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Viral respiratory tract infections and their correlation with clinical presentations and outcomes among young children attending emergency department of tertiary care hospital in China

Jun-Li Dang, Jun-Jun Zhao

Purpose: Besides advent of genome detection for respiratory viral infections by multiplex PCR, the correlation between individual viruses with clinical presentations and outcomes is unclear. We conducted a retrospective monocentric study in order to evaluate virus specific clinical correlation in children attending emergency department.

Methodology: A total 411 children aged<18 years during 5 winter seasons were evaluated for presence of viral infection by using multiplex PCR. Patients were sampled within 48 hours of their presentation to emergency department. Individual viruses were correlated with clinical presentations and clinical outcomes by using multivariate logistic regression analysis.

Results: Results of multiplex PCR demonstrated the presence of virus in 312/411 (76%) patients where single virus infections were identified in 256/312 (82%) patients and multiple (mixed) virus infections were found in 56/312 (18%) patients. Respiratory Syncytial Virus (RSV) and Human Rhinovirus (HRV) were more prominent among young children but only the presence of RSV virus was significantly higher among young children (<3 years) as compared to older (3-18 years). As most of the viral infections share common clinical presentations therefore discrimination of ARTI on the basis of signs and symptoms is not possible. HRV was found to be associated with bronchodilators (OR: 2.5) and corticosteroid treatment (OR: 4.2) as well as severe respiratory complications (OR: 4.7). RSV was found to be correlated with oxygen therapy (OR: 4.7) and inversely correlated with respiratory complications.

Conclusions: Most of the children presenting to emergency department had single virus infections with RSV and HRV. Presenting clinical presentations does not discriminate four virus groups while infections with RSV and HRV portended heavy burden of morbidity in our study.