Prevalence and characteristics of acute respiratory virus infections in pediatric cancer patients

Abstract

Background: Patients with pediatric cancer have a higher risk of morbidity and mortality because of respiratory viral infections than other patient populations.Objectives: To investigate the causative viruses of respiratory infections and their burden among patients with pediatric cancer in Lebanon.Study design: Nasopharyngeal swabs along with clinical and demographic data were collected from patients with pediatric cancer presenting febrile episodes with upper respiratory tract symptoms. Total nucleic acid was extracted from specimens followed by the real-time PCR analysis targeting 14 respiratory viruses to estimate the frequency of infections. Results:We obtained 89 nasopharyngeal swabs from patients with pediatric cancer (mean age, 5.8 ± 4.2 years). Real-time PCR confirmed viral infection in 77 swabs (86.5%). Among these, 151 respiratory viruses were detected. Several viruses cocirculated within the same period; respiratory syncytial virus (RSV) being the most common (45.45%), followed by parainfluenza virus (PIV; 26%), influenza type B (26%), human metapneumovirus (24.6%), and human coronavirus (HCoV; 24.6%). Coinfections were detected in 55% of the subjects, and most of them involved RSV with one or more other viruses. A strong correlation was found between PIV, Flu (influenza of any type), RSV, and HCoV with the incidence of coinfections. RSV was associated with lower respiratory tract infections, nasal congestion, bronchitis, and bacteremia. HCoV was associated with bronchiolitis; rhinovirus was associated with hospital admission. Conclusion: Patients with pediatric cancer have a high burden of respiratory viral infections and a high incidence of coinfections. Molecular diagnostics can improve management of febrile episodes and reduce antibiotic use. K E Y W O R D S coinfection, patients with pediatric cancer, prevalence, real-time PCR, respiratory tract infections, virus infections J Med Virol. 2019;91:1191-1201. wileyonlinelibrary.com/journal/jmv

Epidemiological characteristics and phylogenic analysis of human respiratory syncytial virus in patients with respiratory infections during 2011–2016 in southern China

“…Among the 16 024 patients, 4.8% (771/16 024) had co-detected viruses, and among the 5818 positive patients, 13.3% (771/5818) had more than one virus co-detected. Consistent with Soudani et al (2019), RSV was the most common co-detected virus (49.3%, 380/771), followed by Flu (33.7%, 260/771), HRV (26.3%, 203/771), PIV (24.4%, 188/771), HADV (24.3%, 187/771), HCoV (22.8%, 176/ 771), HBoV (13.1%, 101/771), and HMPV (12.6%, 97/771). Among the 1514 RSV-positive samples, 25.1% (380/1514) were co-detected with other viruses, most commonly with Flu, followed by HRV and HADV (Table 4); 91.1% were double infections (346/380) and 8.9% were triple infections (34/380).…”

The burden of laboratory-confirmed influenza infection in Lebanon between 2008 and 2016: a single tertiary care center experience

“…Samples were collected from these patients and tested for influenza A and B viruses by rapid diagnostic test and/or by real-time reverse-transcriptase polymerase chain reaction (RT-PCR). Information already collected for patients diagnosed to have influenza A or B covering all the seasons from 2008 till 2016 who were previously enrolled in three ongoing surveillance studies at the CIDR at AUBMC (Surveillance of respiratory virus infections among pediatric cancer patients at the children's cancer center of Lebanon [34], Viral infections in patients at the children's cancer center of Lebanon and Epidemiologic surveillance of respiratory viral infections in Lebanon [29][30][31][32][33][34][35] were also included. Influenza season in Lebanon starts in late November and lasts through the month of April.…”

SARS‐CoV‐2 disease and children under treatment for cancer

“…Liang and colleagues noted that individuals with cancer are at higher risk of severe SARS‐CoV‐2 illness than those without cancer 1 . While recognizing that children seem to have a lower incidence of disease from SARS‐CoV‐2, 2‐4 those with cancer carry a higher risk of morbidity and mortality from viral respiratory infections than their healthy peers 5 …”