Clinical characteristics and illness course based on pathogen among children with respiratory illness presenting to an emergency department

Windsor, W. Jon; Lamb, Molly M.; Dominguez, Samuel R.; Mistry, Rakesh D.; Rao, Suchitra

doi:10.1002/jmv.28031

Cited by 3 publications

(2 citation statements)

References 18 publications

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“…Severe outcomes such as hospitalization and mortality in cases of infection are predominantly associated with viral respiratory infections. Notably, respiratory syncytial virus (RSV), human rhinovirus (HRV), and human metapneumovirus (HMPV) are significant pathogens responsible for acute respiratory infections across all age groups globally [ 4 , 5 ]. RSV, first isolated from children in 1957, is considered the most critical virus causing acute respiratory infections in children [ 6 ].…”

Section: Introductionmentioning

confidence: 99%

Molecular Epidemiology and Clinical Characteristics of an Outbreak on Respiratory Virus Coinfection in Gansu, China

Liu,

Zhang,

Zhao

et al. 2024

Viruses

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This study aims to analyze the epidemiological and pathogenic characteristics of an outbreak primarily caused by respiratory syncytial virus (RSV), human rhinovirus (HRV), and human metapneumovirus (HMPV) in a kindergarten and primary school. The outbreak was investigated by field epidemiological investigation, and the common respiratory pathogens were screened by RT-PCR detection technology. The attack rate of this outbreak was 63.95% (110/172). Main symptoms included cough (85.45%), sore throat (60.91%), and sneezing (60.00%). Multifactorial logistic regression analysis revealed that continuous handwashing and mouth and nose covering when sneezing were protective factors. All 15 collected throat swab specimens tested positive for viruses, with HMPV as the predominant pathogen (80.00%), followed by HRV (53.33%), and two cases of positive respiratory syncytial virus (13.33%). Among them, six samples showed coinfections of HMPV and HRV, and one had coinfections of HMPV and RSV, resulting in a coinfection rate of 46.67%. Genetic sequencing indicated that the HMPV genotype in this outbreak was A2c, and the HRV genotype was type A, resulting in a coinfection outbreak of HMPV, HRV, and RSV in schools and kindergartens, suggesting that multi-pathogen surveillance of respiratory tract infections should be strengthened.

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Section: Introductionmentioning

confidence: 99%

Molecular Epidemiology and Clinical Characteristics of an Outbreak on Respiratory Virus Coinfection in Gansu, China

Liu,

Zhang,

Zhao

et al. 2024

Viruses

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“…[10][11][12] Studies evaluating clinical outcomes for children positive for HRV/ENT on RM-PCR testing remain limited, with analyses focusing on inpatient or clinical outcomes in specific populations. [13][14][15][16][17] A 2014 analysis of inpatient clinical measures demonstrated that children with HRV/ENT positivity on RM-PCR were likelier to be hospitalized and have more severe illnesses than those positive for other viruses. 18 An outpatient analysis evaluating the clinical and socioeconomic burden of HRV/ ENT positivity in adults and children revealed that under-17-yearolds positive for HRV/ENT on RM-PCR were likelier than adults to seek medical care.…”

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confidence: 99%

Comparing the Clinical Courses of Children With Human Rhinovirus/Enterovirus to Children With Other Respiratory Viruses in the Outpatient Setting

Jones,

Montgomery,

Coskun

et al. 2023

Pediatric Infectious Disease Journal

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Background: While infections caused by rhinoviruses and enteroviruses are common among children, the entirety of their clinical impact remains elusive. We compared the clinical outcomes of children with rhinovirus/enterovirus infections to other common respiratory viruses in outpatient settings. Methods: We conducted a retrospective analysis of nasopharyngeal samples singly positive for human rhinovirus/enterovirus (HRV/ENT), influenza A/B (FLU) or respiratory syncytial virus (RSV) from patients ≤17 years submitted for clinical testing via multiplex polymerase chain reaction between 2016 and 2019. We evaluated the following outpatient outcomes: days of respiratory symptoms before testing; visits for respiratory symptoms; receipt of a breathing treatment; receipt of antibiotics and hospital admission. Statistical analyses were conducted controlling for age and comorbid conditions. Results: There were 1355 positive samples included in this analysis (HRV/ENT: n = 743, FLU: n = 303 and RSV: n = 309). Compared to HRV/ENT, children with FLU had 28% fewer days of respiratory symptoms (β: −0.32; 95% confidence interval: −0.46 to −0.18; P < 0.001), fewer visits for respiratory symptoms, and significantly decreased odds of receiving a breathing treatment or antibiotics, and admission to the hospital. Children with RSV had a similar number of days of respiratory symptoms, outpatient visits and odds of hospital admission, but significantly increased odds of receiving a breathing treatment and antibiotics compared to those with HRV/ENT. Conclusion: Clinicians should have a high level of vigilance when managing children with positive respiratory viral testing for HRV/ENT given the potential for clinical outcomes similar to and, in some instances, worse than known highly pathogenic viruses.

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A probiotic containing L. plantarum and P. acidilactici strains for treating upper respiratory infections in children aged 6 months to 5 years: a randomized, double-blind trial

Andrade-Platas,

Martinez-Figueroa,

Rodriguez-Palmero

et al. 2024

Preprint

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Upper respiratory infections (URIs) are highly prevalent, especially among young children. We aimed to investigate the efficacy and safety of a specific probiotic formula in shortening the duration of pediatric URIs of viral origin. A randomized, double-blind clinical trial was conducted in children aged 6 months to 5 years, with URI with pharyngitis as diagnosed by a specialist. Participants were allocated to probiotic (strains L. plantarum KABP022, KABP023 and KABP033, and P. acidilactici KABP021) or placebo, twice daily for 15 days, and further followed up at 30 and 60 days from baseline. Antipyretic (ibuprofen) and antihistamine (cetirizine) were allowed as comedication and controlled. Co-primary outcomes were days of fever (axillary temperature >37.5ºC) and days of pain/discomfort (Face, Legs, Activity, Cry and Consolability [FLACC] score >3), as recorded in a diary. Causative viruses were identified by PCR in nasopharyngeal swabs. 75 children were randomized and included in the analysis. Most frequent causative agents were rhinoviruses, coronaviruses and respiratory syncytial virus. Compared to placebo, duration of fever and of pain/discomfort were reduced by 1.1 days (95%CI 0.5-1.7; p=0.001), and by 0.7 days (95%CI 0.2-1.2; p=0.006) in probiotic group, respectively. Sensitivity analyses by detected virus, age, sex and recent URI episodes produced similar results. Use of comedication and other symptoms did not differ between study groups. No significant differences were found in the number of adverse events between the groups. Conclusion: Intervention with this probiotic formula was associated with shorter duration of fever and pain/discomfort in pediatric URIs with pharyngitis. Trial Registration: Prospectively registered on Oct 5th, 2023, as ISRCTN-66122782.

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Clinical characteristics and illness course based on pathogen among children with respiratory illness presenting to an emergency department

Cited by 3 publications

References 18 publications

Molecular Epidemiology and Clinical Characteristics of an Outbreak on Respiratory Virus Coinfection in Gansu, China

Molecular Epidemiology and Clinical Characteristics of an Outbreak on Respiratory Virus Coinfection in Gansu, China

Comparing the Clinical Courses of Children With Human Rhinovirus/Enterovirus to Children With Other Respiratory Viruses in the Outpatient Setting

A probiotic containing L. plantarum and P. acidilactici strains for treating upper respiratory infections in children aged 6 months to 5 years: a randomized, double-blind trial

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