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Suppl 2: Risk Factors for Severe Respiratory Syncytial Virus Lower Respiratory Tract Infection

机译:补充2:严重呼吸道合胞病毒下呼吸道感染的危险因素

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摘要

RSV infection is a leading cause of lower respiratory tract infection, especially in High-risk infants with a history of prematurity, bronchopulmonary dysplasia (BPD), congenital heart disease (CHD), neuromusculair impairment, immunodeficiency, and Down syndrome. Host related risk factors that have been identified to be associated with severe RSV related lower respiratory tract infection include young age below 6 months at the beginning of RSV season, multiple birth, male sex, low socioeconomic status and parental education, crowded living conditions, young siblings, maternal smoking and indoor smoke pollution, malnutrition/small for gestational age, family history of atopy or asthma, low cord serum RSV antibody titers, and living at altitude.Risk factors increasing the risk of acquisition of RSV have been identified to be birth before and/or during RSV season, day care attendance, presence of older siblings in school or day-care, and lack of breast feeding. Some of these risk factors are discussed controversially and some of them are found continuously throughout the literature.Given the high cost of RSV prophylaxis, especially for the large population of late preterm infants, algorithms and risk score systems have been published that could identify high-risk infants for treatment with palivizumab out of this gestational age group. Several models reported on an average sensitivity and specificity of 70 percent and, thus, are helpful to identify infants at high risk for severe RSV infection and need for prophylaxis with palivizumab.
机译:RSV感染是下呼吸道感染的主要原因,尤其是在有早产,支气管肺发育异常(BPD),先天性心脏病(CHD),神经肌肉疾病,免疫缺陷和唐氏综合症的高危婴儿中。已确定与严重RSV相关的下呼吸道感染相关的与宿主相关的危险因素包括RSV季节开始时小于6个月的年轻人,多胎,男性,社会经济地位和父母教育程度低,生活条件拥挤,年轻兄弟姐妹,孕妇吸烟和室内烟雾污染,营养不良/胎龄少,特应性或哮喘的家族病史,脐带血RSV抗体滴度低以及在高海拔地区生活。已发现增加获得RSV的风险的危险因素是出生的。在RSV季节之前和/或期间,日间护理出勤,年长的兄弟姐妹在学校或日间护理中存在以及缺乏母乳喂养。鉴于有争议的这些危险因素中有一些受到争议,整个文献中也不断发现。鉴于RSV预防的成本高昂,特别是对于大量早产婴儿,已发布了可以识别高危早产儿的算法和风险评分系统。在这个胎龄组之外的婴儿中使用帕利珠单抗进行治疗的风险较高。几种模型报道的平均敏感性和特异性为70%,因此有助于鉴定出患严重RSV感染的高风险婴儿以及需要预防使用帕利珠单抗的婴儿。

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