TY - JOUR
T1 - Complications and risk factors for severe outcome in children with measles
AU - Lo Vecchio, Andrea
AU - Krzysztofiak, Andrzej
AU - Montagnani, Carlotta
AU - Valentini, Piero
AU - Rossi, Nadia
AU - Garazzino, Silvia
AU - Raffaldi, Irene
AU - Di Gangi, Maria
AU - Esposito, Susanna
AU - Vecchi, Barbara
AU - Melzi, Maria Luisa
AU - Lanari, Marcello
AU - Zavarise, Giorgio
AU - Bosis, Samantha
AU - Valenzise, Mariella
AU - Cazzato, Salvatore
AU - Sacco, Michele
AU - Govoni, Maria Rita
AU - Mozzo, Elena
AU - Cambriglia, Maria Donata
AU - Bruzzese, Eugenia
AU - Di Camillo, Chiara
AU - Pata, Davide
AU - Graziosi, Alessandro
AU - Sala, Debora
AU - Magurano, Fabio
AU - Villani, Alberto
AU - Guarino, Alfredo
AU - Galli, Luisa
PY - 2018/1/1
Y1 - 2018/1/1
N2 - Objective and design: Risk factors for severe measles are poorly investigated in high-income countries. The Italian Society for Paediatric Infectious Diseases conducted a retrospective study in children hospitalised for measles from January 2016 to August 2017 to investigate the risk factors for severe outcome defined by the presence of long-lasting sequelae, need of intensive care or death. Results: Nineteen hospitals enrolled 249 children (median age 14.5 months): 207 (83%) children developed a complication and 3 (1%) died. Neutropaenia was more commonly reported in children with B3-genotype compared with other genotypes (29.5% vs 7.7%, p=0.01). Pancreatitis (adjusted OR [aOR] 9.19, p=0.01) and encephalitis (aOR 7.02, p=0.04) were related to severe outcome in multivariable analysis, as well as C reactive protein (CRP) (aOR 1.1, p=0.028), the increase of which predicted severe outcome (area under the receiver operating characteristic curve 0.67, 95% CI 0.52 to 0.82). CRP values >2 mg/dL were related to higher risk of complications (OR 2.0, 95% CI 1.15 to 3.7, p=0.01) or severe outcome (OR 4.13, 95% CI 1.43 to 11.8, p<0.01). Conclusion: The risk of severe outcome in measles is independent of age and underlying conditions, but is related to the development of organ complications and may be predicted by CRP value.
AB - Objective and design: Risk factors for severe measles are poorly investigated in high-income countries. The Italian Society for Paediatric Infectious Diseases conducted a retrospective study in children hospitalised for measles from January 2016 to August 2017 to investigate the risk factors for severe outcome defined by the presence of long-lasting sequelae, need of intensive care or death. Results: Nineteen hospitals enrolled 249 children (median age 14.5 months): 207 (83%) children developed a complication and 3 (1%) died. Neutropaenia was more commonly reported in children with B3-genotype compared with other genotypes (29.5% vs 7.7%, p=0.01). Pancreatitis (adjusted OR [aOR] 9.19, p=0.01) and encephalitis (aOR 7.02, p=0.04) were related to severe outcome in multivariable analysis, as well as C reactive protein (CRP) (aOR 1.1, p=0.028), the increase of which predicted severe outcome (area under the receiver operating characteristic curve 0.67, 95% CI 0.52 to 0.82). CRP values >2 mg/dL were related to higher risk of complications (OR 2.0, 95% CI 1.15 to 3.7, p=0.01) or severe outcome (OR 4.13, 95% CI 1.43 to 11.8, p<0.01). Conclusion: The risk of severe outcome in measles is independent of age and underlying conditions, but is related to the development of organ complications and may be predicted by CRP value.
KW - children
KW - complication
KW - genotype
KW - measles
KW - severe outcome
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U2 - 10.1136/archdischild-2018-315290
DO - 10.1136/archdischild-2018-315290
M3 - Article
AN - SCOPUS:85059902738
SN - 0003-9888
JO - Archives of Disease in Childhood
JF - Archives of Disease in Childhood
ER -