Single viral pathogens can cause severe acute respiratory tract infections in children, but viral loads were not significantly different between severe and non-severe cases (median Ct 22.2 vs 25.1, p=0.191).
Observational (n=84)
No
Can single respiratory viruses cause severe acute respiratory tract infections in children in the absence of co-infections, and does viral load correlate with disease severity?
Single viral pathogens, particularly RSV and HRV, can cause severe acute respiratory tract infections in children without bacterial co-infections, and viral load does not correlate with disease severity.
Absolute Event Rate: 22.2% vs 25.1%
p-value: p=0.191
BACKGROUND: Respiratory syncytial virus (RSV) and influenza A viruses are known to cause severe acute respiratory tract infections (SARIs) in children. For other viruses like human rhinoviruses (HRVs) this is less well established. Viral or bacterial co-infections are often considered essential for severe manifestations of these virus infections. OBJECTIVE: The study aims at identifying viruses that may cause SARI in children in the absence of viral and bacterial co-infections, at identifying disease characteristics associated with these single virus infections, and at identifying a possible correlation between viral loads and disease severities. STUDY DESIGN: Between April 2007 and March 2012, we identified children (<18 year) with or without a medical history, admitted to our paediatric intensive care unit (PICU) with SARI or to the medium care (MC) with an acute respiratory tract infection (ARTI) (controls). Data were extracted from the clinical and laboratory databases of our tertiary care paediatric hospital. Patient specimens were tested for fifteen respiratory viruses with real-time reverse transcriptase PCR assays and we selected patients with a single virus infection only. Typical bacterial co-infections were considered unlikely to have contributed to the PICU or MC admission based on C-reactive protein-levels or bacteriological test results if performed. RESULTS: We identified 44 patients admitted to PICU with SARI and 40 patients admitted to MC with ARTI. Twelve viruses were associated with SARI, ten of which were also associated with ARTI in the absence of typical bacterial and viral co-infections, with RSV and HRV being the most frequent causes. Viral loads were not different between PICU-SARI patients and MC-ARTI patients. CONCLUSION: Both SARI and ARTI may be caused by single viral pathogens in previously healthy children as well as in children with a medical history. No relationship between viral load and disease severity was identified.
Moesker et al. (Thu,) conducted a observational in Severe Acute Respiratory Tract Infections (SARI) (n=84). Single respiratory virus infection vs. Acute respiratory tract infection (ARTI) without intensive care need was evaluated on Viral load (cycle threshold values) in nasal washings (p=0.191). Single viral pathogens can cause severe acute respiratory tract infections in children, but viral loads were not significantly different between severe and non-severe cases (median Ct 22.2 vs 25.1, p=0.191).
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