RSV Severe Infection Risk Stratification in a French 5-Year Birth Cohort Using Machine-learning.
Journal
The Pediatric infectious disease journal
ISSN: 1532-0987
Titre abrégé: Pediatr Infect Dis J
Pays: United States
ID NLM: 8701858
Informations de publication
Date de publication:
07 May 2024
07 May 2024
Historique:
medline:
7
5
2024
pubmed:
7
5
2024
entrez:
7
5
2024
Statut:
aheadofprint
Résumé
Respiratory syncytial virus (RSV) poses a substantial threat to infants, often leading to challenges in hospital capacity. With recent pharmaceutical developments to be used during the prenatal and perinatal periods aimed at decreasing the RSV burden, there is a pressing need to identify infants at risk of severe disease. We aimed to stratify the risk of developing a clinically severe RSV infection in infants under 1 year of age. This retrospective observational study was conducted at the Hospices Civils de Lyon, France, involving infants born between 2014 and 2018. This study focused on infants hospitalized with severe and very severe acute lower respiratory tract infections associated with RSV (SARI-WI group). Data collection included perinatal information and clinical data, with machine-learning algorithms used to discriminate SARI-WI cases from nonhospitalized infants. Of 42,069 infants, 555 developed SARI-WI. Infants born in November were very likely (>80%) predicted SARI-WI. Infants born in October were very likely predicted SARI-WI except for births at term by vaginal delivery and without siblings. Infants were very unlikely (<10%) predicted SARI-WI when all the following conditions were met: born in other months, at term, by vaginal delivery and without siblings. Other infants were possibly (10-30%) or probably (30-80%) predicted SARI-WI. Although RSV preventive measures are vital for all infants, and specific recommendations exist for patients with high-risk comorbidities, in situations where prioritization becomes necessary, infants born just before or within the early weeks of the epidemic should be considered as a risk group.
Sections du résumé
BACKGROUND
BACKGROUND
Respiratory syncytial virus (RSV) poses a substantial threat to infants, often leading to challenges in hospital capacity. With recent pharmaceutical developments to be used during the prenatal and perinatal periods aimed at decreasing the RSV burden, there is a pressing need to identify infants at risk of severe disease. We aimed to stratify the risk of developing a clinically severe RSV infection in infants under 1 year of age.
METHODS
METHODS
This retrospective observational study was conducted at the Hospices Civils de Lyon, France, involving infants born between 2014 and 2018. This study focused on infants hospitalized with severe and very severe acute lower respiratory tract infections associated with RSV (SARI-WI group). Data collection included perinatal information and clinical data, with machine-learning algorithms used to discriminate SARI-WI cases from nonhospitalized infants.
RESULTS
RESULTS
Of 42,069 infants, 555 developed SARI-WI. Infants born in November were very likely (>80%) predicted SARI-WI. Infants born in October were very likely predicted SARI-WI except for births at term by vaginal delivery and without siblings. Infants were very unlikely (<10%) predicted SARI-WI when all the following conditions were met: born in other months, at term, by vaginal delivery and without siblings. Other infants were possibly (10-30%) or probably (30-80%) predicted SARI-WI.
CONCLUSIONS
CONCLUSIONS
Although RSV preventive measures are vital for all infants, and specific recommendations exist for patients with high-risk comorbidities, in situations where prioritization becomes necessary, infants born just before or within the early weeks of the epidemic should be considered as a risk group.
Identifiants
pubmed: 38713818
doi: 10.1097/INF.0000000000004375
pii: 00006454-990000000-00850
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Investigateurs
Emilie Bard
(E)
Sylvie Bin
(S)
Marine Butin
(M)
Regine Cartier
(R)
Olivier Claris
(O)
Sandrine Couray-Targe
(S)
Lélia Duclaux-Loras
(L)
Antoine Duclos
(A)
Sylvie Fiorini
(S)
Julie Fort-Jacquier
(J)
Pascal Gaucherand
(P)
Alexandre Gaymard
(A)
Yves Gillet
(Y)
Julie Haesebaert
(J)
Etienne Javouhey
(E)
Marine Jourdain
(M)
Rolf Kramer
(R)
Bruno Lina
(B)
Jerome Massardier
(J)
Elsa Masson
(E)
Mona Massoud
(M)
Yahia Mekki
(Y)
Florence Morfin
(F)
Anne-Florence Myard Dury
(AM)
Michelle Ottmann
(M)
Antoine Ouziel
(A)
Luc Panetta
(L)
Stephanie Polazzi
(S)
Aurélie Portefaix
(A)
Nathalie Rivat
(N)
Olivier Terrier
(O)
Martine Valette
(M)
Philippe Vanhems
(P)
Informations de copyright
Copyright © 2024 The Author(s). Published by Wolters Kluwer Health, Inc.
Déclaration de conflit d'intérêts
M.C.N. reports grants from the Bill & Melinda Gates Foundation, European & Developing Countries Clinical Trials Partnership, Pfizer, AstraZeneca, and Sanofi; and personal fees Sanofi. The other authors have no funding or conflicts of interest to disclose.
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