Bronchiolitis, Viral
Conditions
Brief summary
Respiratory tract infections caused by respiratory syncytial virus (RSV) are a worldwide burden and represent a major public health issue. In France, bronchiolitis is responsible for around 100,000 emergency room visits and 50,000 hospital admissions every year; 75% of infants hospitalised for RSV bronchiolitis are healthy full-term children. Recent discoveries concerning the specific viral epitopes of RSV have made it possible to move from an empirical approach to a targeted preventive or curative approach (monoclonal antibodies, vaccines, anti-viral drugs). Nirsevimab is a monoclonal antibody against RSV with enhanced neutralising activity and a prolonged half-life. A randomised, placebo-controlled phase III trial demonstrated the effectiveness of nirsevimab in reducing lower respiratory tract infections caused by RSV requiring medical management in healthy premature and term infants, with a favourable safety profile. The US Food and Drug Administration (FDA) approved the first RSV vaccine on May 3, 2023, and the second was approved on May 31, 2023. Nirsevimab was approved by the European Medicines Agency (EMA) on November 4, 2022.
Interventions
OTHERNo intervention required by the protocol
No visits or samples will be taken specifically for this study. This research involves only prospective or retrospective data collection in relation to the usual hospital management of the child included. Similarly, patient follow-up will be strictly within the framework of their usual hospital care in relation to their pathology.
Sponsors
Centre Hospitalier Intercommunal Creteil
Study design
Observational model
CASE_CONTROL
Time perspective
PROSPECTIVE
Eligibility
Sex/Gender
ALL
Age
No minimum to 1 Years
Healthy volunteers
No
Inclusion criteria
Cases : * Children under 12 months of age * Treated for acute RSV bronchiolitis * Hospitalised following a visit to the paediatric emergency department Controls : * Children under 12 months * Hospitalised in the conventional sector or in a short-stay hospital unit, or having consulted a paediatric emergency department for one of the following reasons * Febrile urinary tract infection, without acute ear, nose, and throat (ENT) or respiratory symptoms * Acute gastroenteritis, without acute ENT or respiratory symptoms * Infant colic without fever, without ENT or acute respiratory symptoms * Stagnant weight or feeding difficulties without fever, acute ENT or respiratory symptoms * Neonatal jaundice without fever or acute ENT or respiratory symptoms * Unexplained crying without fever, without ENT or acute respiratory symptoms * Head injury, without acute ENT or respiratory symptoms * Patient hospitalised for acute surgery without fever, without ENT or acute respiratory symptoms
Exclusion criteria
* Refusal to participate by the patient, their relative or legal representative * Administration of Palivizumab. * Maternal vaccination against RSV.
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Proportion of patients passively immunised with nirsevimab | 7 days | Proportion of patients passively immunised with nirsevimab in children hospitalised with RSV bronchiolitis and in the control group |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Frequency of hospital admissions | 7 days | Monthly frequency of hospital admissions for RSV bronchiolitis among participating centres over time |
| Proportion of children hospitalised for RSV bronchiolitis with viral co-detection | 7 days | Proportion of children hospitalised for RSV bronchiolitis with viral co-detection or viral detection other than RSV on nasopharyngeal swab |
| Proportion of hospitalised children for RSV bronchiolitis requiring invasive or non-invasive ventilatory passively immunised with nirsevimab | 7 days | Proportion of children passively immunised with nirsevimab hospitalised for bronchiolitis requiring invasive or non-invasive ventilatory support, including RSV bronchiolitis |
| Length of hospital stay | 7 days | Length of hospital stay for children with RSV bronchiolitis. |
| Time immunisation | 7 days | Time between immunisation with nirsevimab and hospitalisation for RSV bronchiolitis. |
Countries
France
Outcome results
None listed