Down's syndrome is a risk factor for severe lower respiratory tract infection due to respiratory syncytial virus

Aim: Previous studies have suggested that Down's syndrome is an independent risk factor for severe respiratory infection due to respiratory syncytial virus (RSV). We compared the clinical characteristics of children with and without Down's syndrome hospitalised due to RSV. Methods: This retrospective cohort study compared data from hospitalisations due to RSV lower respiratory tract infections (LRTI) in children under 14 years of age with (n = 58) and without (n = 58) Down's syndrome. Results: The Down's group had longer hospital stays than the controls of six versus four days (p < 0.0001), even after adjusting for age, weeks of gestation at birth, presence of asthma, bronchopulmonary dysplasia, haemodynamically significant and nonsignificant congenital heart disease. This difference increased when only children under one year of age were analysed to 11 versus five days (p < 0.0001). Children with Down's syndrome were more likely to be admitted to intensive care unit (43.1% versus 22.4%, p = 0.017), need noninvasive mechanical ventilation (36.2% versus 13.7%, p = 0.005) and be prescribed antibiotics and steroids. Conclusion: Children with Down's syndrome hospitalised due to RSV LRTI had longer hospital stays and worse clinical courses than controls, highlighting the need for RSV prophylaxis for children with Down's syndrome, especially under one year of age.