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2018

ANUÁRIO DO HOSPITAL DONA ESTEFÂNIA
REPOSITÓRIO MÉDICO CIENTÍFICO

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RESPIRATORY SYNCYTIAL VIRUS INFECTION AND RISK FACTORS FOR COMPLICATIONS

Luís Rodrigues1, Tânia Mendo1, Luís Carlos Costa1, Rita Corte Real2, Maria João Brito1

1- Infectious Diseases Unit, Hospital de Dona Estefânia Centro Hospitalar de Lisboa Central, Lisboa, Portugal
2- Clinical Pathology Service, Hospital de Dona Estefânia Centro Hospitalar de Lisboa Central, Lisboa, Portugal

- 35th Annual Meeting of the European Society for Paediatric Infectious Diseases (ESPID). Madrid, 23 a 27 de Maio de 2017.
- Apresentação em poster e publicação sob a forma de resumo

Resumo:
Background: Respiratory syncytial virus (RSV) is the leading cause of lower respiratory tract infections in the first two years of life and is responsible for an important number of hospital admissions. The aim of this study was to identify the risk factors for complications in patients with RSV admitted to a tertiary hospital in Lisbon.
Methods:A retrospective study was performed between January 2015 and June 2016. Demographic and socioeconomic data, risk factors and complications were analysed.
Results:A total of 146 patients were included with a median age at admission of 7 months. 68,5% had older siblings, 44,5% were from a poor socioeconomic context, 30,1% had smoking parents and 34,2% attended day-care. 32,9% children had a family history of asthma and 36,3% had reactive airway disease. 13% had a history of prematurity and 21,9% had chronic disease: congenital heart disease (11), chronic lung disease (13) and immunodeficiency (8). We found coinfection with another virus in 64 (43,8%) patients. Complications occurred in 89,1% of the patients: hypoxemia (79,5%), secondary bacterial infection (58,2%), respiratory failure (19,9%), atelectasis (7,5%) and apnea (2,7%). 8,2% of the patients needed intensive care and mechanical ventilation. There was no mortality. Congenital heart disease (p=0.029) resulted as risk factor for apnea. A poor socioeconomic context (p=0.021) and chronic lung disease (p=0.023) were risk factors for respiratory failure and reactive airway disease (p=0.001) a risk factor for hypoxemia. No child with complications had made palivizumab.
Conclusions: Viral co-infection may contribute to a worse prognosis but RSV has the potential to cause severe lower respiratory tract infections. There is no specific and antiviral therapeutics. In high-risk groups it is important to establish clear national guidelines to the prevention of RSV infection.

Palavras Chave: Complications; Respiratory syncytial virus; Risk factors