Retrospective Multicenter Study of Respiratory Syncytial Virus Prophylaxis in Korean Children with Congenital Heart Diseases

Kim, Ah Young; Jung, Se Yong; Choi, Jae Young; Kim, Gi Beom; Kim, Young-Hwue; Shim, Woo Sup; Kang, I-Seok; Jung, Jo Won

For CHD patients in Korea, small doses and omitting or delaying palivizumab prophylaxis were found in major pediatric centers during the 2009-2015 RSV seasons. Even though the current data on RSV prophylaxis has been collected for infants with CHD in Korea, the data might actually be helpful for CHD patients if the Korean guideline would be extended to children up to 24 months of age with HS-CHD, including cardiomyopathy, and postoperative CHD patients. We recommend that the guideline should be updated based on the key findings: (i) the risk of hospitalization due to RSV infection remains high among children with CHD, (ii) children with CHD exhibit a higher rate of morbidity despite prophylactic treatment than that reported in recent studies, 11) [18] [19] [20] [21] [22] and (iii) since the RSV season of Korea is not different with that of other countries, the national guideline might be regarded as outdated by international guidelines. 23) In Korean guidelines, the patient group with HCM was not supported financially. Thus, only a few patients with HCM were included because patients who had received palivizumab injection were rare. This is the first and largest study to evaluate compliance according to the Korean guideline for prophylactic treatment, and to determine that morbidity and mortality due to RSV infection is still significant in children with CHD. According to the Korean guidelines, the risk of RSV infection remains significant among children with hemodynamically insignificant CHD, cardiomyopathy, and children above 1 year-old with HS-CHD.