TY - JOUR
T1 - Respiratory syncytial virus and seasonal influenza cause similar illnesses in children with sickle cell disease
AU - Sadreameli, Sara Christina
AU - Reller, Megan E.
AU - Bundy, David G.
AU - Casella, James F.
AU - Strouse, John J.
PY - 2014/5
Y1 - 2014/5
N2 - Background: Respiratory syncytial virus (RSV) is a cause of acute chest syndrome (ACS) in sickle cell disease (SCD), but its clinical course and acute complications have not been well characterized. We compared RSV to seasonal influenza infections in children with SCD. Procedure: We defined cases as laboratory-confirmed RSV or seasonal influenza infection in inpatients and outpatients <18 years of age with SCD from 1 September 1993 to 30 June 2011. We used Fisher's exact test to compare proportions, Student's t-test or Wilcoxon rank-sum test to compare continuous variables, and logistic regression to evaluate associations. Results: We identified 64 children with RSV and 91 with seasonal influenza. Clinical symptoms, including fever, cough, and rhinorrhea were similar for RSV and influenza, as were complications, including ACS and treatments for SCD. In a multivariable logistic regression model, older age (OR 1.2 per year, 95% CI [1.02-1.5], P=0.04), increased white blood cell count at presentation (OR 1.1 per 1,000/μl increase, 95% CI [1.03-1.3], P=0.008), and a history of asthma (OR 7, 95% [CI 1.3-37], P=0.03) were independently associated with increased risk of ACS in children with RSV. The hospitalization rate for children with SCD and RSV (40 per 1,000 <5 years and 63 per 1,000 <2 years) greatly exceeds the general population (3 in 1,000 <5 years). Conclusions: We conclude that RSV infection is often associated with ACS and similar in severity to influenza infection in febrile children with SCD. Pediatr Blood Cancer 2014;61:875-878.
AB - Background: Respiratory syncytial virus (RSV) is a cause of acute chest syndrome (ACS) in sickle cell disease (SCD), but its clinical course and acute complications have not been well characterized. We compared RSV to seasonal influenza infections in children with SCD. Procedure: We defined cases as laboratory-confirmed RSV or seasonal influenza infection in inpatients and outpatients <18 years of age with SCD from 1 September 1993 to 30 June 2011. We used Fisher's exact test to compare proportions, Student's t-test or Wilcoxon rank-sum test to compare continuous variables, and logistic regression to evaluate associations. Results: We identified 64 children with RSV and 91 with seasonal influenza. Clinical symptoms, including fever, cough, and rhinorrhea were similar for RSV and influenza, as were complications, including ACS and treatments for SCD. In a multivariable logistic regression model, older age (OR 1.2 per year, 95% CI [1.02-1.5], P=0.04), increased white blood cell count at presentation (OR 1.1 per 1,000/μl increase, 95% CI [1.03-1.3], P=0.008), and a history of asthma (OR 7, 95% [CI 1.3-37], P=0.03) were independently associated with increased risk of ACS in children with RSV. The hospitalization rate for children with SCD and RSV (40 per 1,000 <5 years and 63 per 1,000 <2 years) greatly exceeds the general population (3 in 1,000 <5 years). Conclusions: We conclude that RSV infection is often associated with ACS and similar in severity to influenza infection in febrile children with SCD. Pediatr Blood Cancer 2014;61:875-878.
KW - Acute chest syndrome
KW - Influenza
KW - Respiratory syncytial virus
KW - Sickle cell disease
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U2 - 10.1002/pbc.24887
DO - 10.1002/pbc.24887
M3 - Article
C2 - 24481883
AN - SCOPUS:84895733616
SN - 1545-5009
VL - 61
SP - 875
EP - 878
JO - Pediatric Blood and Cancer
JF - Pediatric Blood and Cancer
IS - 5
ER -