory syncytial virus-associated mortality in young children (RSV GOLD): a retrospective case series.
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DOI：
10.1016/s2214-109x(17)30344-3
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发表时间：
2017-10
期刊：
影响因子：
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通讯作者：
Bont LJ
中科院分区：
文献类型：
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作者：
Scheltema NM;Gentile A;Lucion F;Nokes DJ;Munywoki PK;Madhi SA;Groome MJ;Cohen C;Moyes J;Thorburn K;Thamthitiwat S;Oshitani H;Lupisan SP;Gordon A;Sánchez JF;O'Brien KL;PERCH Study Group;Gessner BD;Sutanto A;Mejias A;Ramilo O;Khuri-Bulos N;Halasa N;de-Paris F;Pires MR;Spaeder MC;Paes BA;Simões EAF;Leung TF;da Costa Oliveira MT;de Freitas Lázaro Emediato CC;Bassat Q;Butt W;Chi H;Aamir UB;Ali A;Lucero MG;Fasce RA;Lopez O;Rath BA;Polack FP;Papenburg J;Roglić S;Ito H;Goka EA;Grobbee DE;Nair H;Bont LJ
呼吸道合胞病毒（RSV）感染是幼儿肺炎死亡的重要原因。然而，致死性 RSV 感染的临床数据很少。我们的目的是利用个体患者数据来确定 5 岁以下儿童的临床和社会经济特征以及 RSV 相关死亡率。在这个回顾性病例系列中，我们开发了一份在线调查问卷，通过综合文献检索和现有研究网络确定的儿童肺炎领先研究小组，获取1995年1月1日至2015年10月31日期间死于社区获得性RSV感染的5岁以下儿童的临床和社会经济特征的个体患者数据。对于文献检索，我们检索了 PubMed 中截至 2015 年 2 月 3 日发表的文章，使用关键词“RSV”、“呼吸道合胞病毒”或“呼吸道合胞病毒”并结合“mortality”、“fatality”、“death”、“died”、“deaths”或“CFR”以英语发表的文章。我们邀请了确定在2014年11月1日至2015年10月31日期间参与的研究人员和临床医生。我们计算了所有变量的描述性统计数据。我们研究了来自全球 23 个国家的 358 名因 RSV 相关院内死亡的儿童，数据来自 31 个研究小组。 117 名儿童（33%）来自低收入或中低收入国家，77 名儿童（22%）来自中高收入国家，164 名儿童（46%）来自高收入国家。 190 名（53%）为男性。低收入和中等收入国家的一些儿童的合并症数据缺失。现有数据显示，来自低收入或中低收入国家的至少 33 名儿童（28%）、中高收入国家的 36 名儿童（47%）和高收入国家的 114 名儿童（70%）存在合并症。低收入或中低收入国家 RSV 相关死亡的中位年龄为 5·0 个月（IQR 2·3–11·0），中高收入国家为 4·0 岁（2·0–10·0），高收入国家为 7·0 岁（3·6–16·8）。这项研究是第一个针对死于社区获得性 RSV 感染的儿童的大型病例系列研究。相当一部分因 RSV 相关死亡的儿童患有合并症。我们的结果表明，针对 6 个月以下儿童的围产期免疫策略可能会对低收入和中等收入国家与 RSV 相关的儿童死亡率产生重大影响。比尔及梅琳达·盖茨基金会。
Respiratory syncytial virus (RSV) infection is an important cause of pneumonia mortality in young children. However, clinical data for fatal RSV infection are scarce. We aimed to identify clinical and socioeconomic characteristics of children aged younger than 5 years with RSV-related mortality using individual patient data. In this retrospective case series, we developed an online questionnaire to obtain individual patient data for clinical and socioeconomic characteristics of children aged younger than 5 years who died with community-acquired RSV infection between Jan 1, 1995, and Oct 31, 2015, through leading research groups for child pneumonia identified through a comprehensive literature search and existing research networks. For the literature search, we searched PubMed for articles published up to Feb 3, 2015, using the key terms “RSV”, “respiratory syncytial virus”, or “respiratory syncytial viral” combined with “mortality”, “fatality”, “death”, “died”, “deaths”, or “CFR” for articles published in English. We invited researchers and clinicians identified to participate between Nov 1, 2014, and Oct 31, 2015. We calculated descriptive statistics for all variables. We studied 358 children with RSV-related in-hospital death from 23 countries across the world, with data contributed from 31 research groups. 117 (33%) children were from low-income or lower middle-income countries, 77 (22%) were from upper middle-income countries, and 164 (46%) were from high-income countries. 190 (53%) were male. Data for comorbidities were missing for some children in low-income and middle-income countries. Available data showed that comorbidities were present in at least 33 (28%) children from low-income or lower middle-income countries, 36 (47%) from upper middle-income countries, and 114 (70%) from high-income countries. Median age for RSV-related deaths was 5·0 months (IQR 2·3–11·0) in low-income or lower middle-income countries, 4·0 years (2·0–10·0) in upper middle-income countries, and 7·0 years (3·6–16·8) in high-income countries. This study is the first large case series of children who died with community-acquired RSV infection. A substantial proportion of children with RSV-related death had comorbidities. Our results show that perinatal immunisation strategies for children aged younger than 6 months could have a substantial impact on RSV-related child mortality in low-income and middle-income countries. Bill & Melinda Gates Foundation.