Racial/Ethnic differences in the presentation and management of severe bronchiolitis

Santiago, Jonathan; Mansbach, Jonathan M.; Chou, Shih‐Chuan; Delgado, C Alfredo; Piedra, Pedro A.; Sullivan, Ashley F.; Espinola, Janice A.; Camargo, Carlos A.

doi:10.1002/jhm.2223

Cited by 24 publications

(24 citation statements)

References 36 publications

(63 reference statements)

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“…10 The potential relevance of genetic background to the degree of severity of bronchiolitis is further reinforced by the differences in the rate of RSV hospitalization observed in populations from different racial and ethnic backgrounds living in the same geographic region or country. 11,12 Together, these findings suggest that host genetic factors might likely contribute to the severity of virus-induced bronchiolitis.…”

Section: Introductionmentioning

confidence: 86%

Correlation between female sex, IL28B genotype, and the clinical severity of bronchiolitis in pediatric patients

et al. 2019

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BACKGROUND: Single-nucleotide polymorphisms (SNPs) that impact on the differential expression of interleukin 28B (IL28B) are implicated in the progression of viral-induced diseases. In this prospective longitudinal cohort study, we evaluated the association between IL28B SNPs rs12979860 and rs8099917 and the clinical outcome of bronchiolitis in pediatric patients. METHODS: A total of 682 infants suffering from bronchiolitis, categorized based on the final clinical outcome as mild or severe, were genotyped for IL28B SNPs rs12979860 and rs8099917. RESULTS: When infants were categorized exclusively based on the final clinical outcome, no association was established between IL28B SNPs and the severity of bronchiolitis. However, when stratified by sex, the homozygotes for the minor alleles of rs12979860 (T) and rs8099917 (G) were associated with a mild disease in girls but not in boys. CONCLUSION: SNPs rs12979860 and rs8099917 correlate with the severity of bronchiolitis and display a sex bias, where GG rs8099917 and TT rs12979860 genotypes are associated with a mild disease in girls but not in boys. These findings suggest that innate immunity and female sex links with the outcome of the diseases induced by respiratory viruses, such as RSV.

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Section: Introductionmentioning

confidence: 86%

Correlation between female sex, IL28B genotype, and the clinical severity of bronchiolitis in pediatric patients

et al. 2019

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“…One prior study by Santiago et al looked at racial and ethnic differences in infants admitted for bronchiolitis. 20 Although Hispanic patients did receive more chest x-rays, steroids, and nebulized treatments compared to non-Hispanic patients, their findings were not statistically significant and they did not conduct an analysis on potential differences in management based on language. In contrast, our study only included patients who had the same primary diagnosis of bronchiolitis and we evaluated management differences based on language.…”

Section: Article In Pressmentioning

confidence: 94%

Language Barriers and the Management of Bronchiolitis in a Pediatric Emergency Department

Zamor

Byczkowski

Yin

et al. 2020

Academic Pediatrics

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“…The study design, setting, participants, and methods of data collection have been reported previously. 9–14 Briefly, we conducted this prospective cohort study at 16 sites across 12 US states during the 2007–2010 winter seasons, as part of the Multicenter Airway Research Collaboration (MARC). MARC is a program of the Emergency Medicine Network (EMNet) (www.emnet-usa.org), a collaboration with >225 participating hospitals.…”

Section: Methodsmentioning

confidence: 99%

Association Between Hyponatremia and Higher Bronchiolitis Severity Among Children in the ICU With Bronchiolitis

Hasegawa

Stevenson

Mansbach

et al. 2015

Hospital Pediatrics

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Background It remains unclear whether hyponatremia independently predicts a higher severity in children with bronchiolitis. Objective To investigate the association between hyponatremia and bronchiolitis severity in children hospitalized to the intensive care unit (ICU) for bronchiolitis. Methods We conducted a 16-center, prospective cohort study of hospitalized children age <2 years with bronchiolitis during the winters of 2007 to 2010. We classified patients into two groups: normonatremia (135–145 mEq/L) and hyponatremia (<135 mEq/L) based on the first-measured serum sodium concentration on the day of hospitalization. Outcomes were use of mechanical ventilation and ICU length-of-stay (LOS). To examine the association of sodium status with outcomes, we fit logistic and linear regression models with propensity score adjustment. Results Of 231 children hospitalized to the ICU for bronchiolitis, 193 patients (84%) were categorized into the normonatremia group, and 38 children (16%) into hyponatremia group. Compared to children with normonatremia, those with hyponatremia had higher risks of mechanical ventilation use (40% vs. 58%; P=0.04) and longer ICU LOS (median, 3 days vs. 6 days; P=0.007). Likewise, in the adjusted analyses, children with hyponatremia had significantly higher risks of mechanical ventilation use (OR, 2.14; 95%CI, 1.03–4.48; P=0.04) and longer ICU LOS (β-coefficient 2.21 days; 95%CI, 0.68–3.73 days; P=0.003). Conclusions In this prospective, multicenter study of children hospitalized for bronchiolitis, hyponatremia on the day of hospitalization was associated with a higher severity. Our data support hyponatremia as a prognostic factor that might improve the ability of clinicians to predict the disease course of children with severe bronchiolitis.

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Racial/Ethnic differences in the presentation and management of severe bronchiolitis

Cited by 24 publications

References 36 publications

Correlation between female sex, IL28B genotype, and the clinical severity of bronchiolitis in pediatric patients

Correlation between female sex, IL28B genotype, and the clinical severity of bronchiolitis in pediatric patients

Language Barriers and the Management of Bronchiolitis in a Pediatric Emergency Department

Association Between Hyponatremia and Higher Bronchiolitis Severity Among Children in the ICU With Bronchiolitis

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