Respiratory syncytial virus and seasonal influenza cause similar illnesses in children with sickle cell disease
- 31 January 2014
- journal article
- research article
- Published by Wiley in Pediatric Blood & Cancer
- Vol. 61 (5), 875-878
- https://doi.org/10.1002/pbc.24887
Abstract
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 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.Keywords
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