Korean J Pediatr.  2010 Mar;53(3):380-391. 10.3345/kjp.2010.53.3.380.

Respiratory syncytial virus infection cases in congenital heart disease patients

• Shim WS
• Lee JY
• Song JY
• Kim SJ
• Kim SH
• Jang SI
• Choi EY

• KMID: 2281320
• DOI: http://doi.org/10.3345/kjp.2010.53.3.380

Abstract

PURPOSE
Respiratory syncytial virus (RSV) is one of the main pathogens causing lower respiratory infections (LRI) in young children, usually of limited severity. However, in congenital heart disease (CHD) patients, one of the high-risk groups for RSV infection, RSV can cause serious illnesses and fatal results. To elucidate the effects of RSV infection in CHD patients, we observed RSV infection cases among CHD patients and non-CHD patients.
METHODS
On admission of 343 LRI patients over 3 years, 77 cases of RSV infection were detected by the RSV antigen rapid test of nasopharyngeal secretion. We compared RSV infection cases among groups of CHD and non-CHD patients.
RESULTS
During the winter season, RSV caused 20-50% of LRI admissions in children. In patients with completely repaired simple left to right (L-R) shunt diseases such as ventricular septal defect, atrial septal defect, and patent ductus arteriosus, RSV infections required short admission days similar to non-CHD patients. In patients with repaired CHD other than simple L-R shunt CHD, for whom some significant hemodynamic problems remained, RSV infection required long admission days with severe clinical course. In children with unrepaired CHD, RSV infection mostly occurred in early infant age, with long admission days. RSV infections within a month after cardiac surgery also required long admission days and severe clinical course.
CONCLUSION
To avoid the tragedic outcome of severe RSV infection in the CHD patients, efforts to find the subgroups of CHD patients at high risk to RSV infection are needed, and effective preventive treatment should be applied.

Keyword

Respiratory syncytial virus (RSV); Bronchiolitis; Pneumonia; Congenital heart defects/disease; Palivizumab

MeSH Terms

Antibodies, Monoclonal, Humanized
Bronchiolitis
Child
Ductus Arteriosus, Patent
Heart
Heart Diseases
Heart Septal Defects, Atrial
Heart Septal Defects, Ventricular
Hemodynamics
Humans
Infant
Pneumonia
Respiratory Syncytial Viruses
Respiratory Tract Infections
Seasons
Thoracic Surgery
Palivizumab
Antibodies, Monoclonal, Humanized