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  • Respiratory Syncytial Virus-Associated Neurologic Complications in Children: A Systematic Review and Aggregated Case Series

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    Accepted Manuscript (AM)
    Author(s)
    Saravanos, Gemma L
    King, Catherine L
    Deng, Lucy
    Dinsmore, Nicole
    Ramos, Isabelle
    Takashima, Mari
    Crawford, Nigel
    Clark, Julia E
    Dale, Russell C
    Jones, Cheryl A
    Wood, Nicholas J
    Britton, Philip N
    Griffith University Author(s)
    Takashima, Mari
    Year published
    2021
    Metadata
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    Abstract
    OBJECTIVES: To describe the features and frequency of RSV-associated severe acute neurologic disease in children. STUDY DESIGN: We performed a systematic review of the literature to identify reports of severe acute neurologic complications associated with acute respiratory syncytial virus (RSV) infection in children aged <15 years (PROSPERO Registration CRD42019125722). Main outcomes included neurologic, clinical, and demographic features of cases, and the frequency of disease. We aggregated available case data from the published literature and from the Australian Acute Childhood Encephalitis (ACE) study. RESULTS: We identified ...
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    OBJECTIVES: To describe the features and frequency of RSV-associated severe acute neurologic disease in children. STUDY DESIGN: We performed a systematic review of the literature to identify reports of severe acute neurologic complications associated with acute respiratory syncytial virus (RSV) infection in children aged <15 years (PROSPERO Registration CRD42019125722). Main outcomes included neurologic, clinical, and demographic features of cases, and the frequency of disease. We aggregated available case data from the published literature and from the Australian Acute Childhood Encephalitis (ACE) study. RESULTS: We identified 87 unique studies from 26 countries describing a spectrum of RSV-associated severe acute neurologic syndromes including proven encephalitis, acute encephalopathy, complex seizures, hyponatremic seizures, and immune-mediated disorders. The frequency of RSV infection in acute childhood encephalitis/encephalopathy was 1.2 to 6.5%. We aggregated data from 155 individual cases with RSV-associated severe acute neurologic complications; median age was 11.0 months (IQR 2.0-21.5), most were previously healthy (71/104, 68%). Seizure was the most frequently reported neurologic feature (127/150, 85%). RSV was detected in the central nervous system of 12 cases. Most children recovered (81/122, 66%), however some reports described partial recovery (33/122, 27%) and death (8/122, 7%). CONCLUSIONS: RSV-associated neurologic complications have been widely reported but there is substantial heterogeneity in the design and quality of existing studies. The findings from our study have implications for the investigation, management, and prevention of RSV-associated neurologic complications. Further, this systematic review can inform the design of future studies aiming to quantify the burden of childhood RSV-associated neurologic disease.
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    Journal Title
    The Journal of Pediatrics
    DOI
    https://doi.org/10.1016/j.jpeds.2021.06.045
    Copyright Statement
    © 2021 Mosby, Inc. Published by Elsevier Ltd. Licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International Licence (http://creativecommons.org/licenses/by-nc-nd/4.0/) which permits unrestricted, non-commercial use, distribution and reproduction in any medium, providing that the work is properly cited.
    Subject
    Sports science and exercise
    Paediatrics
    Reproductive medicine
    child
    encephalitis
    neurologic manifestations
    respiratory syncytial viruses
    seizures
    Publication URI
    http://hdl.handle.net/10072/405721
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    • Journal articles

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