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Respiratory syncytial virus (RSV) hospitalization in infants with congenital airway anomalies (CAA) in the canadian registry of palivizumab (CARESS) after prophylaxis (2005-2012)

Ian Mitchell, Bosco Paes, Abby Li, Hao Yi, Krista Lanctot
European Respiratory Journal 2014 44: P1259; DOI:
Ian Mitchell
1Paediatrics/ACH Research Institute, University of Calgary, Calgary, AB, Canada
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Bosco Paes
2Paediatrics, McMaster University, Hamilton, ON, Canada
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Abby Li
3Medical Outcomes and Research in Economics (MORE®) Research Group, Sunnybrook Hospital, Toronto, ON, Canada
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Hao Yi
3Medical Outcomes and Research in Economics (MORE®) Research Group, Sunnybrook Hospital, Toronto, ON, Canada
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Krista Lanctot
3Medical Outcomes and Research in Economics (MORE®) Research Group, Sunnybrook Hospital, Toronto, ON, Canada
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Abstract

Background:. CARESS tracks palivizumab use and outcomes in high-risk infants. We compared hazards for hospitalization for respiratory illness (RIH) and RSV (RSVH) in CAA infants versus those prophylaxed for other medical disorders (MD) and standard indications (SD).

Methods: Infants receiving ≥1 dose of palivizumab in 2005-2012 RSV seasons recruited from 32 Canadian sites. Utilization and hospitalization collected monthly.

Results: 13,310 infants enrolled (309 CAA, 1816 MD, 11185 SD). There were statistically significant group differences (p<0.05) in: enrolment and gestational age, birth and enrolment weight, proportions of: Caucasians, daycare attendance, smoking exposure, siblings, multiple birth, household crowding, and atopy.CAA infants had RIH rate of 12.9%; MD (9.9%); SD (5.9%) with significantly increased hazard of hospitalization compared to MD (HR = 1.47, 95%CI 1.04-2.10, p = 0.030) and SD (HR = 1.92, 95%CI 1.39-2.67, p < 0.0005). 40/309 CAA infants were hospitalized for RI, 32 were tested for RSV; 4 were positive (RSVH rate: 1.61% versus 2.06% (MD), 1.47% (SD). ByCox proportional hazard analysis, CAA did not increase hazard of first RSVH compared to MD or SD infants (χ2 = 0.79, df = 2, p = 0.67). After risk factor adjustment for daycare attendance, siblings, smoking exposure and crowding, the model was significant (χ2 = 66.1, df = 10, p < 0.0005); individual groups as risk factors remained insignificant (p = 0.73).

Conclusions: This is the largest report of CAA infants receiving palivizumab . Despite differences in risk factors, the groups appear to have similar hazards in terms of RSVH.

  • Bronchiolitis
  • Vaccination
  • Health policy
  • © 2014 ERS
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Respiratory syncytial virus (RSV) hospitalization in infants with congenital airway anomalies (CAA) in the canadian registry of palivizumab (CARESS) after prophylaxis (2005-2012)
Ian Mitchell, Bosco Paes, Abby Li, Hao Yi, Krista Lanctot
European Respiratory Journal Sep 2014, 44 (Suppl 58) P1259;

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Respiratory syncytial virus (RSV) hospitalization in infants with congenital airway anomalies (CAA) in the canadian registry of palivizumab (CARESS) after prophylaxis (2005-2012)
Ian Mitchell, Bosco Paes, Abby Li, Hao Yi, Krista Lanctot
European Respiratory Journal Sep 2014, 44 (Suppl 58) P1259;
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