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RISK FACTORS FOR BRONCHIOLITIS HOSPITALIZATIONS IN CHILDREN WITH CHRONIC DISEASES
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  • Einat Shmueli,
  • Ori Goldberg,
  • Meir Mei-Zahav,
  • Patrick Stafler,
  • Ophir Bar-On,
  • Hagit Levine,
  • Guy Steuer,
  • Yulia Gendler,
  • Huda Mussaffi,
  • Hannah Blau,
  • Dario Prais
Einat Shmueli
Schneider Children's Medical Center of Israel
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Ori Goldberg
Schneider Children's Medical Center of Israel
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Meir Mei-Zahav
Schneider Children's Medical Center of Israel
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Patrick Stafler
Schneider Children's Medical Center of Israel
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Ophir Bar-On
Schneider Children's Medical Center of Israel
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Hagit Levine
Schneider Children's Medical Center of Israel
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Guy Steuer
Schneider Children's Medical Center of Israel
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Yulia Gendler
Ariel University
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Huda Mussaffi
Schneider Children's Medical Center of Israel
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Hannah Blau
Schneider Children's Medical Center of Israel
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Dario Prais
Schneider Children's Medical Center of Israel
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Abstract

Background: Respiratory syncytial virus (RSV) bronchiolitis is the most common lower respiratory tract disorder causing hospitalization in infants. Palivizumab has shifted the profile of the hospitalized population away from premature infants and towards those with chronic morbidities who are not eligible for prophylaxis. Aim: To characterize RSV bronchiolitis hospitalizations in infants with chronic diseases, compared to otherwise healthy infants. Methods: A four consecutive RSV season retrospective analysis of patients younger than two years admitted with bronchiolitis. Background demographic and clinical data, including vital sign measurements, laboratory tests, and pediatric intensive care unit (PICU) admissions during hospitalization, were analyzed. Results: Of 1124 hospitalizations due to RSV bronchiolitis, 244 (22%) were in infants with chronic diseases. Although 20/1124 qualified for RSV prophylaxis, only 8 had been vaccinated. Compared to otherwise healthy infants, children with chronic diseases had longer hospitalizations, median 4 days (IQR 4-7) vs 3 days (2-5), p<0.001; and higher PICU and readmission rates (9% vs 4.5%, p=0.007 and 3% vs 1%, p=0.055, respectively). Children with Down’s syndrome comprised 2% of all hospitalizations, but 8% of PICU admissions; their median length of hospitalization was 11 days. Respiratory tract malformations were present in 2% of hospitalizations, and comprised 4% of PICU admissions. Conclusion: Infants with chronic diseases admitted with RSV bronchiolitis are prone to longer hospitalization and PICU admission. Children with Down’s syndrome and respiratory tract malformations may benefit from RSV prophylaxis.

Peer review status:ACCEPTED

30 Oct 2020Submitted to Pediatric Pulmonology
02 Nov 2020Submission Checks Completed
02 Nov 2020Assigned to Editor
04 Nov 2020Reviewer(s) Assigned
16 Nov 2020Review(s) Completed, Editorial Evaluation Pending
19 Nov 2020Editorial Decision: Revise Major
15 Feb 20211st Revision Received
16 Feb 2021Submission Checks Completed
16 Feb 2021Assigned to Editor
16 Feb 2021Reviewer(s) Assigned
03 Mar 2021Review(s) Completed, Editorial Evaluation Pending
06 Mar 2021Editorial Decision: Revise Minor
04 Apr 20212nd Revision Received
05 Apr 2021Submission Checks Completed
05 Apr 2021Assigned to Editor
05 Apr 2021Reviewer(s) Assigned
14 Apr 2021Review(s) Completed, Editorial Evaluation Pending
15 Apr 2021Editorial Decision: Accept