Key result
The presence, number, or type of respiratory viruses were not associated with disease severity in hospitalized children with SARI, whereas prematurity and lower weight-for-age z-score predicted worse outcomes.
Why the study?
It was unknown whether the presence, number, or type of virus is associated with clinical outcomes of pediatric severe acute respiratory infection in developing countries.
Is the presence, number, or type of respiratory viruses associated with clinical outcomes in hospitalized children with severe acute respiratory infection?
Observational (n=316)
No
Is the presence, number, or type of respiratory viruses associated with clinical outcomes in hospitalized children with severe acute respiratory infection?
In hospitalized children with severe acute respiratory infection in Suriname, clinical outcomes were driven by host factors like prematurity and underweight rather than the specific viral etiology.
This is the authors' abstract. We don't add key points for this paper.
BACKGROUND: Viruses are the most frequent cause of severe acute respiratory infection (SARI) in children. It is currently unknown whether presence of a virus, the number of viruses, or type of virus, are associated with clinical outcomes of pediatric SARI in developing countries. METHODS: Between 2012 and 2014 nasopharyngeal swabs and demographic and clinical variables were prospectively collected for surveillance of viral causes of SARI in Surinamese children within 48 hours after hospitalization. These swabs were tested for 18 respiratory viruses using a multiplex polymerase chain reaction (PCR) panel to identify the specific viral causes of SARI, unknown to the treating physicians. In post hoc analyses we evaluated if the PCR results, and demographic and clinical characteristics, were associated with course of disease, duration of respiratory support, and length of stay (LOS). RESULTS: Of a total of 316 analyzed children, 290 (92%) had one or more viruses. Rhinovirus/enterovirus (43%) and respiratory syncytial virus (34%) were most prevalent. Course of disease was mild in 234 (74%), moderate in 68 (22%), and severe in 14 (4%) children. Neither presence of a single virus, multiple viruses, or the type of virus, were different between groups. Prematurity and lower weight-for-age-z-score were independent predictors of a severe course of disease, longer duration of respiratory support, and longer LOS. CONCLUSIONS: Viruses are common causes of pediatric SARI in Suriname, yet not necessarily associated with clinical outcomes. In developing countries, demographic and clinical variables can help to identify children at-risk for worse outcome, while PCR testing may be reserved to identify specific viruses, such as influenza, in specific patient groups or during outbreaks.
Answers are grounded in this paper and cite their sources.
Viral testing should not guide severity assessment in pediatric SARI; leaves open whether prematurity and underweight status independently drive outcomes.
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Juliana et al. (2021) conducted an observational in Severe acute respiratory infection (SARI) (n=316). Viral infection (detected via PCR) vs. No viral infection was evaluated on Course of disease severity (mild, moderate, severe) (p=0.365). The presence, number, or type of respiratory viruses were not associated with disease severity in hospitalized children with SARI, whereas prematurity and lower weight-for-age z-score predicted worse outcomes.
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