Rapid typing diagnosis and clinical analysis of subtypes A and B of human respiratory syncytial virus in children

Abstract

Background Human respiratory syncytial virus (HRSV) is the leading pathogens causing acute respiratory infections (ARI) in children under five years old. We aimed to investigate the distribution of HRSV subtypes and explore the relationship between viral subtypes and clinical symptoms and disease severity. Methods From November 2016 to April 2017, 541 children hospitalized because of ARI were included in the study. Throat swabs were collected for analysis and all samples were tested by multiplex one-step qRT-PCR for quantitative analysis and typing of HRSV. Patients’ demographics, clinical symptoms as well as laboratory and imaging results were retrieved from medical records. Results HRSV was detected in 19.6% of children hospitalized due to ARI. HRSV-positive children were younger (P < 0.001), had a higher frequency of wheezing and pulmonary rales (P < 0.001; P = 0.003), and were more likely to develop bronchopneumonia (P < 0.001). Interleukin (IL) 10、CD4/CD8 (below normal range) and C-reactive protein levels between subtypes A and B groups were significantly different (P = 0.037; P = 0.029; P = 0.007), and gender differences were evident. By age-stratified analysis between subtypes A and B, we found significant differences in fever frequency and lymphocyte ratio (P = 0.008; P = 0.03) in the 6–12 months age group, while the 12. 1–36 months age group showed significant differences in fever days and count of leukocytes, platelets, levels aspartate aminotransferase, IL-6, lactate dehydrogenase and proportion CD4 positive T cells(P = 0.013; P = 0.018; P = 0.016; P = 0.037; P = 0.049; P = 0.025; P = 0.04). We also found a positive correlation between viral load and wheezing days in subtype A (P < 0.05), and a negative correlation between age, monocyte percentage and LDH concentration in subtype B (P < 0.05). Conclusions HRSV is the main causative virus of bronchopneumonia in infants and children. The multiplex one-step qRT-PCR not only provides a rapid and effective diagnosis of HRSV infection, but also allows its typing. There were no significant differences in the severity of HRSV infection between subtypes A and B, except significant gender-specific and age-specific differences in some clinical characteristics and laboratory results. Knowing the viral load of HRSV infection can help understanding the clinical features of different subtypes of HRSV infection.

The Impact of Respiratory Symptoms on the Risk of Serious Bacterial Infection in Febrile Infants < 60 Days Old

“…In recent years, new methods for rapid on-site viral testing have been developed for patients presenting to the ED with respiratory infections. These tests are highly sensitive and specific for diagnosing the presence of a viral infection within 20 min [25,26]. Additionally, to aid in clinical decision making, several diagnostic tests have been used in an attempt to distinguish between viral and bacterial infections.…”

Immunity towards human respiratory syncytial virus

“…hRSV-A and hRSV-B groups have cocirculated during specific seasonal epidemics but can circulate independently in human populations (Pangesti et al, 2018). Some studies report a higher prevalence and severe clinical course in hRSV-A (Jafri et al, 2013;Tabarani et al, 2013;Shen et al, 2022), but the evidence is contradictory (McIntosh et al, 1993;Devincenzo, 2004;Laham et al, 2017).…”

Prediction of Bronchopneumonia Inpatients’ Total Hospitalization Expenses Based on BP Neural Network and Support Vector Machine Models

“…Once infected, it will affect patients' quality of life and bring a certain economic burden to families. In addition, the disease can cause pressure on the national medical insurance fund [ 7 , 8 ]. Therefore, strengthening the cost research of bronchopneumonia and formulating effective intervention measures can reduce the economic burden on patients and medical insurance [ 9 ].…”