The severity of respiratory syncytial disease (RSV) in infants can be predicted from clinical findings and the viral strain.
Parameters found to be associated with severe disease:
(1) premature birth
(2) presence of an underlying condition
(3) age of infant at time of infection
(4) viral strain
RSV viral strains: A or B
Underlying conditions:
(1) bronchopulmonary dysplasia
(2) cystic fibrosis
(3) previously diagnosed with asthma
(4) congenital heart disease
(5) HIV infection (immunodeficiency state)
(6) leukemia (immunodeficiency state)
(7) chemotherapy for malignancy (immunodeficiency state)
(8) corticosteroid therapy (immunodeficiency state; not listed in paper)
(9) Down's syndrome (immunodeficiency state)
(10) severe neuromuscular disorder
(11) swallowing disorder
|
Predictors of Severe RSV Disease |
lambda |
standard error |
Odds Ratio (95% confidence interval) |
|
premature birth |
0.1508 |
0.1128 |
1.83 (0.87 - 3.84) |
|
underlying condition |
0.2613 |
0.1264 |
2.84 (1.24 - 6.53) |
|
age <= 3 months |
0.3698 |
0.1072 |
4.39 (2.19 - 8.88) |
|
group A virus |
0.2952 |
0.1046 |
3.26 (1.64 - 6.48) |
|
intercept |
0.8260 |
0.1094 |
|
(after Table 6, page 817)
With 4 variables, there are 2^4 = 16 combinations:
|
Premature |
Underlying Condition |
Age <= 3 months |
Virus Group A |
Percent with severe disease |
|
N |
N |
N |
N |
2% |
|
N |
N |
N |
Y |
7% |
|
N |
N |
Y |
N |
9% |
|
N |
N |
Y |
Y |
24% |
|
N |
Y |
N |
N |
6% |
|
N |
Y |
N |
Y |
17% |
|
N |
Y |
Y |
N |
22% |
|
N |
Y |
Y |
Y |
48% |
|
Y |
N |
N |
N |
4% |
|
Y |
N |
N |
Y |
12% |
|
Y |
N |
Y |
N |
15% |
|
Y |
N |
Y |
Y |
37% |
|
Y |
Y |
N |
N |
10% |
|
Y |
Y |
N |
Y |
27% |
|
Y |
Y |
Y |
N |
34% |
|
Y |
Y |
Y |
Y |
62% |
(after Table 5, page 817)
Limitations:
• The information on the viral strain may not be readily available.
Specialty: Infectious Diseases, Pedatrics
