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February 19, 2021PLoS ONEOpen Access

Viral causes of severe acute respiratory infection in hospitalized children and association with outcomes: A two-year prospective surveillance study in Suriname

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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?

Population

316 hospitalized children with SARI in Suriname

Comparison

Presence, number, or type of virus identified via multiplex PCR panel

Design

Two-year prospective surveillance study

Authors

AJAmadu JulianaMTMing-Jan TangLKLex Kemps

Discussion

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Member takes

Overview

Viral testing should not guide severity assessment in pediatric SARI; leaves open whether prematurity and underweight status independently drive outcomes.

Study Design

Type

Observational (n=316)

Multicenter

No

Structured PICO

Is the presence, number, or type of respiratory viruses associated with clinical outcomes in hospitalized children with severe acute respiratory infection?

P
Population
316 hospitalized children under 18 years of age with severe acute respiratory infection in Suriname, prospectively evaluated for viral etiologies and clinical outcomes.
E
Exposure
Multiplex polymerase chain reaction (PCR) testing for 18 respiratory viruses from nasopharyngeal swabs.
O
Outcome
Course of disease (mild, moderate, or severe based on maximum respiratory support received).hard clinical

Main Result

p-value: p=0.365

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.

Limitations

  • A positive PCR result does not differentiate between viable pathogenic viruses or nonviable viral DNA or RNA material after shedding.
  • Did not systematically test for bacterial infection due to the invasive nature of sample collection in small children.
  • Study period of two consecutive years may not be sufficient to observe cyclic patterns of RSV.
  • Did not systematically test for bacterial infection.
  • A study period of two consecutive years may not be sufficient to observe cyclic patterns of RSV.

Cite This Study

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.

synapsesocial.com/papers/6a9fea6dc2a6bb3d9844b061https://doi.org/10.1371/journal.pone.0247000
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Also Consider

Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context:

  1. 1Viral Etiologies of Acute Respiratory Infections among Hospitalized Vietnamese Children in Ho Chi Minh City, 2004–20082011 · 142 citations
  2. 2Single- and multiple viral respiratory infections in children: disease and management cannot be related to a specific pathogen2017 · 82 citations
  3. 3Severity of viral coinfection in hospitalized infants with respiratory syncytial virus infection2011 · 64 citations
  4. 4Multicentre validation of the bedside paediatric early warning system score: a severity of illness score to detect evolving critical illness in hospitalised children2011 · 240 citations
  5. 5Multiplex Platforms for the Identification of Respiratory Pathogens: Are They Useful in Pediatric Clinical Practice?2019 · 55 citations