Citations 2
Infants Admitted to US Intensive Care Units for RSV Infection During the 2022 Seasonal Peak
Halasa, Natasha , Zambrano, Laura D. , Stewart, Laura S , Newhams, Margaret M. , Levy, Emily R. , Carroll, Christopher L. , Fitzgerald, Julie C. , Bline, Katherine , Cullimore, Melissa L. , Loftis, Laura L. , Jeyapalan, Asumthia , Schwarz, Adam J. , Zinter, Matt S. , Irby, Katherine , Kuebler, Joseph D. , Babbitt, Christopher , Gaspers, Mary Glas , Nofziger, Ryan A. , Kong, Michele , Coates, Bria M. , Schuster, Jennifer E. , Gertz, Shira J. , Mack, Elizabeth H. , White, Benjamin R. , Harvey, Helen , Butler, Andrew , Bradford, Tamara T. , Rowan, Courtney M. , Staat, Mary Allen , Aguiar, Cassyanne L. , Randolph, Adrienne G. , Campbell, Angela P. , Investigators, RSV-PIC, Tomcany, Merry, Price, Heather E. , Sanders, Ronald C., Dixon, Lexie, Kücükak, Suden, McNamara, Elizabeth R, Chen, Sabrina R., Listerud, Eve, Vargas-Shiraishi, Ofelia, Oberle, Betty, Zorensky, Frances, Mansour, Rachel, Jumarang, Jaycee , Johnston, Marla , Bush, Jenny L., Dickey, Shawn, Sullivan, Melissa, Kietzman, Abigail , Colston, Candice , Murdock, Meghan, Kelley, Heather M., Wright-Sexton, Laura, Martin, Maygan, Malloch, Lacy , Patterson, Kayla, Sanders, Cameron , Rohlfs, Chelsea , Rice, Marilyn, Howard, Miranda, Murphy, M. Gail, Soma, Vijaya L, Job, Megan , Mennie, Colleen, Simkhada, Kamala, Drapeau, Noelle M., Hayek, Haya , Maranto, Molly, Waters, Aubrie, Flowers, Maggie, Havlin, Kevin , Furlong-Dillard, Jamie , Porter, Melissa , Nason, Jennifer, Ray, Madison, Gossett, Kristen, Crandall, Hillary , Heller, Evan G, Foley, Jennifer, Rasal, Rajashri, Marlow, Christine, Senthil, Anurithi, Myers, Kimberly, Tudor, Betsy, Garcia, Nereyda, Treister, Natalie, Sun, Kathleen, Villarreal-Chico, Denise, Kainaroi, Sophia, Levy, Emily R , Randolph, Adrienne G , Kong, Michele , Staat, Mary A , Gertz, Shira J , Bline, Katherine E , Amarin, Justin Z. , Shein, Steven L. , Michaels, Marian G , Montgomery, Vicki , Pannaraj, Pia S. , Cvijanovich, Natalie Z , Maddux, Aline B. , Bembea, Melania M. , Zerr, Danielle M. , Hobbs, Charlotte V. , Dapul, Heda , Wellnitz, Kari , Hymes, Saul , Investigators, RSV-PIC, Michelson, Kelly Nicole , Typpo, Katri , Harwayne‐Gidansky, Ilana , Bush, Jenny, Hill, Shannon, Kelley, Heather, Martin, Lora , Rice, Marilyn, Howard, Miranda, Murphy, Makayla, Ratner, Adam J. , Behl, Supriya , Betters, Kristina Ann , Maranto, Molly , Nason, Jennifer, Marlow, Christine, Myers, Kimberly, Adler, Amanda , Garcia, Nereyda, McQuillen, Patrick S. , Williams, John V.
JAMA Network Open | August 15, 2023 | Volume: 6 | Issue: 8 | Pages: e2328950
10.1001/jamanetworkopen.2023.28950
ImportanceRespiratory syncytial virus (RSV) is the leading cause of lower respiratory tract infections (LRTIs) and infant hospitalization worldwide.ObjectiveTo evaluate the characteristics and outcomes of RSV-related critical illness in US infants during peak 2022 RSV transmission.Design, Setting, and ParticipantsThis cross-sectional study used a public health prospective surveillance registry in 39 pediatric hospitals across 27 US states. Participants were infants admitted for 24 or more hours between October 17 and December 16, 2022, to a unit providing intensive care due to laboratory-confirmed RSV infection.ExposureRespiratory syncytial virus.Main Outcomes and MeasuresData were captured on demographics, clinical characteristics, signs and symptoms, laboratory values, severity measures, and clinical outcomes, including receipt of noninvasive respiratory support, invasive mechanical ventilation, vasopressors or extracorporeal membrane oxygenation, and death. Mixed-effects multivariable log-binomial regression models were used to assess associations between intubation status and demographic factors, gestational age, and underlying conditions, including hospital as a random effect to account for between-site heterogeneity.ResultsThe first 15 to 20 consecutive eligible infants from each site were included for a target sample size of 600. Among the 600 infants, the median (IQR) age was 2.6 (1.4-6.0) months; 361 (60.2%) were male, 169 (28.9%) were born prematurely, and 487 (81.2%) had no underlying medical conditions. Primary reasons for admission included LRTI (594 infants [99.0%]) and apnea or bradycardia (77 infants [12.8%]). Overall, 143 infants (23.8%) received invasive mechanical ventilation (median [IQR], 6.0 [4.0-10.0] days). The highest level of respiratory support for nonintubated infants was high-flow nasal cannula (243 infants [40.5%]), followed by bilevel positive airway pressure (150 infants [25.0%]) and continuous positive airway pressure (52 infants [8.7%]). Infants younger than 3 months, those born prematurely (gestational age <37 weeks), or those publicly insured were at higher risk for intubation. Four infants (0.7%) received extracorporeal membrane oxygenation, and 2 died. The median (IQR) length of hospitalization for survivors was 5 (4-10) days.Conclusions and RelevanceIn this cross-sectional study, most US infants who required intensive care for RSV LRTIs were young, healthy, and born at term. These findings highlight the need for RSV preventive interventions targeting all infants to reduce the burden of severe RSV illness.
BNT162b2 mRNA Vaccination Against Coronavirus Disease 2019 is Associated With a Decreased Likelihood of Multisystem Inflammatory Syndrome in Children Aged 5–18 Years—United States, July 2021 – April 2022
Zambrano, Laura D. , Newhams, Margaret M. , Olson, Samantha M. , Halasa, Natasha , Price, Ashley M. , Orzel, Amber, Boom, Julie A. , Bline, Katherine , Kamidani, Satoshi , Tarquinio, Keiko M. , Schuster, Jennifer E. , Cullimore, Melissa L. , Heidemann, Sabrina M. , Nofziger, Ryan A. , Cameron, Melissa A. , Walker, Tracie C. , Michelson, Kelly N, Coates, Bria M. , Flori, Heidi R. , Mack, Elizabeth H. , Smallcomb, Laura , Gertz, Shira J. , Bhumbra, Samina S. , Bradford, Tamara T. , Levy, Emily R. , Kong, Michele , Irby, Katherine, Zinter, Matt S. , Bowens, Cindy, Crandall, Hillary , Hume, Janet R. , Patel, Manish M, Campbell, Angela P. , Randolph, Adrienne G. , Investigators, for the Overcoming COVID-19, Murdock, Meghan, Gaspers, Mary Glas , Kelley, Connor P. , Irby, Katherine, Sanders, Ronald C., Yates, Masson, Smith, Chelsea , Crane, Katheryn, Lionetti, Geraldina, Murcia-Montoya, Juliana, Villarreal-Chico, Denise, Skura, Adam L., Hakimi, Daniel , Peralta, Harvey, Sea, Yea Ji, Mrotek, Kennis-Grace, Lockwood, Justin M. , Port, Emily, Carson, Imogene A., Chatani, Brandon , Kamidani, Satoshi, Hussaini, Laila, Baida, Nadine, Michelson, Kelly N, Rhodes, Simone T., Khan, Hassan A, Rowan, Courtney M. , Stumpf, Mary, Johnston, Marla , Newhams, Margaret M, Kücükak, Suden, Orzel, Amber O, Chen, Sabrina R., Boutselis, Benjamin J., McCadden, Timothy P. , Stewart, Kasey R, Weller, Edie, Berbert, Laura , He, Jie , Bruno, Ellen R., Goertzen, Lexie A., Drapeau, Noelle M., Martin, Lora , Malloch, Lacy , Harrison, Virginia A., Sanders, Cameron , Patterson, Kayla , Chikere, Chidinma A, Kietzman, Abigail , Sullivan, Melissa, Rinehart, Valerie H., Hoody, Lauren A., Bennett, Paris C., Twinem, Nicole A., Tomcany, Merry, Staat, Mary Allen , Rohlfs, Chelsea C., Wolfe, Amber, Chiotos, Kathleen, Douglas, Rebecca L. , Phengchomphet, Kathlyn, Bickford, Megan M., Wakefield, Lauren E., Hayek, Haya , Romero, Yesenia, Boom, Julie A, Oates, Jennifer N., Maamari, Mia , Bowens, Cindy, Olson, Mady, Zambrano, Laura D, Patel, Manish M, Kamidani, Satoshi , Levy, Emily R , Randolph, Adrienne G , Kong, Michele , Hume, Janet R , Zambrano, Laura D , Staat, Mary A , Gertz, Shira J , Bline, Katherine E , Young, Cameron C. , Sahni, Leila C , Maddux, Aline B. , Chiotos, Kathleen , Hobbs, Charlotte V. , Pannaraj, Pia S. , Schwartz, Stephanie P. , Michelson, Kelly N, Irby, Katherine, Cvijanovich, Natalie Z , Bowens, Cindy, Patel, Manish M, Investigators, for the Overcoming COVID-19, Typpo, Katri , Irby, Katherine, Kamidani, Satoshi, Michelson, Kelly N, Newhams, Margaret M, Orzel, Amber O, Moran, Patrick, Behl, Supriya , Chiotos, Kathleen, Boom, Julie A, Bowens, Cindy, Olson, M, Zambrano, Laura D, Patel, Manish M
Clinical Infectious Diseases | August 4, 2022 | Volume: 76 | Issue: 3 | Pages: e90-e100
Abstract Background Multisystem inflammatory syndrome in children (MIS-C), linked to antecedent severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection, is associated with considerable morbidity. Prevention of SARS-CoV-2 infection or coronavirus disease 2019 (COVID-19) by vaccination might also decrease MIS-C likelihood. Methods In a multicenter, case-control, public health investigation of children ages 5–18 years hospitalized from 1 July 2021 to 7 April 2022, we compared the odds of being fully vaccinated (2 doses of BNT162b2 vaccine ≥28 days before hospital admission) between MIS-C case-patients and hospital-based controls who tested negative for SARS-CoV-2. These associations were examined by age group, timing of vaccination, and periods of Delta and Omicron variant predominance using multivariable logistic regression. Results We compared 304 MIS-C case-patients (280 [92%] unvaccinated) with 502 controls (346 [69%] unvaccinated). MIS-C was associated with decreased likelihood of vaccination (adjusted OR [aOR]: .16; 95% CI: .10–.26), including among children ages 5–11 years (aOR: .22; 95% CI: .10–.52), ages 12–18 years (aOR: .10; 95% CI: .05–.19), and during the Delta (aOR: .06; 95% CI: .02–.15) and Omicron (aOR: .22; 95% CI: .11–.42) variant-predominant periods. This association persisted beyond 120 days after the second dose (aOR: .08; 95% CI: .03–.22) in 12–18-year-olds. Among all MIS-C case-patients, 187 (62%) required intensive care unit admission and 280 (92%) vaccine-eligible case-patients were unvaccinated. Conclusions Vaccination with 2 doses of BNT162b2 is associated with reduced likelihood of MIS-C in children ages 5–18 years. Most vaccine-eligible hospitalized patients with MIS-C were unvaccinated.