Risk factors of prolonged hospital stay in children with viral severe acute respiratory infections

Abstract

Introduction: Severe acute lower respiratory infections (SARIs) are one of the major causes of morbidity and mortality in young children, especially in developing countries. The present study focused on detection of risk factors for prolonged hospital stays among children with viral SARIs. Methodology: A sentinel surveillance study was conducted at Cairo University Hospital (CUH) between February 2010 and May 2011. Nasopharyngeal (NP) and oropharyngeal (OP) swabs were collected from all children admitted with SARIs. Viruses were identified using reverse transcription polymerase chain reaction (RT-PCR). Results: Out of 1,046 children, 380 (36%) were positive for one or more viruses; these included respiratory syncytial virus (RSV) (22.9%), adenovirus (6.2%), parainfluenza viruses (PIVs1-3) (5.1%), human metapneumovirus (HMPV) (4.5%), influenza A (1.4%), and influenza B (0.6%). Viral etiology was mainly detected in children under one year of age (88.9%). Prolonged length of stay was independently associated with the presence of cyanosis and underlying chronic illness (OR 7.4, CI: 1.8-30.32 [p = 0.005], OR 2.5, CI: 1.36-4.64 [p = 0.004], respectively). Virus type did not affect the length of hospital stay (p > 0.05). Oxygen therapy was required in 91% of the patients. A total of 43 patients (11.6%) required intensive care admission. Twenty-one patients (5.5%) died, and 15 of them (71.4%) had an underlying chronic illness. Conclusions: The study demonstrated the important burden of respiratory viruses as a cause of SARI in hospitalized children in a tertiary Egyptian hospital. Cyanosis and underlying chronic illness were significantly associated with prolonged length of stay.

Clinical characteristics and outcomes of patients with severe acute respiratory infections (SARI): results from the Egyptian surveillance study 2010–2014

“…The worldwide distribution of viral etiology as a cause of SARI varies between 2% and up to 78% [7,11,13,14]. In this study, we found a viral etiology in 33.5 % of hospitalized patients with SARI, which is comparable to previous studies conducted in either developing or Middle Eastern countries [9][10][11]13]. The finding that two-thirds of SARI cases had no pathogen detected suggests that poor or late specimen collection may have contributed to a lower yield of detected viruses.…”

“…The 2009 influenza pandemic had highlighted the need for more global data on severe influenza disease, so the WHO recommended conducting surveillance for hospitalized severe acute respiratory infection (SARI), as well as influenza-like illness (ILI) in outpatients [3][4][5][6]. SARI surveillances are now conducted in many countries around the world; however, because of limited resources, they are only conducted in limited settings in the Middle East and Egypt [7][8][9]. Furthermore, the role of individual viral or atypical bacterial infection in causing ARI is not usually documented [10,11].…”

Prevalence of human respiratory syncytial virus infection in people with acute respiratory tract infections in Africa: A systematic review and meta‐analysis

“…The inter‐rater agreement for study selection was high ( κ = 0.81). Finally, 66 full texts including 67 studies were included (one paper included two studies) …”

Predictors of Prolonged Length of Hospital Stay for Infants with Bronchiolitis

“…In the same manner, in a prospective cohort study that included 232 indigenous infants hospitalized with bronchiolitis, McCallum et al 18 identified a 12-point severity score (including accessory muscle use) as the only factor associated with prolonged LOS. The presence of cyanosis was significantly associated with prolonged LOS in a population of 1046 children hospitalized for acute lower respiratory infections in a hospital located in Cairo, Egypt 32. Janahi et al 28 in a retrospective cohort study examined an inpatient population of 369 infants admitted with acute bronchiolitis in a hospital in Qatar, and found that retraction was an independent predictor of longer LOS.…”