Risk factors of severe respiratory syncytial virus pneumonia

ObjectiveTo understand the risk factors of severe respiratory syncytial virus (RSV) pneumonia.

MethodsBy using Respiratory Pathogen Surveillance System in Beijing, pneumonia cases were recruited from 35 sentinel hospitals in Beijing. Their demographic and medical data were collected and their clinical specimens were obtained. Laboratory detection and genotype identification of RSV were performed. Univariate and multivariate analyses were applied to identify the risk factors for severe RSV pneumonia.

ResultsFrom March 2015 to February 2019, a total of 369 RSV pneumonia cases were surveyed, including 61 severe pneumonia cases. Univariate analysis showed that the differences in age distribution, gender distribution, prevalence of underlying disease, prevalence of disorder of consciousness, abnormally elevated respiratory rate, systolic blood pressure<90 mmHg, prevalence of lymphocytopenia and abnormally elevated blood urea nitrogen level between severe RSV pneumonia cases and mild RSV pneumonia cases were significant. Multivariate analysis showed that underlying disease (OR＝4.108, 95% CI: 1.425–11.840), abnormally elevated respiratory rate (OR＝10.738, 95% CI: 3.690–31.252), lymphocytopenia (OR＝ 6.110, 95% CI: 2.041–18.288) were the independent risk factors for severe RSV pneumonia. However, being female (OR＝0.471, 95% CI: 0.199–1.115), RSV subtype B (OR＝0.425, 95% CI: 0.158–1.141) might be the protective factors for severe RSV pneumonia, even though no significant difference was observed.

ConclusionUnderlying disease, abnormally elevated respiratory rate and lymphocytopenia were the independent risk factors for the development of severe RSV pneumonia, to which close attention should be paid in clinical diagnosis and treatment.