Down Syndrome and Hospitalizations due to Respiratory Syncytial Virus: A Population-Based Study

Objective To assess the risk estimates for respiratory syncytial virus (RSV) hospitalization in children with Down syndrome (DS) and the clinical features and severity of RSV lower respiratory tract infection (LRTI) in hospitalized children. Study design Statewide hospitalization data for children with DS for 1995 through 2006 from the Colorado Health and Hospital Association database were combined with birth data from the Colorado Department of Public Health and Environment to obtain population-based estimates of RSV LRTI hospitalization for children with DS in the first 2 years of life. RSV hospitalization data for children with DS at the Children’s Hospital Colorado for 2000 through 2006 were used to compare the course and severity of hospitalization of DS LRTI admissions with those of matched control subjects. Results There were 85 RSV LRTI hospitalizations in 630 children born with DS in Colorado, with 50 having no concurrent underlying conditions identified. Children with DS had a significantly higher risk than did those without DS for being hospitalized with RSV LRTI (OR, 5.99; 95% CI, 6.68-5.38), even in the absence of other underlying conditions (OR 3.5; 95% CI, 3.10-4.12). In the case-control study, children with DS hospitalized for RSV presented more frequently with fever ( P = .005), had consolidation reported more often on chest radiography ( P = .003), and were given bronchodilator therapy more often during the hospital stay ( P = .002). Conclusions Children with DS have a higher risk of being hospitalized with RSV LRTI even in the absence of coexisting risk factors. They present more often with fever and more often have radiographic consolidation detected on chest radiography.