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婴幼儿呼吸道合胞病毒感染重症危险因素的研究进展
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Abstract:
呼吸道合胞病毒在全球范围内广泛流行，是引起5岁以下儿童急性下呼吸道感染最主要的病毒病原之一。RSV传染性较强，几乎所有儿童在出生后头两年都会发生一次或多次RSV感染。大部分儿童感染RSV后仅表现出轻微至中度的呼吸道症状，但高危婴幼儿(如早产儿、低出生体重儿及患有基础疾病者)中，感染可迅速进展为重症，甚至发生死亡结局。既往已有大量探讨RSV感染重症危险因素的研究，但缺乏系统性的总结更新。目前，长效单克隆抗体Nirsevimab已在国内获批上市，即将广泛应用于婴幼儿RSV预防，明确高危因素对指导RSV被动免疫策略、减轻相关疾病负担至关重要。本文将全面综述婴幼儿RSV感染重症化的主要高危因素，以期为RSV科学防治提供参考。
Respiratory syncytial virus (RSV) is one of the most common viral pathogens worldwide causing acute lower respiratory tract infections (ALTI) in children under 5 years of age. RSV is highly contagious, with almost all children developing one or more RSV infections in the first two years of life. Most children infected with RSV show only mild to moderate respiratory symptoms, but in high-risk infants and young children (e.g., preterm infants, low-birth-weight infants, and those with underlying medical conditions), the infection can rapidly progress to severe illness and even fatal outcomes. There have been many studies exploring the risk factors for severe RSV infection, but a systematic summary update is lacking. Nirsevimab, a long-acting monoclonal antibody, has been approved for market use in China and is about to be widely applied in the prevention of RSV in infants and young children. Identifying high-risk factors is crucial for guiding passive immunization strategies for RSV and alleviating the associated disease burden. This article aims to comprehensively review the major high-risk factors for severe RSV infection in infants and young children, with the goal of providing a reference for the scientific prevention and treatment of RSV.
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