Development of a Global Respiratory Severity Score for Respiratory Syncytial Virus Infection in Infants

Authors

Mary T. Caserta, Division of Infectious Diseases, Department of Pediatrics, University of Rochester Medical Center, Rochester, NY, USA.
Xing Qiu, Department of Biostatistics and Computational Biology, New York Influenza Center of Excellence at the University of Rochester Medical Center, Rochester, NY, USA.
Brenda Tesini, Division of Infectious Diseases, Department of Pediatrics, University of Rochester Medical Center, Rochester, NY, USA.
Lu Wang, Department of Biostatistics and Computational Biology, New York Influenza Center of Excellence at the University of Rochester Medical Center, Rochester, NY, USA.
Amy Murphy, Division of Infectious Diseases, Department of Pediatrics, University of Rochester Medical Center, Rochester, NY, USA.
Anthony Corbett, Department of Biostatistics and Computational Biology, New York Influenza Center of Excellence at the University of Rochester Medical Center, Rochester, NY, USA.
David J. Topham, Center for Vaccine Biology and Immunology, University of Rochester, Rochester, New York, USA.
Ann R. Falsey, Rochester Regional HealthFollow
Jeanne Holden-Wiltse, Department of Biostatistics and Computational Biology, New York Influenza Center of Excellence at the University of Rochester Medical Center, Rochester, NY, USA.
Edward E. Walsh, Rochester Regional HealthFollow

Department

Medicine

Document Type

Article

Publication Title

The Journal of Infectious Diseases

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.

First Page

750

Last Page

756

DOI

10.1093/infdis/jiw624

Volume

215

Issue

5

Publication Date

3-1-2017

Medical Subject Headings

Female; Gestational Age; Hospitalization; Humans; Infant; Infant, Newborn; Length of Stay; Linear Models; Male; Prospective Studies; Reproducibility of Results; Respiratory Syncytial Virus Infections (diagnosis, epidemiology); Respiratory Syncytial Virus, Human; Risk Factors; Severity of Illness Index

PubMed ID

28011907

Recommended Citation

Caserta, M. T., Qiu, X., Tesini, B., Wang, L., Murphy, A., Corbett, A., Topham, D. J., Falsey, A. R., Holden-Wiltse, J., & Walsh, E. E. (2017). Development of a Global Respiratory Severity Score for Respiratory Syncytial Virus Infection in Infants. The Journal of Infectious Diseases, 215 (5), 750-756. https://doi.org/10.1093/infdis/jiw624