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Research

Outcomes related to respiratory syncytial virus with an abbreviated palivizumab regimen in children with congenital heart disease: a descriptive analysis

Jennifer Claydon, Constantin R. Popescu, Lana Shaiba, Cheryl Christopherson, Derek Human, Richard Taylor, Alfonso Solimano and Pascal M. Lavoie
February 18, 2019 7 (1) E88-E93; DOI: https://doi.org/10.9778/cmajo.20180167
Jennifer Claydon
Children’s & Women’s Health Centre of British Columbia (Claydon, Popescu, Christopherson, Human, Solimano, Lavoie); Divisions of Neonatology (Popescu, Shaiba, Solimano, Lavoie) and Cardiology (Human), Department of Pediatrics, University of British Columbia; British Columbia Children’s Hospital Research Institute (Popescu, Human, Lavoie), Vancouver, BC; Victoria General Hospital (Taylor), Victoria, BC; University of Toronto (Shaiba), Toronto, Ont.
MSc
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Constantin R. Popescu
Children’s & Women’s Health Centre of British Columbia (Claydon, Popescu, Christopherson, Human, Solimano, Lavoie); Divisions of Neonatology (Popescu, Shaiba, Solimano, Lavoie) and Cardiology (Human), Department of Pediatrics, University of British Columbia; British Columbia Children’s Hospital Research Institute (Popescu, Human, Lavoie), Vancouver, BC; Victoria General Hospital (Taylor), Victoria, BC; University of Toronto (Shaiba), Toronto, Ont.
MD MSc
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Lana Shaiba
Children’s & Women’s Health Centre of British Columbia (Claydon, Popescu, Christopherson, Human, Solimano, Lavoie); Divisions of Neonatology (Popescu, Shaiba, Solimano, Lavoie) and Cardiology (Human), Department of Pediatrics, University of British Columbia; British Columbia Children’s Hospital Research Institute (Popescu, Human, Lavoie), Vancouver, BC; Victoria General Hospital (Taylor), Victoria, BC; University of Toronto (Shaiba), Toronto, Ont.
MBBS MS
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Cheryl Christopherson
Children’s & Women’s Health Centre of British Columbia (Claydon, Popescu, Christopherson, Human, Solimano, Lavoie); Divisions of Neonatology (Popescu, Shaiba, Solimano, Lavoie) and Cardiology (Human), Department of Pediatrics, University of British Columbia; British Columbia Children’s Hospital Research Institute (Popescu, Human, Lavoie), Vancouver, BC; Victoria General Hospital (Taylor), Victoria, BC; University of Toronto (Shaiba), Toronto, Ont.
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Derek Human
Children’s & Women’s Health Centre of British Columbia (Claydon, Popescu, Christopherson, Human, Solimano, Lavoie); Divisions of Neonatology (Popescu, Shaiba, Solimano, Lavoie) and Cardiology (Human), Department of Pediatrics, University of British Columbia; British Columbia Children’s Hospital Research Institute (Popescu, Human, Lavoie), Vancouver, BC; Victoria General Hospital (Taylor), Victoria, BC; University of Toronto (Shaiba), Toronto, Ont.
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Richard Taylor
Children’s & Women’s Health Centre of British Columbia (Claydon, Popescu, Christopherson, Human, Solimano, Lavoie); Divisions of Neonatology (Popescu, Shaiba, Solimano, Lavoie) and Cardiology (Human), Department of Pediatrics, University of British Columbia; British Columbia Children’s Hospital Research Institute (Popescu, Human, Lavoie), Vancouver, BC; Victoria General Hospital (Taylor), Victoria, BC; University of Toronto (Shaiba), Toronto, Ont.
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Alfonso Solimano
Children’s & Women’s Health Centre of British Columbia (Claydon, Popescu, Christopherson, Human, Solimano, Lavoie); Divisions of Neonatology (Popescu, Shaiba, Solimano, Lavoie) and Cardiology (Human), Department of Pediatrics, University of British Columbia; British Columbia Children’s Hospital Research Institute (Popescu, Human, Lavoie), Vancouver, BC; Victoria General Hospital (Taylor), Victoria, BC; University of Toronto (Shaiba), Toronto, Ont.
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Pascal M. Lavoie
Children’s & Women’s Health Centre of British Columbia (Claydon, Popescu, Christopherson, Human, Solimano, Lavoie); Divisions of Neonatology (Popescu, Shaiba, Solimano, Lavoie) and Cardiology (Human), Department of Pediatrics, University of British Columbia; British Columbia Children’s Hospital Research Institute (Popescu, Human, Lavoie), Vancouver, BC; Victoria General Hospital (Taylor), Victoria, BC; University of Toronto (Shaiba), Toronto, Ont.
MD PhD
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  • Figure 1:
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    Figure 1:

    Intention-to-treat distribution of palivizumab doses administered to young children with congenital heart disease in British Columbia, November 2012 to April 2016.

  • Figure 2:
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    Figure 2:

    Hospital admissions for lower respiratory tract infection (LRTI), November 2012 to April 2016. Data are reported as number of children-approvals (i.e., approvals for each season in children who received palivizumab for more than 1 season are counted separately). Note: RSV = respiratory syncytial virus.

Tables

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    Table 1:

    Clinical characteristics of 325 children with congenital heart disease enrolled in the British Columbia RSV Immunoprophylaxis Program

    Characteristic% (95% CI)*
    Gestational age, wk, mean ± SD (n = 318)36.9 ± 6.2
    Birth weight, g, mean ± SD (n = 319)2870 ± 871
    Male sex (n = 324)52 (46–57)
    Age at start of first season, mo, median (IQR)2.2 (0–6.0)
    Surgical correction† (n = 315)51 (45–57)
    Required bypass procedure (n = 288)34 (29–40)
    Died4.0 (2.1–6.7)
    • Note: CI = confidence interval, IQR = interquartile range, RSV = respiratory syncytial virus, SD = standard deviation.

    • ↵* Except where noted otherwise.

    • ↵† For the congenital heart defect during the follow-up period.

    • View popup
    Table 2:

    Clinical characteristics of infants with RSV-confirmed lower respiratory tract infection versus those whose admissions for lower respiratory tract infection were RSV-negative

    CharacteristicRSV-confirmed
    n = 17
    RSV-negative
    n = 40
    Gestational age, wk, mean ± SD37.7 ± 2.537.8 ± 2.3
    Birth weight, g, mean ± SD2939 ± 7482778 ± 651
    Male sex, % (95% CI)47 (23–72)50 (34–66)
    Age at first in-season hospital admission, mo, median (IQR)5 (4–10)6 (4–13)
    Type of congenital heart disease,* % (95% CI)
     Cyanotic47 (23–72)50 (34–66)
     Left–right shunt35 (14–62)33 (19–49)
     Obstructive lesion12 (1.5–36)5 (0.6–17)
     Cardiomyopathy6 (0.0–29)2 (0.0–13)
     Combination010 (2.8–24)
    Surgical correction, % (95% CI)47 (23–72)48 (32–64)†
    Required bypass procedure, % (95% CI)25 (7.3–52)‡40 (24–58)§
    Died, % (95% CI)12 (1.5–36)7 (1.5–20)
    • Note: CI = confidence interval, IQR = interquartile range, RSV = respiratory syncytial virus, SD = standard deviation.

    • ↵* Before surgical correction.

    • ↵† n = 39.

    • ↵‡ n = 16.

    • ↵§ n = 34.

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CMAJ Open: 7 (1)
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Outcomes related to respiratory syncytial virus with an abbreviated palivizumab regimen in children with congenital heart disease: a descriptive analysis
Jennifer Claydon, Constantin R. Popescu, Lana Shaiba, Cheryl Christopherson, Derek Human, Richard Taylor, Alfonso Solimano, Pascal M. Lavoie
Jan 2019, 7 (1) E88-E93; DOI: 10.9778/cmajo.20180167

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Outcomes related to respiratory syncytial virus with an abbreviated palivizumab regimen in children with congenital heart disease: a descriptive analysis
Jennifer Claydon, Constantin R. Popescu, Lana Shaiba, Cheryl Christopherson, Derek Human, Richard Taylor, Alfonso Solimano, Pascal M. Lavoie
Jan 2019, 7 (1) E88-E93; DOI: 10.9778/cmajo.20180167
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