Rhinoviruses as critical agents in severe bronchiolitis in infants

Bastos, Juliana Cristina Santiago; Simas, Paulo Vitor Marques; Caserta, Leonardo Cardia; Bragunde, Alfonso Eduardo Alvarez; Marson, Fernando Augusto Lima; Martini, Matheus Cavalheiro; Padilla, Marina Aiello; Ribeiro, José Dirceu; Santos, Márcia Mercês Aparecida Bianchi dos; Arns, Clarice Weis

doi:10.1016/j.jped.2021.11.006

Cited by 4 publications

(5 citation statements)

References 26 publications

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“…The availability of multiplex PCR tests in the 2020−2021 period allowed for a better microbiological characterization, with findings similar to other authors that have identified rhinovirus as the second most common isolate, 25 and also helped to identify false negatives in RSV rapid antigen tests. The percentage of codetections was lower than other studies, which include up to 30% codetections between RSV and rhinovirus, 3 and did not confer a higher severity in our sample, but their role remains to be established 3,26 .…”

Section: Discussionsupporting

confidence: 70%

Bronchiolitis before and after the SARS‐CoV‐2 pandemic: Twelve years of experience in a Spanish paediatric hospital

Guerrero-del-Cueto

Ramos-Fernández

Leiva-Gea

et al. 2023

Pediatric Pulmonology

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Introduction Acute bronchiolitis is the main cause of hospitalization in children under 2 years of age, with a regular seasonality, mostly due to the respiratory syncytial virus. Objectives To describe the epidemiology of bronchiolitis hospitalizations in our center in the last 12 years, and analyze the changes in clinical characteristics, microbiology, and adverse outcomes during the SARS‐CoV‐2 pandemic. Methods Observational study including patients admitted for bronchiolitis between April 2010 and December 2021 in a Spanish tertiary paediatric hospital. Relevant demographic, clinical, microbiological, and adverse outcome variables were collected in an anonymized database. The pandemic period (April 2020 to December 2021) was compared to 2010−2015 seasons using appropriate statistical tests. Results There were 2138 bronchiolitis admissions, with a mean of 195.6 per year between 2010 and 2019 and a 2−4‐month peak between November and March. In the expected season of 2020, there was a 94.4% reduction of bronchiolitis hospitalizations, with only 11 cases admitted in the first year of the pandemic. Bronchiolitis cases increased from the summer of 2021 during a 6‐month long peak, reaching a total of 171 cases. Length of stay was significantly shorter during the pandemic, but no differences were found in clinical and microbiological characteristics or other adverse outcomes. Conclusions The SARS‐CoV‐2 pandemic has modified the seasonality of bronchiolitis hospitalizations, with a dramatic decrease in cases during the expected season of 2020−2021, and an extemporaneous summer−autumn peak in 2021 with longer duration but similar patient characteristics and risk factors.

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Section: Discussionsupporting

confidence: 70%

Bronchiolitis before and after the SARS‐CoV‐2 pandemic: Twelve years of experience in a Spanish paediatric hospital

Guerrero-del-Cueto

Ramos-Fernández

Leiva-Gea

et al. 2023

Pediatric Pulmonology

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“…In the study published in this issue of the journal, Bastos and colleagues provided data regarding the causative agents of severe bronchiolitis in hospitalized children < 2 years of age. 3 They found that of the 173 nasopharyngeal (NP) aspirates analyzed using a 15-plex PCR assay, a respiratory virus was identified in 87% of children and viral confections in 23% of them. Overall, RSV alone or in combination with another respiratory virus, was the most common pathogen identified in 78% of children, followed by rhinoviruses in 20%.…”

mentioning

confidence: 99%

“… 13 Of all viral coinfections, RSV-RV represents the most common association, as was areported in the aforementioned study. 3 Relying exclusively on national or local trends of viral circulation, or rapid RSV antigen testing for patient placement and cohorting is likely not sufficient. The isolation of children with RSV infection requires contact precautions, while for rhinovirus infections both contact and droplet precautions are indicated.…”

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confidence: 99%

The importance of viral testing in infants and young children with bronchiolitis

Mejías

Sánchez-Códez

Ramilo

et al. 2022

Jornal de Pediatria

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“…Most previous studies only included hospitalized patients and therefore comparison between patients suffering from both mild and severe diseases could not unbiasedly be made. For instance, a recent study from Brazil found RV in almost a quarter of cases with severe bronchiolitis in small children, but the samples were not typed 34 . The present study includes patients from both hospitals (emergency departments, hospital wards, and intensive care units) and primary care centers.…”

Section: Discussionmentioning

confidence: 99%

“…For instance, a recent study from Brazil found RV in almost a quarter of cases with severe bronchiolitis in small children, but the samples were not typed. 34 The present study includes patients from both hospitals (emergency departments, hospital wards, and intensive care units) and primary care centers.…”

Section: Discussionmentioning

confidence: 99%

Epidemiology and clinical manifestations of different enterovirus and rhinovirus types show that EV‐D68 may still have an impact on severity of respiratory infections

Larsson

Vracar

Karlsson

et al. 2022

Journal of Medical Virology

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Respiratory infections are often caused by enteroviruses (EVs). The aim of this study was to identify whether certain types of EV were more likely to cause severe illness in 2016, when an increasing spread of upper respiratory infections was observed in Gothenburg, Sweden. The EV strain in 137 of 1341 nasopharyngeal samples reactive for EV by polymerase chain reaction could be typed by sequencing the viral 5′-untranslated region and VP1 regions.Phylogenetic trees were constructed. Patient records were reviewed. Hospital care was needed for 46 of 74 patients with available medical records. The majority of the patients (83) were infected with the rhinovirus (RV). The remaining 54 were infected with EV A, B, C, and D strains of 13 different types, with EV-D68 and CV-A10 being the most common (17 vs. 14). Significantly more patients with EV-D68 presented with dyspnea, both when compared with other EV types (p = 0.003) and compared to all other EV and RV infections (p = 0.04). Phylogenetic analysis of the sequences revealed the spread of both Asian and European CV-A10 strains and 12 different RV C types. This study showed an abundance of different EV types spreading during a year with increased upper respiratory increased infections. EV-D68 infections were associated with more severe disease manifestation. Other EV and RV types were more evenly distributed between hospitalized and nonhospitalized patients. The EV type CV-A10 was also found in infected patients, which warrants further studies and surveillance, as this pathogen could cause more severe disease and outbreaks of hand, foot, and mouth disease.

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Rhinoviruses as critical agents in severe bronchiolitis in infants

Cited by 4 publications

References 26 publications

Bronchiolitis before and after the SARS‐CoV‐2 pandemic: Twelve years of experience in a Spanish paediatric hospital

Bronchiolitis before and after the SARS‐CoV‐2 pandemic: Twelve years of experience in a Spanish paediatric hospital

The importance of viral testing in infants and young children with bronchiolitis

Epidemiology and clinical manifestations of different enterovirus and rhinovirus types show that EV‐D68 may still have an impact on severity of respiratory infections

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