Detection of Respiratory Syncytial Virus or Rhinovirus Weeks After Hospitalization for Bronchiolitis and the Risk of Recurrent Wheezing.
Bronchiolitis
/ diagnosis
Coinfection
/ epidemiology
Cross Infection
/ epidemiology
Hospitalization
Humans
Incidence
Molecular Typing
Picornaviridae Infections
/ epidemiology
Proportional Hazards Models
Recurrence
Respiratory Sounds
Respiratory Syncytial Virus Infections
/ epidemiology
Respiratory Syncytial Virus, Human
/ classification
Rhinovirus
/ classification
Viral Load
delayed clearance
recurrent wheezing
respiratory syncytial virus
rhinovirus
sequential infection
Journal
The Journal of infectious diseases
ISSN: 1537-6613
Titre abrégé: J Infect Dis
Pays: United States
ID NLM: 0413675
Informations de publication
Date de publication:
03 02 2021
03 02 2021
Historique:
received:
18
04
2020
accepted:
12
06
2020
pubmed:
22
6
2020
medline:
7
9
2021
entrez:
22
6
2020
Statut:
ppublish
Résumé
In severe bronchiolitis, it is unclear if delayed clearance or sequential infection of respiratory syncytial virus (RSV) or rhinovirus (RV) is associated with recurrent wheezing. In a 17-center severe bronchiolitis cohort, we tested nasopharyngeal aspirates (NPA) upon hospitalization and 3 weeks later (clearance swab) for respiratory viruses using PCR. The same RSV subtype or RV genotype in NPA and clearance swab defined delayed clearance (DC); a new RSV subtype or RV genotype at clearance defined sequential infection (SI). Recurrent wheezing by age 3 years was defined per national asthma guidelines. Among 673 infants, RSV DC and RV DC were not associated with recurrent wheezing, and RSV SI was rare. The 128 infants with RV SI (19%) had nonsignificantly higher risk of recurrent wheezing (hazard ratio [HR], 1.31; 95% confidence interval [CI], .95-1.80; P = .10) versus infants without RV SI. Among infants with RV at hospitalization, those with RV SI had a higher risk of recurrent wheezing compared to children without RV SI (HR, 2.49; 95% CI, 1.22-5.06; P = .01). Among infants with severe bronchiolitis, those with RV at hospitalization followed by a new RV infection had the highest risk of recurrent wheezing.
Sections du résumé
BACKGROUND
In severe bronchiolitis, it is unclear if delayed clearance or sequential infection of respiratory syncytial virus (RSV) or rhinovirus (RV) is associated with recurrent wheezing.
METHODS
In a 17-center severe bronchiolitis cohort, we tested nasopharyngeal aspirates (NPA) upon hospitalization and 3 weeks later (clearance swab) for respiratory viruses using PCR. The same RSV subtype or RV genotype in NPA and clearance swab defined delayed clearance (DC); a new RSV subtype or RV genotype at clearance defined sequential infection (SI). Recurrent wheezing by age 3 years was defined per national asthma guidelines.
RESULTS
Among 673 infants, RSV DC and RV DC were not associated with recurrent wheezing, and RSV SI was rare. The 128 infants with RV SI (19%) had nonsignificantly higher risk of recurrent wheezing (hazard ratio [HR], 1.31; 95% confidence interval [CI], .95-1.80; P = .10) versus infants without RV SI. Among infants with RV at hospitalization, those with RV SI had a higher risk of recurrent wheezing compared to children without RV SI (HR, 2.49; 95% CI, 1.22-5.06; P = .01).
CONCLUSIONS
Among infants with severe bronchiolitis, those with RV at hospitalization followed by a new RV infection had the highest risk of recurrent wheezing.
Identifiants
pubmed: 32564083
pii: 5860466
doi: 10.1093/infdis/jiaa348
pmc: PMC7857353
doi:
Types de publication
Journal Article
Multicenter Study
Research Support, N.I.H., Extramural
Langues
eng
Sous-ensembles de citation
IM
Pagination
268-277Subventions
Organisme : NIAID NIH HHS
ID : R01 AI108588
Pays : United States
Organisme : NHLBI NIH HHS
ID : R21 HL129909
Pays : United States
Organisme : NIAID NIH HHS
ID : U19 AI104317
Pays : United States
Organisme : NIH HHS
ID : UH3 OD023282
Pays : United States
Organisme : NIAID NIH HHS
ID : U01 AI087881
Pays : United States
Organisme : NIAID NIH HHS
ID : R01 AI114552
Pays : United States
Informations de copyright
© The Author(s) 2020. Published by Oxford University Press for the Infectious Diseases Society of America. All rights reserved. For permissions, e-mail: journals.permissions@oup.com.