Evidence map›Paper›PMID 39812486›Full record

ArticleThe Journal of infectious diseases2025

Assessing Clinical Improvement of Infants Hospitalized for Respiratory Syncytial Virus-Related Critical Illness.

Shannon B Leland, Laura D Zambrano, Steven J Staffa, Elizabeth R McNamara, Margaret M Newhams, Natasha Halasa, Justin Z Amarin, Laura S Stewart, Steven L Shein, Christopher L Carroll and 38 more

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Article in The Journal of infectious diseases, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

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4 · The record

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5 · Who and what money

Authors and funding

48 authors.

Shannon B LelandDepartment of Anesthesiology, Critical Care, and Pain Medicine, Boston Children's Hospital, Boston, Massachusetts.ORCID 0000-0002-2239-7120
Laura D ZambranoCoronavirus and Other Respiratory Viruses Division, Centers for Disease Control and Prevention, Atlanta, Georgia.ORCID 0000-0002-0145-9142
Steven J StaffaDepartment of Anesthesiology, Critical Care, and Pain Medicine, Boston Children's Hospital, Boston, Massachusetts.ORCID 0000-0002-7588-7596
Elizabeth R McNamaraDepartment of Anesthesiology, Critical Care, and Pain Medicine, Boston Children's Hospital, Boston, Massachusetts.
Margaret M NewhamsDepartment of Anesthesiology, Critical Care, and Pain Medicine, Boston Children's Hospital, Boston, Massachusetts.ORCID 0000-0002-3738-1172
Natasha HalasaDivision of Pediatric Infectious Diseases, Department of Pediatrics, Vanderbilt University Medical Center, Nashville, Tennessee.
Justin Z AmarinDivision of Pediatric Infectious Diseases, Department of Pediatrics, Vanderbilt University Medical Center, Nashville, Tennessee.ORCID 0000-0002-4484-1077
Laura S StewartDivision of Pediatric Infectious Diseases, Department of Pediatrics, Vanderbilt University Medical Center, Nashville, Tennessee.
Steven L SheinDivision of Pediatric Critical Care Medicine, Rainbow Babies and Children's Hospital, Cleveland, Ohio.
Christopher L CarrollDepartment of Pediatrics, Connecticut Children's Medical Center, Hartford, Connecticut.
Julie C FitzgeraldDepartment of Anesthesiology and Critical Care, Children's Hospital of Philadelphia, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania.
Marian G MichaelsDivision of Infectious Diseases, Department of Pediatrics, UPMC Children's Hospital of Pittsburgh, Pittsburgh, Pennsylvania.ORCID 0000-0002-2556-0544
Katherine BlineDivision of Pediatric Critical Care Medicine, Nationwide Children's Hospital, Columbus, Ohio.ORCID 0000-0002-2399-8075
Melissa L CullimoreDivision of Pediatric Critical Care, Department of Pediatrics, Children's Nebraska, Omaha, Nebraska.
Laura LoftisDepartment of Pediatrics, Baylor College of Medicine, Houston, Texas.
Vicki L MontgomeryDepartment of Pediatrics, University of Louisville and Norton Children's Hospital, Louisville, Kentucky.ORCID 0000-0002-3414-4294
Asumthia S JeyapalanDivision of Pediatric Critical Care Medicine, University of Miami Miller School of Medicine, Miami, Florida.ORCID 0000-0001-7166-0725
Pia S PannarajDivision of Infectious Diseases, Department of Pediatrics, University of California San Diego, Rady Children's Hospital, San Diego, California.
Adam J SchwarzDivision of Critical Care Medicine, Children's Hospital Orange County, Orange, California.
Natalie Z CvijanovichDivision of Critical Care, Department of Pediatrics, UCSF Benioff Children's Hospital Oakland, Oakland, California.
Matt S ZinterDivision of Critical Care, Department of Pediatrics, UCSF Benioff Children's Hospital, San Francisco, California.ORCID 0000-0003-3351-3278
Aline B MadduxDepartment of Pediatrics, Section of Critical Care Medicine, University of Colorado School of Medicine and Children's Hospital Colorado, Aurora, Colorado.ORCID 0000-0002-0949-4284
Melania M BembeaDepartment of Anesthesiology and Critical Care Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland.ORCID 0000-0003-4984-520X
Katherine IrbySection of Pediatric Critical Care, Department of Pediatrics, Arkansas Children's Hospital, Little Rock, Arkansas.
Danielle M ZerrDivision of Pediatric Infectious Diseases, Department of Pediatrics, University of Washington and Seattle Children's Hospital, Seattle, Washington.
Joseph D KueblerDivision of Pediatric Critical Care, Department of Pediatrics, Golisano Children's Hospital, University of Rochester Medical Center, Rochester, New York.ORCID 0000-0002-2581-1817
Christopher J BabbittDivision of Pediatric Critical Care, Miller Children's and Women's Hospital of Long Beach, Long Beach, California.
Mary G GaspersDivision of Critical Care, Department of Pediatrics, Banner Children's at Diamond Children's Medical Center, Tucson, Arizona.ORCID 0000-0003-0561-9411
Ryan NofzigerDivision of Critical Care Medicine, Akron Children's Hospital, Akron, Ohio.ORCID 0000-0001-7057-2686
Michele KongDivision of Pediatric Critical Care Medicine, Department of Pediatrics, University of Alabama at Birmingham, Birmingham, Alabama.ORCID 0000-0001-6596-3965
Bria M CoatesDivision of Pediatric Critical Care Medicine, Ann and Robert H. Lurie Children's Hospital of Chicago, Northwestern University Feinberg School of Medicine, Chicago, Illinois.ORCID 0000-0003-4264-5440
Jennifer E SchusterDivision of Pediatric Infectious Diseases, Department of Pediatrics, Children's Mercy Kansas City, Kansas City, Missouri.
Shira J GertzDivision of Pediatric Critical Care, Department of Pediatrics, Cooperman Barnabas Medical Center, Livingston, New Jersey.ORCID 0000-0001-8119-6006
Elizabeth H MackDivision of Pediatric Critical Care Medicine, Medical University of South Carolina, Charleston, South Carolina.
Benjamin R WhiteDivision of Pediatric Critical Care, Department of Pediatrics, University of Utah, Salt Lake City, Utah.ORCID 0000-0002-9237-0185
Helen HarveyDivision of Pediatric Critical Care, Department of Pediatrics, University of California San Diego, Rady Children's Hospital, San Diego, California.ORCID 0000-0001-5835-9575
Charlotte V HobbsDivision of Infectious Diseases, Department of Pediatrics, University of Mississippi Medical Center, Jackson, Mississippi.
Heda DapulDivision of Pediatric Critical Care Medicine, Department of Pediatrics, New York University Grossman School of Medicine, New York, New York.ORCID 0000-0002-7209-1285
Andrew D ButlerDivision of Pediatric Critical Care, St Christopher's Hospital for Children, Philadelphia, Pennsylvania.
Tamara T BradfordDivision of Cardiology, Department of Pediatrics, Louisiana State University Health Sciences Center and Children's Hospital of New Orleans, New Orleans, Louisiana.ORCID 0000-0001-5220-7423
Courtney M RowanDivision of Pediatric Critical Care Medicine, Department of Pediatrics, Indiana University School of Medicine, Riley Hospital for Children, Indianapolis, Indiana.ORCID 0000-0003-1393-6476
Kari WellnitzDivision of Pediatric Critical Care, Stead Family Department of Pediatrics, University of Iowa Carver College of Medicine, Iowa City, Iowa.ORCID 0000-0001-9451-8879
Mary Allen StaatDepartment of Pediatrics, University of Cincinnati College of Medicine, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio.
Cassyanne L AguiarDivision of Pediatric Rheumatology, Children's Hospital of The King's Daughters, Eastern Virginia Medical School, Norfolk, Virginia.ORCID 0000-0001-8368-4628
Saul R HymesDivision of Pediatric Infectious Diseases, Department of Pediatrics, Bernard and Millie Duker Children's Hospital, Albany Med Health System, Albany, New York.ORCID 0000-0002-2276-7160
Angela P CampbellCoronavirus and Other Respiratory Viruses Division, Centers for Disease Control and Prevention, Atlanta, Georgia.ORCID 0000-0002-2576-482X
Adrienne G RandolphDepartment of Anesthesiology, Critical Care, and Pain Medicine, Boston Children's Hospital, Boston, Massachusetts.
Respiratory Syncytial Virus - Pediatric Intensive Care (RSV-PIC) Investigators

Funding

Immunobiology of Influenza Virus-related Critical Illness in Young HostsR01AI154470 · NIAID · BOSTON CHILDREN'S HOSPITAL · PI RANDOLPH, ADRIENNE G, THOMAS, PAUL G. · 2020 to 2024
$4.7M
Training Program in Resuscitation ScienceT32HL155020 · NHLBI · BETH ISRAEL DEACONESS MEDICAL CENTER · PI Michael William Donnino, Robert Yeh · 2021 to 2026
$2.6M
Pediatric septic acute kidney injury: personalizing antibiotic dosing through understanding acute kidney injury risk factors and biomarker profilesK23DK119463 · NIDDK · CHILDREN'S HOSP OF PHILADELPHIA · PI FITZGERALD, JULIE C. HOLLOWS · 2020 to 2024
$810k
CDC HHSNHLBI NIH HHSNHLBI NIH HHS T32 HL155020NIAID NIH HHS R01 AI154470NIDDK NIH HHS K23 DK119463NIH HHS T32HL155020
6 · The paper itself

Abstract

backgroundPediatric respiratory syncytial virus (RSV)-related acute lower respiratory tract infection (LRTI) commonly requires hospitalization. The Clinical Progression Scale-Pediatrics (CPS-Ped) measures level of respiratory support and degree of hypoxia across a range of disease severity, but it has not been applied in infants hospitalized with severe RSV-LRTI.

methodsWe analyzed data from a prospective surveillance registry of infants hospitalized for RSV-related complications across 39 pediatric intensive care units in the United States from October through December 2022. We assigned CPS-Ped (0 = discharged home at respiratory baseline to 8 = death) at admission and days 2-7, 10, and 14. We identified predictors of clinical improvement (CPS-Ped ≤2 or 3-point decrease) by day 7 using multivariable log-binomial regression models and estimated the sample size (80% power) to detect 15% between-group clinical improvement with CPS-Ped versus hospital length of stay (LOS).

resultsOf 585 hospitalized infants, 138 (23.6%) received invasive mechanical ventilation (IMV) and 1 died. Failure to clinically improve by day 7 occurred in 205 (35%) infants and was associated with age <3 months, prematurity, underlying respiratory condition, and IMV in the first 24 hours in the multivariable analysis. The estimated sample size per arm required for detecting a 15% clinical improvement in a potential study was 584 using CPS-Ped clinical improvement versus 2031 for hospital LOS.

conclusionsCPS-Ped can be used to capture a range of disease severity and track clinical improvement in infants who develop RSV-related critical illness and could be useful for evaluating therapeutic interventions for RSV.

Indexed as

HospitalizationRespiratory Syncytial Virus InfectionsRespiratory Tract InfectionsCritical IllnessFemaleHumansInfantInfant, NewbornIntensive Care Units, PediatricLength of StayMaleProspective StudiesRegistriesRespiration, ArtificialRespiratory Syncytial Virus, HumanSeverity of Illness Indexacute hypoxic respiratory failureacute respiratory distress syndromeintensive care unitoutcomepediatric

Identifiers

PMID39812486
PMCPMC12265475

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.