Seasonal epidemiological and clinical characteristics of pediatric patients with human parainfluenza virus infection by serotype: a retrospective study

Abstract

Background The development of the polymerase chain reaction (PCR) test promoted the evaluation of the epidemiological and clinical characteristics of human parainfluenza virus (HPIV) type 4, which has been rarely studied using conventional diagnostic methods. This study aimed to determine the seasonal epidemiological and clinical characteristics of all four HPIV serotypes (HPIV-1, HPIV-2, HPIV-3, and HPIV-4) during the era of PCR testing. Methods The medical records of hospitalized pediatric patients diagnosed with HPIV infections by a multiplex PCR test between 2015 and 2021 were retrospectively reviewed to determine the seasonal distributions of each HPIV serotype. For patients with a single HPIV infection, the clinical characteristics of each HPIV serotype were evaluated and compared with one another. Results Among the 514 cases of HPIV infection, HPIV-1, HPIV-2, HPIV-3, and HPIV-4 were identified in 27.2%, 11.9%, 42.6%, and 18.3% of cases, respectively. HPIV-3 was most prevalent in spring, and the other three serotypes were most prevalent in autumn. For patients with a single HPIV infection, those infected by HPIV-1 and HPIV-3 were younger than those infected by HPIV-2 and HPIV-4 (P < 0.001). Croup and lower respiratory tract infection (LRI) were most frequently diagnosed in patients infected by HPIV-1 (P < 0.001) and HPIV-4 (P = 0.002), respectively. During 2020–2021, HPIV-3 was most prevalent in autumn and caused fewer LRIs (P = 0.009) and more seizures (P < 0.001) than during 2015–2019. Conclusions Each HPIV serotype exhibited a distinct seasonal predominance, and some differences in the clinical characteristics of the HPIV serotypes were observed. HPIV-4 acted as an important cause of LRI. Considering the recent changes in the epidemiological and clinical characteristics of HPIV-3, more time-series analyses should be conducted.

Human Parainfluenza Virus (HPIV) Detection in Hospitalized Children with Acute Respiratory Tract Infection in the Western Cape, South Africa during 2014–2022 Reveals a Shift in Dominance of HPIV 3 and 4 Infections

“…Despite its lower prevalence, overall, in the pre-pandemic period, HPIV 3 was the most prevalent, causing infection in very young children throughout the study period, accounting for 47% of infections in the 0-6-month age group (2014-2019) and 73% in this age group between 2020 and 2022. This is concordant with findings in other studies, including one from South Africa, which also sug-gest that HPIV 3 infections occur early in life [17,20]. HPIV 3 and 4 viruses each displayed distinct seasonality, with HPIV 3 activity mainly in late winter/spring and HPIV 4 mainly in autumn in the pre-COVID period.…”

“…This prevalence of infection is comparable with findings in other parts of the world where reported prevalence of HPIV in hospitalized children with ARI is estimated to vary between 4 and 14% [5]. The median age of infection of 0.86 years in positive children between 2016 and 2022 is similar to that reported in other low and middle income countries [5,14], but infections in age groups younger than that is seen in more developed nations, where the majority of infections are reported to occur in the 1-5-year age group [14][15][16][17][18]. This could reflect higher transmissibility of infection due to crowded living conditions and greater difficulty in applying measures to limit the spread of infections in lower socio-economic environments.…”

The prevalence of 17 common respiratory viruses in patients with respiratory illness but negative for COVID‐19: A cross‐sectional study

“…In this study, prevalence of coronaviruses in 2020–2021 showed that they are common in winter similar to the results we found in our study. The HPiV is commonly found in November which is similar to other reports in the literature 20,22 . Our study HMPV cases were identified in winter which is not seen by seasonal spreading; however, in some cases, it was reported to happen more in summer 23,24 …”

“…The HPiV is commonly found in November which is similar to other reports in the literature. 20,22 Our study HMPV cases were identified in winter which is not seen by seasonal spreading; however, in some cases, it was reported to happen more in summer. 23,24 Similar to Ntagereka et al, we did not find differences in the clinical behavior and viruses' infection except for sore throat (0.028), headache (p = 0.016), and body pain (p = 0.0001), either.…”

Molecular Evolution of Human Parainfluenza Virus Type 2 Based on Hemagglutinin-Neuraminidase Gene

“…A systemic review in 2021 estimated that infection with HPIV1–4 caused approximately 13% of acute lower respiratory infection (ALRI) cases, 4 to 14% of ALRI hospital admissions, and 4% of ALRI mortality worldwide among children younger than 5 years ( 5 ). Generally, HPIV2 prevalence was ranked after HPIV3 and HPIV1, accounting for 2.6 to 14% of HPIV infections, depending on the case definition, detection method, and duration of the studies ( 6 to 9 ). However, due to the lack of systematic surveillance, the disease burden of HPIV2 in China remains unclear.…”