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Kocoglu Barlas U, Akcay N, Menentoglu ME, Sevketoglu E, Duyu M, Telhan L, Kangin M, Tugrul HC, Erdogan S, Durak C, Guney Sahin E, Umur O, Sik SG, Citak A, Yaman A. Assessment of the Clinical Course of Human Rhinovirus/Enterovirus Infections in Pediatric Intensive Care. Pediatr Infect Dis J 2023; 42:e454-e460. [PMID: 37820286 DOI: 10.1097/inf.0000000000004127] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/13/2023]
Abstract
BACKGROUND This study aims to evaluate the clinical course of human rhinovirus/enterovirus (HRV/EV) infections in the pediatric intensive care unit. METHODS The study was conducted as a multicenter, prospective observational study from September 2022 to December 2022. Cases with positive polymerase chain reaction testing for HRV/EV of nasopharyngeal swab samples within the first 24 hours of pediatric intensive care unit admission were recorded. There were 2 groups: 1-24 months and >24 months. RESULTS A total of 75 cases (39 male) were included in the study. The median age for all cases was 21 months. The highest polymerase chain reaction positivity rates were observed in October (37.33%). Among the cases, 32 (42.67%) presented with bronchopneumonia/pneumonia, 24 (32%) presented with acute bronchiolitis/bronchitis and 7 (9.33%) presented with sepsis/septic shock. The frequency of pediatric acute respiratory distress syndrome was found to be 6.67%. In the age group of 1-24 months, mean lymphocyte and liver enzyme levels were higher, while in the age group of >24 months, mean hemoglobin and mean kidney function test levels were higher ( P ≤ 0.05). Continuous oxygen therapy was provided to 65.3% of the cases, noninvasive ventilation to 33.3%, high-flow nasal cannula-oxygen therapy to 32% and invasive mechanical ventilation to 16%. CONCLUSIONS HRV/EV infections primarily affect the respiratory system and generally exhibit a clinical course with low mortality rates (1, 1.3%). In cases with underlying chronic diseases, more severe clinical conditions such as pediatric acute respiratory distress syndrome and septic shock may occur.
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Affiliation(s)
- Ulkem Kocoglu Barlas
- From the Pediatric Intensive Care Unit, Department of Pediatrics, Istanbul Medeniyet University, Goztepe Prof Dr Süleyman Yalcin City Hospital, Istanbul, Turkey
| | - Nihal Akcay
- Pediatric Intensive Care Unit, Department of Pediatrics, University of Health Sciences Turkey, Kanuni Sultan Suleyman Training and Research Hospital, Istanbul, Turkey
| | - Mehmet Emin Menentoglu
- Pediatric Intensive Care Unit, Department of Pediatrics, University of Health Sciences Turkey, Bakirkoy Dr Sadi Konuk Training and Research Hospital, Istanbul, Turkey
| | - Esra Sevketoglu
- Pediatric Intensive Care Unit, Department of Pediatrics, University of Health Sciences Turkey, Bakirkoy Dr Sadi Konuk Training and Research Hospital, Istanbul, Turkey
| | - Muhterem Duyu
- From the Pediatric Intensive Care Unit, Department of Pediatrics, Istanbul Medeniyet University, Goztepe Prof Dr Süleyman Yalcin City Hospital, Istanbul, Turkey
| | - Leyla Telhan
- Pediatric Intensive Care Unit, Department of Pediatrics, Istanbul Medipol University, Bagcilar Mega Hospital, Istanbul, Turkey
| | - Murat Kangin
- Pediatric Intensive Care Unit, Department of Pediatrics, Istanbul Medipol University, Bagcilar Mega Hospital, Istanbul, Turkey
| | - Hazal Ceren Tugrul
- Pediatric Intensive Care Unit, Department of Pediatrics, University of Health Sciences Turkey, Umraniye Training and Research Hospital, Istanbul, Turkey
| | - Seher Erdogan
- Pediatric Intensive Care Unit, Department of Pediatrics, University of Health Sciences Turkey, Umraniye Training and Research Hospital, Istanbul, Turkey
| | - Cansu Durak
- Pediatric Intensive Care Unit, Department of Pediatrics, University of Health Sciences Turkey, Sancaktepe Sehit Prof Dr Ilhan Varank Training and Research Hospital, Istanbul, Turkey
| | - Ebru Guney Sahin
- Pediatric Intensive Care Unit, Department of Pediatrics, University of Health Sciences Turkey, Sancaktepe Sehit Prof Dr Ilhan Varank Training and Research Hospital, Istanbul, Turkey
| | - Ozge Umur
- Pediatric Intensive Care Unit, Department of Pediatrics, Acibadem Mehmet Ali Aydinlar University, Atakent Hospital, Istanbul, Turkey
| | - Sare Guntulu Sik
- Pediatric Intensive Care Unit, Department of Pediatrics, Acibadem Mehmet Ali Aydinlar University, Atakent Hospital, Istanbul, Turkey
| | - Agop Citak
- Pediatric Intensive Care Unit, Department of Pediatrics, Acibadem Mehmet Ali Aydinlar University, Atakent Hospital, Istanbul, Turkey
| | - Ayhan Yaman
- Pediatric Intensive Care Unit, Department of Pediatrics, Istinye University, Bahcesehir Liv Hospital, Istanbul, Turkey
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Smith ME, Wilson PT. Human Rhinovirus/Enterovirus in Pediatric Acute Respiratory Distress Syndrome. J Pediatr Intensive Care 2020; 9:81-86. [PMID: 32351760 PMCID: PMC7186013 DOI: 10.1055/s-0039-3400466] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2019] [Accepted: 10/12/2019] [Indexed: 02/04/2023] Open
Abstract
The role of human rhinovirus/enterovirus (HRV/HEV) in severe lower respiratory tract infections remains unclear. We characterized the respiratory status of children admitted to a large academic pediatric intensive care unit (PICU) who tested positive for only HRV/HEV. One hundred and fifty-five children met inclusion criteria with 62% requiring positive pressure respiratory support of 5 cm of water pressure or more within the first 24 hours of admission. Among them, 34% had SaO
2
to FiO
2
ratios of 264 or less with 22 patients (14%) meeting criteria for pediatric acute respiratory distress syndrome. HRV/HEV is associated with significant respiratory disease in children admitted to the PICU.
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Affiliation(s)
- Michele E Smith
- Department of Pediatrics, Columbia University Medical Center, New York-Presbyterian Children's Hospital, New York, United States
| | - Patrick T Wilson
- Department of Pediatrics, Columbia University Medical Center, New York-Presbyterian Children's Hospital, New York, United States
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Yuan XH, Li YM, Shen YY, Yang J, Jin Y. Clinical and Th1/Th2 immune response features of hospitalized children with human rhinovirus infection. J Med Virol 2019; 92:26-33. [PMID: 31475732 PMCID: PMC7166431 DOI: 10.1002/jmv.25587] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2019] [Accepted: 08/28/2019] [Indexed: 02/03/2023]
Abstract
This study aimed to assess the clinical characteristics and T-helper 1 (Th1)/Th2 profile of human rhinovirus (HRV) infection in children with bronchiolitis and pneumonia, compared with the respiratory syncytial virus (RSV). In September 2013 to August 2014, 335 nasopharyngeal aspirates from children below 14 with bronchiolitis and pneumonia were screened for HRV and 13 other respiratory viruses by PCR or reverse transcription PCR. Interferon (IFN)-γ, interleukin (IL)-2, IL-4, IL-6, IL-10, and tumor necrosis factor (TNF)-α were detected by multiplex enzyme-linked immunosorbent assay. HRVs were found in 66 cases (19.7%), including 35 bronchiolitis and 31 pneumonia cases. Compared with the RSV alone group, children with pneumonia had more frequent wheezing episodes in HRV (Pa = .001) and HRV + non-RSV (Pb = .002) groups, and fever in the HRV (Pf = .004) and HRV + RSV (Pg = .005) groups. Among patients with bronchiolitis, cases with HRV alone were more likely to present in winter than those with RSV alone (Pi = .010) and HRV + non-RSV (Pj = .014), and less numerous in summer compared with HRV + non-RSV (Ph = .005). Children with HRV alone were more susceptible to have a history of eczema than RSV alone among bronchiolitis (Pc < .001) and pneumonia (Pe = .033) cases. HRV bronchiolitis cases had increased IL-4/IFN-γ and decreased TNF-α/IL-10 ratios, compared with HRV pneumonia counterparts. HRV is a major non-RSV pathogen causing hospitalization in children with bronchiolitis and pneumonia and induces an imbalanced Th1/Th2 response in bronchiolitis. Compared with RSV infection, HRV bronchiolitis and pneumonia differ significantly regarding wheezing episodes, susceptibility to eczema, fever occurrence, and seasonal prevalence.
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Affiliation(s)
- Xin-Hui Yuan
- Department of Clinical Medicine, Nanjing University Medical School, Nanjing, China.,Digestive Department, Nanjing Children's Hospital Affiliated to Nanjing Medical University, Nanjing, China.,Department of Pediatrics, The First Hospital of Lanzhou University, Lanzhou, China
| | - Yu-Mei Li
- Department of Pediatrics, The First Hospital of Lanzhou University, Lanzhou, China
| | - Yi-Yi Shen
- Digestive Department, Nanjing Children's Hospital Affiliated to Nanjing Medical University, Nanjing, China
| | - Jin Yang
- Digestive Department, Nanjing Children's Hospital Affiliated to Nanjing Medical University, Nanjing, China
| | - Yu Jin
- Department of Clinical Medicine, Nanjing University Medical School, Nanjing, China.,Digestive Department, Nanjing Children's Hospital Affiliated to Nanjing Medical University, Nanjing, China
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