A Multicenter Outcomes Analysis of Children With Severe Rhino/Enteroviral Respiratory Infection*

Abstract

There is substantial morbidity associated with severe respiratory infection due to human rhino/enteroviruses in children. Mortality was less severe than reported in other respiratory viruses such as influenza and respiratory syncytial virus. The burden of illness from human rhino/enteroviruses in the ICU in terms of resource utilization may be considerable.

Viruses as Sole Causative Agents of Severe Acute Respiratory Tract Infections in Children

“…In accordance with several other studies, RSV and HRV were the most frequently detected respiratory pathogens throughout the study [3,31,39,40]. RSV is a well-established respiratory virus known to cause severe disease by itself, especially in younger children [31,39,40].…”

“…For HRV this role as single pathogenic agent has been less well established as it is frequently detected in combination with other respiratory viruses, and has therefore frequently been considered an innocent bystander. We described eleven critically ill patients with HRV as single pathogen detected, supporting other studies that have described HRV as an agent that may cause more or less severe disease [3,41,42]. Less common respiratory viruses such as HCoV and PIV 1-4 were detected, but additional analyses were not performed due to a lack of power.…”

“…SARIs are characterized by respiratory failure and are an indication for admission to a paediatric intensive care unit (PICU) because of the need of respiratory support. Some viruses such as respiratory syncytial virus (RSV) and influenza viruses have been shown to be the single cause of SARI, but for other viruses like human rhinoviruses (HRVs) and human coronavirus-NL63 (HCoV-NL63) this is under debate [3][4][5]. It may be that these viruses cause minimal or mild disease only, but in combination with bacterial co-infections, viral co-infections or alternatively, underlying high-risk conditions infection may result into SARI [6][7][8].…”

Virus detection in critically ill children with acute respiratory disease: a new profile in view of new technology

“…There have been only a limited number of studies evaluating the epidemiology of respiratory viral infections in PICU population. Rhinovirus/enterovirus and RSV were the two most prevalent viruses in critically ill children admitted with acute respiratory disease in our PICU, which is similar to recent studies (17,18). Although there were minor annual fluctuations during the study period, the overall rate of detection of adenovirus, hMPV and other IQR (interquartile range), *median of days, † for patients who was endotracheally intubated.…”

“…The hospital outcomes in the eight viruses were addressed in Table 2. Among all the viruses, adenovirus had a clinically significantly higher endotracheal intubation rate (36/50, 72%) and longer hospital LOS (19 days, IQR: [11][12][13][14][15][16][17][18][19].…”