Affiliations: Department of Pediatrics, Hospital Fernando Fonseca,
Amadora, Portugal | Department of Pediatrics, Hospital Dona Estef\^{a}nia,
Lisbon, Portugal
Note: [] Correspondence: Dr. Vanda Bento, Department of Pediatrics,
Hospital Fernando Fonseca, IC 19 2700 Amadora, Portugal. Tel.: +351 214348401;
Fax: +351 21 434 55 66; E-mail: vandaabento@gmail.com
Abstract: The aim of this study was to characterize the infection by
respiratory syncytial virus (RSV), identify risk factors, complications and
compare treatment strategies in children admitted to two Portuguese hospitals.
It was a retrospective study performed between January 2005 and December 2006.
Demographic and socioeconomic data, risk factors, treatment, complications and
medical follow-up were analyzed. A total of 328 children were studied (135 from
Hospital Dona Estefânia and 193 from Hospital Fernando Fonseca), about half
(52.7%) being male, with a mean age of 5 months. 41% of the patients were
from a poor socioeconomic context, 55.8% had older siblings, 32.2% had
smoking parents and 11.3% had reactive airway disease. Complications
occurred in 76.1% of the patients, namely, hypoxemia (63.5%), secondary
bacterial infection (26.5%), atelectasis (11.5%), respiratory failure
(10%) and apnea (2.4%). Most of the patients (92.3%) were treated with
bronchodilators, 69% had oxygen supplementation, 45% were on antibiotics
and 31% were treated with systemic corticosteroids. Ten percent needed
mechanical ventilation. Twenty-seven (8.2%) children developed reactive
airway disease. Having older siblings (63.1% vs. 49.3% P= 0.05) and
being newborn (32.7% vs. 16.5% P=0.006) resulted as risk factors for
complications, while the risk factors identified for bacterial infection were
having older siblings (71.4% vs. 55.7%; P= 0.013) and being from a
poor socioeconomic context (64.7% vs. 47.6%; P=0.017). The treatment
strategies differed in the two hospitals (Hospital Fernando Fonseca vs.
Hospital Dona Estefânia) regarding the use of systemic corticosteroids
(1.6% vs. 73.3%, P=0.000) and antibiotics (39.4% vs. 52.6%;
P=0.011). RSV infections can result in serious complications. According to
the current knowledge, most of the therapeutic measures carried out in this
study were probably unnecessary. It is important to establish clear national
guidelines for the treatment of RSV infection.
