Viral Etiology and Clinical Characteristics of Acute Respiratory Tract Infections in Hospitalized Children in Southern Germany (2014–2018)

Abstract

Background Viral acute respiratory tract infections (ARTI) are a leading cause of hospitalization in infants and young children. Methods During winter seasons 2014-2018, hospitalised children (<18 years) with symptoms of ARTI were prospectively included at the University Hospital Heidelberg/Germany. Nasopharyngeal swabs were obtained for multiplex molecular analysis of 10 groups of respiratory viruses, and clinical data was obtained using a standardized questionnaire. Results Of 1.353 children included in this study, 1.142 (84.4%) were positive for ≥1 viral pathogen. Single virus infection was detected in 797 (69.8%) children, whereas 345 (30.2%) children had co-infections with 2-4 viral pathogens. Respiratory syncytial virus (RSV), rhinovirus and influenza virus were the main pathogens detected. RSV-positive children had significantly more often lower ARTI including symptoms of severe cough, wheezing, chest indrawing, tachypnoea, and pulmonary rales. Hospitalized children <6 months represented the largest age group with detection of ≥1 viral pathogen in=455/528 (86.2%) children. Co-infection was more frequent in younger children and particularly for RSV with rhinovirus significantly associated with more severe respiratory symptoms (p=0.01). Conclusion A better understanding of the aetiology of viral ARTIs in children as provided for hospitalized children plays a key role for future strategies in prevention, control, and treatment of ARTIs.

Molecular Mechanisms of N-Acetylcysteine in RSV Infections and Air Pollution-Induced Alterations: A Scoping Review

“…Respiratory syncytial virus (RSV) is one of the major etiological factors in acute respiratory tract infections in children, characterized by a high incidence, especially in infancy and early childhood; the vast majority of children are infected with RSV at least once during the first 3 years of life, with the RSV-specific antibody seroprevalence exceeding 90% [ 4 ]. The disease severity may vary from mild infections treated in the community to hospitalized cases of lower respiratory tract infection (LRTI), including bronchitis, bronchiolitis, and/or pneumonia, and some patients may require intensive care [ 4 , 5 ]. Exposure to air pollution, including cigarette smoke, particulate matter, benzene, ozone (O 3 ), carbon monoxide (CO), or nitric dioxide (NO 2 ), appears to be associated with a higher RSV incidence and disease severity, resulting in a greater socioeconomic impact of the disease [ 6 , 7 , 8 , 9 , 10 , 11 , 12 , 13 ].…”

Respiratory Syncytial Virus Infections in Polish Pediatric Patients from an Expert Perspective

“…Acute respiratory tract infections (ARTIs) are among the most frequent causes of hospitalizations and visits to follow-up departments in children. One of the most common pathogens responsible for ARTIs in children is respiratory syncytial virus (RSV) [ 1 , 2 ]. The exact frequency of RSV infections is unknown because some cases are asymptomatic [ 3 ].…”

“…Thus, the current study was designed to summarize the most important information on RSV disease in the pediatric population in Poland with the aim to help assess the appropriate level of resources and develop preventive strategies. Specifically, our goals were: (1) to understand the healthcare burden of RSV infections in Poland; (2) to collect data on infection seasonality, patient pathway, and management patterns; and (3) to evaluate RSV infection surveillance in Poland.…”

Epidemiology and clinical characteristics of severe acute respiratory infections among hospitalized children under 5 years of age in a tertiary care center in Bangkok, Thailand, 2019–2020

“…Aberle et al reported that among infants with lower respiratory tract infection, those co-infected with RSV had a decreased interferon-gamma response in peripheral blood mononuclear cells and an increase in severity of the disease compared to those co-infected with other viruses [ 16 ]. Another study by Tabatabai et al found that co-infection was more frequent in young children, and co-infection with RSV and HRV was associated with more severe respiratory symptoms [ 17 ].…”