Development of a Global Respiratory Severity Score for Respiratory Syncytial Virus Infection in Infants. (23rd December 2016)

• Record Type: Journal Article
• Authors: Caserta, Mary T; Qiu, Xing; Tesini, Brenda; Wang, Lu; Murphy, Amy; Corbett, Anthony; Topham, David J; Falsey, Ann R; Holden-Wiltse, Jeanne; Walsh, Edward E
• Is Part Of: Journal of infectious diseases. Volume 215:Number 5(2017:Mar. 01)
• Page Start: 750
• Page End: 756
• Publication Date: 2016-12-23
• Subjects: Lower respiratory tract infection -- respiratory severity score -- respiratory syncytial virus -- upper respiratory tract infection; Communicable diseases -- Periodicals; Diseases -- Causes and theories of causation -- Periodicals; Medicine -- Periodicals; Communicable Diseases -- Periodicals; Electronic journals; 616.9
• DOI: 10.1093/infdis/jiw624
• Languages: English
• ISSNs: 0022-1899

Abstract

Abstract: Background: Respiratory syncytial virus (RSV) infection in infants has recognizable clinical signs and symptoms. However, quantification of disease severity is difficult, and published scores remain problematic. Thus, as part of a RSV pathogenesis study, we developed a global respiratory severity score (GRSS) as a research tool for evaluating infants with primary RSV infection. Methods: Previously healthy infants <10 months of age with RSV infections representing the spectrum of disease severity were prospectively evaluated. Clinical signs and symptoms were collected at 3 time points from hospitalized infants and those seen in ambulatory settings. Data were also extracted from office, emergency department, and hospital records. An unbiased data-driven approach using factor analysis was used to develop a GRSS. Results: A total of 139 infants (84 hospitalized and 55 nonhospitalized) were enrolled. Using hospitalization status as the output variable, 9 clinical variables were identified and weighted to produce a composite GRSS. The GRSS had an area under the receiver operator curve of 0.961. Construct validity was demonstrated via a significant correlation with length of stay (r = 0.586, P < .0001). Conclusions: Using routine clinical variables, we developed a severity score for infants with RSV infection that should be useful as an end point for investigation of disease pathogenesis and as an outcome measure for therapeutic interventions.