Journal article
Assessing Clinical Improvement of Infants Hospitalized for Respiratory Syncytial Virus-Related Critical Illness
The Journal of infectious diseases, v 232(6), pp 1283-1291
20 Dec 2025
PMID: 39812486
Featured in Collection : UN Sustainable Development Goals @ Drexel
Abstract
Background Pediatric 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. Methods We 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). Results Of 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. Conclusions CPS-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.
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Details
- Title
- Assessing Clinical Improvement of Infants Hospitalized for Respiratory Syncytial Virus-Related Critical Illness
- Creators
- Shannon B. Leland - Boston Children's HospitalLaura D. Zambrano - Centers for Disease Control and PreventionSteven J. Staffa - Boston Children's HospitalElizabeth R. Mcnamara - Boston Children's HospitalMargaret M. Newhams - Boston Children's HospitalNatasha Halasa - Vanderbilt University Medical CenterJustin Z. Amarin - Vanderbilt University Medical CenterLaura S. Stewart - Vanderbilt University Medical CenterSteven L. Shein - Rainbow Babies & Children's HospitalChristopher L. Carroll - Connecticut Children's Medical CenterJulie C. Fitzgerald - Children's Hospital of PhiladelphiaMarian G. Michaels - Children's Hospital of PittsburghKatherine Bline - Nationwide Children's HospitalMelissa L. Cullimore - Children's Hospital & Medical CenterLaura Loftis - Baylor College of MedicineVicki L. Montgomery - University of LouisvilleAsumthia S. Jeyapalan - University of MiamiPia S. Pannaraj - University of California San DiegoAdam J. Schwarz - Children's Hospital of Orange CountyNatalie Z. Cvijanovich - UCSF Benioff Children's HospitalMatt S. Zinter - UCSF Benioff Children's HospitalAline B. Maddux - Children's Hospital ColoradoMelania M. Bembea - Johns Hopkins UniversityKatherine Irby - Arkansas Children's HospitalDanielle M. Zerr - Seattle Children's HospitalJoseph D. Kuebler - University of Rochester MedicineChristopher J. Babbitt - Miller Children's & Women's HospitalMary G. Gaspers - Children's Medical CenterRyan Nofziger - Akron Children's HospitalMichele Kong - University of Alabama at BirminghamBria M. Coates - Northwestern UniversityJennifer E. Schuster - Children's Mercy HospitalShira J. Gertz - Saint Barnabas Medical CenterElizabeth H. Mack - Medical University of South CarolinaBenjamin R. White - University of UtahHelen Harvey - University of California San DiegoCharlotte Hobbs - University of Mississippi Medical CenterHeda Dapul - New York UniversityAndrew D. Butler - St. Christopher's Hospital for ChildrenTamara T. Bradford - Louisiana State UniversityCourtney M. Rowan - Riley Hospital for ChildrenKari Wellnitz - University of IowaMary Allen Staat - Cincinnati Children's Hospital Medical CenterCassyanne L. Aguiar - Eastern Virginia Medical SchoolSaul R. Hymes - Albany College of Pharmacy and Health SciencesAngela P. Campbell - Centers for Disease Control and PreventionAdrienne G. Randolph - Boston Children's HospitalMerry Resp Syncytial Virus Pediat Intensive Care RSV-PIC InvestigatorsRespiratory Syncytial Virus - Pediatric Intensive Care (RSV-PIC) Investigators
- Publication Details
- The Journal of infectious diseases, v 232(6), pp 1283-1291
- Publisher
- Oxford University Press
- Number of pages
- 9
- Grant note
- 75D30122C13330 / Centers for Disease Control and Prevention; United States Department of Health & Human Services; Centers for Disease Control & Prevention - USA National Heart, Lung, and Blood Institute of the National Institutes of Health; United States Department of Health & Human Services; National Institutes of Health (NIH) - USA; NIH National Heart Lung & Blood Institute (NHLBI) T32HL155020 / National Heart, Lung, and Blood Institute of the National Institutes of Health; United States Department of Health & Human Services; National Institutes of Health (NIH) - USA; NIH National Heart Lung & Blood Institute (NHLBI)
- Resource Type
- Journal article
- Language
- English
- Academic Unit
- College of Medicine
- Web of Science ID
- WOS:001408216700001
- Scopus ID
- 2-s2.0-105025549443
- Other Identifier
- 991022197422604721
UN Sustainable Development Goals (SDGs)
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- Collaboration types
- Domestic collaboration
- Web of Science research areas
- Immunology
- Infectious Diseases
- Microbiology