A Hypothesis-Generating Prospective Longitudinal Study to Assess the Relative Contribution of Common Respiratory Viruses to Severe Lower Respiratory Infections in Young Children. Issue 5 (8th March 2023)

• Record Type: Journal Article
• Authors: Ben-Shimol, Shalom; Ramilo, Octavio; Leber, Amy L.; van der Beek, Bart Adriaan; Everhart, Kathy; Mertz, Sara; Mejias, Asuncion; Dagan, Ron
• Is Part Of: Pediatric infectious disease journal. Volume 42:Issue 5(2023)
• Page Start: 396
• Page End: 404
• Publication Date: 2023-03-08
• Subjects: respiratory viruses -- community alveolar pneumonia -- bronchiolitis -- carriage; Communicable diseases in children -- Periodicals; Infection in children -- Periodicals; 618.929
• DOI: 10.1097/INF.0000000000003865
• Languages: English
• ISSNs: 0891-3668

Abstract

Abstract : Background: Respiratory viruses such as respiratory syncytial virus (RSV), influenza, parainfluenza and human metapneumovirus are well-established etiologies of acute lower respiratory tract infections (ALRIs; LRI-viruses). In contrast, adenovirus (AdV), rhinovirus/enterovirus (RV/EV) and seasonal human coronaviruses (CoV), collectively termed AdV/RV/CoV, are detected both in healthy children and children with ALRI. Methods: The methods include a prospective longitudinal case–control study, assessing the prevalence of LRI-viruses versus AdV/RV/CoV in ALRI [community-acquired alveolar pneumonia (CAAP) and bronchiolitis] during hospitalization (visit 1), 7–14 days (visit 2) and 28–35 days (visit 3) in 2–17-month-old children. Controls were 2–27-month-old children hospitalized for elective surgery during the same respiratory seasons. Results: We enrolled 99 infants (37 CAAP, 38 bronchiolitis and 24 controls) and obtained 211 nasopharyngeal swabs. Overall, 163 (77%) had greater than or equal to 1 viruses detected; RV/EV (n = 94; 45%) and RSV (n = 71; 34%) were the most frequently detected viruses. In CAAP, the overall LRI-virus prevalence was 78.4%, 32.4% and 5.4% in visits 1, 2 and 3, respectively; the respective rates in bronchiolitis were 73.7%, 34.5% and 8.0%. In controls, no LRI-viruses were detected. In contrast, the overall AdV/RV/CoV prevalence was high among controls (70.8%) and similar among CAAP (48.6%, 40.5% and 40.5%) and bronchiolitis (47.4, 58.6% and 64.0%) across visits. Conclusions: Among ALRI cases, LRI-viruses dominated during the acute disease, with prevalence declining within 28–35 days, suggesting their causative role. In contrast, AdV/RV/CoV prevalence was similar during all 3 visits and in controls, suggesting that carriage of these viruses is common during the viral respiratory season. The current study is relatively small and of short duration; however, the findings are supported by other recent studies.