Family history of atopy and clinical course of RSV infection in ambulatoryand hospitalized infants

Respiratory syncytial virus (RSV) infection can be severe in pediatric pati ents. Risk factors for severe disease include age less than 6 months, prema turity, preexisting heart or lung disease or malformations, gastroesophagea l reflux, and immunodeficiency. The aim of the present study was to investi gate the influence of family history of allergy on the clinical course of R SV infection in ambulatory and hospitalized infants. In a retrospective stu dy, 172 patients younger than 12 months of age (99 inpatients and 73 outpat ients) were enrolled. Information was obtained from hospital charts and fro m questionnaires sent to pediatricians. Inpatients had a significantly higher rate of atopy in their family history than outpatients, 62% and 29%, respectively (P < 0.001). Bronchiolitis was diagnosed more frequently in patients with an atopic burden than those wit hout, 89% versus 74%, respectively (P< 0.02). Inpatients with an atopic fam ily history had a significantly longer hospital stay than those without suc h a history, 7.4 +/- 3.7 days and 6.1 +/- 2.3 days, respectively (P < 0.04) . Factors other than age that are considered a risk for severe infection wi th RSV (prematurity, preexisting heart or lung disease or malformation, and gastroesophageal reflux) were not confirmed in the present study. We conclude that infants with a family history of atopy are at increased ri sk for severe RSV infection as indicated by higher rates of hospitalization , longer hospital stay, and more frequent occurrence of bronchiolitis. Pedi atr Pulmonol, 2000; 30:302-306. (C) 2000 Wiley-Liss. Inc.