Defining Age-specific Relationships of Respiratory Syncytial Virus and Rhinovirus Species in Hospitalized Children With Acute Wheeze. Issue 10 (October 2021)

• Record Type: Journal Article
• Authors: Oo, Stephen W.C.; Khoo, Siew-Kim; Cox, Des W.; Chidlow, Glenys; Franks, Kimberley; Prastanti, Franciska; Bochkov, Yury A.; Borland, Meredith L.; Zhang, Guicheng; Gern, James E.; Smith, David W.; Bizzintino, Joelene A.; Laing, Ingrid A.; Le Souëf, Peter N.
• Is Part Of: Pediatric infectious disease journal. Volume 40:Issue 10(2021)
• Publication Date: 2021-10
• Subjects: pediatric asthma -- wheeze -- rhinovirus -- RSV -- age; Communicable diseases in children -- Periodicals; Infection in children -- Periodicals; 618.929
• DOI: 10.1097/INF.0000000000003194
• Languages: English
• ISSNs: 0891-3668

Abstract

Abstract : Background: Acute wheezing is one of the most common hospital presentations for young children. Respiratory syncytial virus (RSV) and rhinovirus (RV) species A, B and the more recently described species C are implicated in the majority of these presentations. However, the relative importance and age-specificities of these viruses have not been defined. Hence, this study aimed to establish these relationships in a large cohort of prospectively recruited hospitalized children. Methods: The study cohort was 390 children 0–16 years of age presenting with acute wheezing to a children's emergency department, 96.4% being admitted. A nonwheezing control population of 190 was also recruited. Nasal samples were analyzed for viruses. Results: For the first 6 months of life, RSV was the dominant virus associated with wheezing ( P < 0.001). From 6 months to 2 years, RSV, RV-A and RV-C were all common but none predominated. From 2 to 6 years, RV-C was the dominant virus detected (50–60% of cases), 2–3 times more common than RV-A and RSV, RSV decreasing to be absent from 4 to 7 years. RV-B was rare at all ages. RV-C was no longer dominant in children more than 10 years of age. Overall, RV-C was associated with lower mean oxygen saturation than any other virus ( P < 0.001). Controls had no clear age distribution of viruses. Conclusion: This study establishes a clear profile of age specificity of virus infections causing moderate to severe wheezing in children: RSV as the dominant cause in the first 6 months and RV-C in preschool-age children. Abstract : Supplemental Digital Content is available in the text.