Risk of Respiratory Syncytial Virus Infection in Cyanotic Congenital Heart Disease in a Subtropical Area

J Pediatr. 2016 Apr:171:25-30.e1. doi: 10.1016/j.jpeds.2015.12.029. Epub 2016 Jan 25.

Abstract

Objective: To compare the risk of respiratory syncytial virus (RSV)-associated hospitalization and analyze the epidemiology of RSV infection in patients with cyanotic and acyanotic congenital heart disease (CHD), we analyzed the nationwide health insurance database from 2005-2010.

Study design: This study included 1050 patients with cyanotic CHD and 7077 patients with acyanotic CHD. Patients with acyanotic CHD were further classified into hemodynamically significant (hs)-acyanotic and non-hs-acyanotic groups according to whether they underwent surgery or took at least 2 anticongestive medications.

Results: RSV-associated hospitalization was higher in the cyanotic group than in hs-acyanotic and non-hs-acyanotic groups both before 1 year of age (4.8% vs 2.1% vs 1.5%, P < .001) and between 1 and 2 years of age (0.9% vs 0.56% vs 0.14%, P = .003). The hospitalization duration, intensive care, ventilator support prevalence, hospitalization cost, and mortality rate were significantly higher in the cyanotic group than in the other 2 groups. Logistic regression revealed that cyanotic CHD was the most significant risk factor for the ventilator support and RSV-associated mortality. In both patients with cyanotic and acyanotic CHD, RSV-associated hospitalization rate was higher in patients aged younger than 1 year and in spring and autumn in Taiwan, a subtropical country.

Conclusions: The results show that patients with cyanotic CHD have a higher risk of severe RSV infection than do those with acyanotic CHD. RSV prophylaxis is more important and may reduce costs more for patients with cyanotic CHD.

MeSH terms

  • Antiviral Agents / therapeutic use
  • Cyanosis / complications
  • Cyanosis / diagnosis*
  • Cyanosis / epidemiology
  • Databases, Factual
  • Female
  • Heart Defects, Congenital / complications
  • Heart Defects, Congenital / diagnosis*
  • Heart Defects, Congenital / epidemiology
  • Hemodynamics
  • Hospitalization
  • Humans
  • Incidence
  • Infant
  • Infant, Newborn
  • Insurance, Health
  • Male
  • Palivizumab / therapeutic use
  • Registries
  • Respiratory Syncytial Virus Infections / complications*
  • Respiratory Syncytial Virus Infections / diagnosis*
  • Respiratory Syncytial Virus Infections / epidemiology
  • Respiratory Syncytial Viruses
  • Risk
  • Seasons
  • Taiwan

Substances

  • Antiviral Agents
  • Palivizumab