Respiratory syncytial virus and adenovirus in acute lower respiratory infections in hospitalized infants and children

Barberi, Salvatore; Barreto, Mario; Penna, Francesco La; Mazzarella, Bernardina; Liverani, Maria-Elena; Luca, Ottavia De; Simmaco, Maurizio; Villa, Maria Pia

doi:10.4236/ojped.2012.21004

Cited by 4 publications

(5 citation statements)

References 40 publications

(61 reference statements)

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“…This greater severity of mixed RSV‐adenovirus infections compared to single RSV infections was suggested by a previous study in hospitalized infants, which reported that mixed viral infections (of which a significant proportion had mixed RSV‐adenovirus infections) were associated with longer hospital stays compared to single RSV infections . Possible reasons for these variability in the reported outcome of mixed RSV‐adenovirus infections are differences in environmental, host (e.g., genetic immune response, previous immune condition, infected target cells), and viral factors (e.g., serotypes) . Another possible reason could be that adenovirus alone produces a more severe disease with no additional severity of a RSV infection.…”

Section: Discussionmentioning

confidence: 73%

“…Another possible reason could be that adenovirus alone produces a more severe disease with no additional severity of a RSV infection. Although this concept may be supported by the prominent effects of adenovirus on mononuclear cell activation and release of pro‐inflammatory cytokines compared to RSV, at the present time, there is no clear evidence demonstrating that adenovirus causes more severe respiratory disease in children than RSV …”

Section: Discussionmentioning

confidence: 88%

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Predictors of severity and mortality in children hospitalized with respiratory syncytial virus infection in a tropical region

Rodríguez¹,

Rodríguez‐Martínez

Cárdenas³

et al. 2013

Pediatric Pulmonology

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Summary Introduction Respiratory syncytial virus (RSV) is one of the leading causes of acute lower respiratory infection (ALRI) in infants and young children. Although ALRI is a major public health problem in developing countries located in tropical areas, studies about RSV epidemiology in these regions are scarce. Methods In a retrospective cohort study, we investigated the epidemiology and predictive variables that reflect disease severity and mortality in young children hospitalized with ALRI due to RSV in Colombia, South-America, during a 2-year period (2009–2011). Results Of a total of 6,344 children with a diagnosis of ALRI, we selected 2,147 (33.8%) that were positive for RSV. After controlling for pre-existing conditions, we found that independent predictors of severe disease in our population included age <6 months (RR 2.01; CI 95% 1.70–2.38; P < 0.001), prematurity (RR 1.61; CI 95% 1.20–2.17; P = 0.001), congenital heart disease (RR 2.03; CI 95% 1.16–3.54; P = 0.013), and mixed RSV-adenovirus infection (RR 2.09; CI 95% 1.60–2.73; P < 0.001). Multivariate analysis identified that cancer (RR 31.60; CI 95% 5.97–167.13; P < 0.001) is a predictor of mortality in our RSV-infected pediatric population independently of age and other co-morbidities. Conclusions RSV is an important cause of ALRI in infants and young children living in tropical regions, especially during the rainy season. The identified predictors of severe disease and mortality should be taken into account when planning interventions to reduce the burden of ALRI in young children living in these regions.

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Section: Discussionmentioning

confidence: 73%

Section: Discussionmentioning

confidence: 88%

Predictors of severity and mortality in children hospitalized with respiratory syncytial virus infection in a tropical region

Rodríguez¹,

Rodríguez‐Martínez

Cárdenas³

et al. 2013

Pediatric Pulmonology

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“…Another study of 9 RSV-confirmed infants found that 75% of children with RSV-ADV coinfection died despite mechanical ventilation [ 35 ]. Even though ADV alone may be responsible for more severe disease, clinical features such as hospital stay were not found to differ between RSV and ADV hospitalized LRTI [ 36 ]. However, increased pathogenicity may be explained by distinctly different immunological responses produced by RSV and ADV.…”

Section: Discussionmentioning

confidence: 99%

Severity of Respiratory Syncytial Virus Lower Respiratory Tract Infection With Viral Coinfection in HIV-Uninfected Children

Bont

Cohen

et al. 2016

CLINID

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Background Molecular diagnostics enable sensitive detection of respiratory viruses, but their clinical significance remains unclear in pediatric lower respiratory tract infection (LRTI). We aimed to determine whether viral coinfections increased life-threatening disease in a large cohort. Methods Molecular testing was performed for respiratory viruses in nasopharyngeal aspirates collected from children aged <5 years within 24 hours of hospital admission during sentinel surveillance for severe acute respiratory illness (SARI) hospitalization conducted in South Africa during February 2009–December 2013. The primary outcome was life-threatening disease, defined as mechanical ventilation, intensive care unit admission, or death. Results Of 2322 HIV-uninfected children with respiratory syncytial virus (RSV)–associated LRTI, 1330 (57.3%) had RSV monoinfection, 38 (1.6%) had life-threatening disease, 575 (24.8%) had rhinovirus, 347 (14.9%) had adenovirus (ADV), and 30 (1.3%) had influenza virus. RSV and any other viral coinfection was not associated with severe disease (odds ratio [OR], 1.4; 95% confidence interval [CI], OR, 0.74; 95% CI, .39–1.4), ADV coinfection had increased odds of life-threatening disease (adjusted OR, 3.4; 95% CI, 1.6–7.2; P = .001), and influenza coinfection had increased odds of life-threatening disease and prolonged length of stay (adjusted OR, 2.1; 95% CI, 1.0–4.5; P = .05) compared with RSV monoinfection. Conclusions RSV coinfection with any respiratory virus is not associated with more severe disease when compared to RSV alone in this study. However, increased life-threatening disease in RSV-ADV and RSV-influenza coinfection warrants further study.

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“…In contrast to our previous findings showing that age less than 6 months, prematurity, congenital heart disease, and mixed RSV‐adenovirus infection were independent predictors of severe ALRI in a different population of patients, [Rodriguez et al, ] the present study identified different predictors of severe ALRI. Possible explanations for these discrepancies might be differences in environmental, host (e.g., genetic immune response, previous immune condition, infected target cells), and viral factors (e.g., serotypes) [Barberi et al, ].…”

Section: Discussionmentioning

confidence: 99%

Predictors of severe disease in a hospitalized population of children with acute viral lower respiratory tract infections

Pedraza-Bernal

Rodríguez‐Martínez

Acuña‐Cordero

2015

Journal of Medical Virology

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Although predictors of severe viral acute lower respiratory infections (ALRIs) in children have been reported, there have been few research studies performed in low- and middle-income countries (LMIC). The aim of the present study was to determine predictors of disease severity in a population of Colombian children <5 years of age with ALRI. In a prospective cohort study, we determined independent predictors of severe ALRI in a hospitalized population of children under 5 years old with ALRI during a 1-year period. We included both underlying disease conditions and the infecting respiratory viruses as predictor variables of severe disease. We defined severe disease as the necessity of pediatric intensive care unit admission. Of a total of 1,180 patients admitted with a diagnosis of ALRI, 416 (35.3%) were included because they were positive for any kind of respiratory virus. After controlling for potential confounders, it was found that a history of pulmonary hypertension (RR 3.62; CI 95% 2.38-5.52; P < 0.001) and a history of recurrent wheezing (RR 1.77; CI 95% 1.12-2.79; P = 0.015) were independent predictors of severe disease. The present study shows that respiratory viruses are significant causes of ALRI in infants and young children in Colombia, a typical tropical LMIC, especially during the rainy season. Additionally, the results of the present study show that clinical variables such as a history of pulmonary hypertension and a history of recurrent wheezing are more relevant for predicting ALRI severity than the infecting respiratory viruses.

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Respiratory syncytial virus and adenovirus in acute lower respiratory infections in hospitalized infants and children

Abstract: ABSTRACT

Cited by 4 publications

References 40 publications

Predictors of severity and mortality in children hospitalized with respiratory syncytial virus infection in a tropical region

Predictors of severity and mortality in children hospitalized with respiratory syncytial virus infection in a tropical region

Severity of Respiratory Syncytial Virus Lower Respiratory Tract Infection With Viral Coinfection in HIV-Uninfected Children

Predictors of severe disease in a hospitalized population of children with acute viral lower respiratory tract infections

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