scholarly journals Respiratory syncytial virus and seasonal influenza cause similar illnesses in children with sickle cell disease

2014 ◽  
Vol 61 (5) ◽  
pp. 875-878 ◽  
Author(s):  
Sara Christina Sadreameli ◽  
Megan E. Reller ◽  
David G. Bundy ◽  
James F. Casella ◽  
John J. Strouse
Keyword(s):  
Respiratory Syncytial Virus ◽  
Sickle Cell Disease ◽  
Sickle Cell ◽  
Seasonal Influenza ◽  
Cell Disease ◽  
Syncytial Virus

scholarly journals The burden of respiratory syncytial virus infections among children with sickle cell disease

2020 ◽  
Vol 68 (1) ◽  
Author(s):  
Christina A. Rostad ◽  
Alexander N. Maillis ◽  
Kristina Lai ◽  
Nitya Bakshi ◽  
Robert C. Jerris ◽  
...  
Keyword(s):  
Respiratory Syncytial Virus ◽  
Sickle Cell Disease ◽  
Sickle Cell ◽  
Virus Infections ◽  
Cell Disease ◽  
Respiratory Syncytial Virus Infections ◽  
Syncytial Virus

ACUTE CHEST SYNDROME with RESPIRATORY Syncytial VIRUS and SEASONAL INFLUENZA In CHILDREN with SICKLE CELL DISEASE

Blood ◽  
2011 ◽  
Vol 118 (21) ◽  
pp. 4845-4845
Author(s):  
John J. Strouse ◽  
Sara C Sadreameli ◽  
James F. Casella
Keyword(s):  
Logistic Regression ◽  
Risk Factor ◽  
Respiratory Syncytial Virus ◽  
Seasonal Influenza ◽  
Influenza Infection ◽  
Johns Hopkins Hospital ◽  
Acute Chest Syndrome ◽  
Cell Disease ◽  
Rsv Infection ◽  
Syncytial Virus

Abstract Abstract 4845 Background: Respiratory syncytial virus (RSV) has been recognized as a cause of acute chest syndrome (ACS) in children with sickle cell disease (SCD). However, the proportion of children with RSV and SCD that are admitted to hospital or develop ACS is unknown. In studies of young children without SCD, RSV has traditionally been associated with more hospitalizations in the first three years of life then influenza has. To compare the relative severity of RSV vs. seasonal influenza in children with SCD, we compared the clinical characteristics and complications associated with these infections at a single tertiary care hospital. Methods: We defined a case as laboratory-confirmed RSV infection in a patient <18 years with SCD who was evaluated at Johns Hopkins Hospital from 1 September 1993 to June 30 2008. Through July 2006, we searched the discharge and billing databases for Johns Hopkins Hospital to identify those with SCD and laboratory testing for respiratory infections. Thereafter, we prospectively identified cases through divisional records. We confirmed the diagnosis of RSV by review of microbiology results in each patient's paper and/or electronic medical record. We used Fisher's exact test to compare proportions, Student's t-test or Wilcoxon rank-sum test to compare continuous variables, and logistic regression to evaluate associations. Results: We identified 47 patients with SCD and RSV and 76 with influenza during the study period. Clinical symptoms, such as reported fever (83% vs. 89%), cough (98% vs. 93%), and rhinorrhea (90% vs. 80%), were similar for RSV and influenza as were complications, including acute chest syndrome (Table). Treatments given for RSV and influenza including antibacterials (100% vs. 97%), transfusions (7% vs. 11%), and invasive ventilation (4% vs. 0%, p=0.15),with possibly more bronchodilator use for RSV (50% vs. 33%, p=0.055). In a multivariable logistic regression model, older age (OR 1.3 per year, 95% CI 1.04 –1.5, P=.02) and increased white blood cell count (WBC) at presentation (OR 1.2 per 1000/ul increase, 95% CI 1.03 – 1.4, P=0.02) were independently associated with increased risk of ACS in children with RSV. Discussion: Laboratory confirmed RSV infection was predominantly identified in infants and toddlers, while influenza infection was identified in children of all ages. This parallels RSV hospitalizations in the general population, where children are most likely to be hospitalized in the first few years of life. Both older age and high WBC at presentation may be a risk factor for more severe disease. This is unlikely to reflect referral bias (with only the sickest older children being referred for tertiary pediatric care) as a similar pattern was not seen for influenza infection. We conclude that RSV infection is often associated with ACS and similar in severity to influenza infection in children with SCD. An episode of ACS in the first three years of life was associated with more frequent ACS episodes later in childhood in the Dallas Newborn cohort. Since a significant proportion of patients with RSV develop ACS at a young age, RSV infection may represent a modifiable risk factor for recurrent ACS. An area for further study would be the efficacy or cost effectiveness of prevention of RSV-related hospitalizations. Palivizumab, a monoclonal antibody to RSV, has been shown to prevent complications related to RSV in other high risk groups and could be considered as an intervention in SCD that may decrease morbidity. Disclosures: No relevant conflicts of interest to declare.

scholarly journals Antibiotic Use and Respiratory Pathogens in Adults With Sickle Cell Disease and Acute Chest Syndrome

2019 ◽  
Vol 53 (10) ◽  
pp. 991-996
Author(s):  
Alyssa M. Claudio ◽  
Lindsey Foltanski ◽  
Tracie Delay ◽  
Ashley Britell ◽  
Ashley Duckett ◽  
...  
Keyword(s):  
Sickle Cell Disease ◽  
Sickle Cell ◽  
Cohort Analysis ◽  
Empirical Therapy ◽  
Antibiotic Use ◽  
Chlamydophila Pneumoniae ◽  
Acute Chest Syndrome ◽  
Respiratory Pathogens ◽  
Cell Disease ◽  
Syncytial Virus

Background: Acute chest syndrome (ACS) is an acute complication of sickle cell disease (SCD). Historically, the most common pathogens were Chlamydophila pneumoniae, Mycoplasma pneumoniae, and respiratory syncytial virus. Pediatric patients receiving guideline-adherent therapy experienced fewer ACS-related and all-cause 30-day readmissions compared with those receiving nonadherent therapy. This has not been evaluated in adults. Objectives: The primary objectives were to characterize antibiotic use and pathogens. The secondary objective was to assess the occurrence of readmissions associated with guideline-adherent and clinically appropriate treatment compared with regimens that did not meet those criteria. Methods: A retrospective cohort analysis was conducted for adults with SCD hospitalized between August 1, 2014, and July 31, 2017, with pneumonia (PNA) or ACS. The study was approved by the institutional review board. Results: A total of 139 patients with 255 hospitalizations were reviewed. Among 41 respiratory cultures, 3 organisms were isolated: Cryptococcus neoformans, Pseudomonas aeruginosa, and budding yeast. Respiratory panels were collected on 121 admissions, with 17 positive for 1 virus; all were negative for Chlamydophila pneumoniae and M pneumoniae. There were significantly more ACS-/PNA-related 7-day readmissions from patients on guideline-adherent regimens compared with nonadherent regimens (3.7% vs 0%; P = 0.04). Conclusion and Relevance: These findings challenge existing knowledge regarding the most common pathogens in adults with SCD with ACS or PNA. Routine inclusion of a macrolide may not be necessary. Future studies focused on pathogen characterization with standardized assessment are necessary to determine appropriate empirical therapy in this population.

scholarly journals Severe pandemic H1N1 and seasonal influenza in children and young adults with sickle cell disease

Blood ◽  
2010 ◽  
Vol 116 (18) ◽  
pp. 3431-3434 ◽  
Author(s):  
John J. Strouse ◽  
Megan E. Reller ◽  
David G. Bundy ◽  
Martha Amoako ◽  
Maria Cancio ◽  
...  
Keyword(s):  
Intensive Care ◽  
Sickle Cell Disease ◽  
Sickle Cell ◽  
Seasonal Influenza ◽  
H1n1 Influenza ◽  
Older Age ◽  
Acute Chest Syndrome ◽  
Cell Disease ◽  
Excess Morbidity ◽  
Children And Young Adults

Abstract Influenza causes excess morbidity in sickle cell disease (SCD). H1N1 pandemic influenza has been severe in children. To compare H1N1 with seasonal influenza in SCD (patients younger than 22), we reviewed medical records (1993-2009). We identified 123 cases of laboratory-confirmed influenza (94 seasonal, 29 H1N1). Those with seasonal influenza were younger (median 4.4 vs 8.7 years old, P = .006) and had less asthma (24% vs 56%, P = .002). Those with H1N1 influenza more often had acute chest syndrome (ACS; 34% vs 13%, P = .01) and required intensive care (17% vs 3%, P = .02), including mechanical ventilation (10% vs 0%, P = .02). In multivariate analysis, older age (odds ratio [OR] 1.1 per year, P = .04) and H1N1 influenza (OR 3.0, P = .04) were associated with ACS, and older age (OR 1.1 per year, P = .02) and prior ACS (OR 3.3 per episode in last year, P < .006) with intensive care. Influenza, especially H1N1, causes critical illness in SCD and should be prevented.

Hemolysis in sickle cell disease

1974 ◽  
Vol 133 (4) ◽  
pp. 624-631 ◽  
Author(s):  
T. A. Bensinger
Keyword(s):  
Sickle Cell Disease ◽  
Sickle Cell ◽  
Cell Disease

Computerized cognitive training in pediatric sickle cell disease: A randomized controlled pilot study.

2020 ◽  
Vol 8 (4) ◽  
pp. 390-401 ◽  
Author(s):  
Taryn M. Allen ◽  
Lindsay M. Anderson ◽  
Samuel M. Brotkin ◽  
Jennifer A. Rothman ◽  
Melanie J. Bonner
Keyword(s):  
Pilot Study ◽  
Sickle Cell Disease ◽  
Cognitive Training ◽  
Sickle Cell ◽  
Cell Disease ◽  
Computerized Cognitive Training ◽  
Randomized Controlled ◽  
Pediatric Sickle Cell Disease
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