Outcomes of viral coinfections in infants hospitalized for acute bronchiolitis
Abstract Background and Objective The clinical relevance of the detection of multiple respiratory viruses in acute bronchiolitis (AB) has not been established. Our goal was to evaluate the effect of viral coinfections on the progression and severity of AB. Methods A retrospective observational study...
| Main Authors: | , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
BMC
2023-10-01
|
| Series: | Virology Journal |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s12985-023-02197-7 |
| _version_ | 1827635659274190848 |
|---|---|
| author | Lorena Bermúdez-Barrezueta Pablo López-Casillas Silvia Rojo-Rello Laura Sáez-García José Manuel Marugán-Miguelsanz María de la Asunción Pino-Vázquez |
| author_facet | Lorena Bermúdez-Barrezueta Pablo López-Casillas Silvia Rojo-Rello Laura Sáez-García José Manuel Marugán-Miguelsanz María de la Asunción Pino-Vázquez |
| author_sort | Lorena Bermúdez-Barrezueta |
| collection | DOAJ |
| description | Abstract Background and Objective The clinical relevance of the detection of multiple respiratory viruses in acute bronchiolitis (AB) has not been established. Our goal was to evaluate the effect of viral coinfections on the progression and severity of AB. Methods A retrospective observational study was conducted in a tertiary hospital in Spain from September 2012 to March 2020. Infants admitted for AB with at least one respiratory virus identified by molecular diagnostic techniques were included. A comparison was made between single-virus infections and viral coinfections. The evolution and severity of AB were determined based on the days of hospitalization and admission to the pediatric intensive care unit (PICU). Results Four hundred forty-five patients were included (58.4% male). The median weight was 5.2 kg (IQR 4.2–6.5), and the median age was 2.5 months (IQR 1.4–4.6). A total of 105 patients (23.6%) were admitted to the PICU. Respiratory syncytial virus (RSV) was the most frequent etiological agent (77.1%). A single virus was detected in 270 patients (60.7%), and viral coinfections were detected in 175 (39.3%), of which 126 (28.3%) had two viruses and 49 (11%) had three or more viruses. Hospital length of stay (LOS) increased in proportion to the number of viruses detected, with a median of 6 days (IQR 4–8) for single infections, 7 days (IQR 4–9) for coinfections with two viruses and 8 days (IQR 5–11) for coinfections with ≥ 3 viruses (p = 0.003). The adjusted Cox regression model showed that the detection of ≥ 3 viruses was an independent risk factor for a longer hospital LOS (HR 0.568, 95% CI 0.410–0.785). No significant association was observed between viral coinfections and the need for PICU admission (OR 1.151; 95% CI 0.737–1.797). Conclusions Viral coinfections modified the natural history of AB, prolonging the hospital LOS in proportion to the number of viruses detected without increasing the need for admission to the PICU. |
| first_indexed | 2024-03-09T15:29:41Z |
| format | Article |
| id | doaj.art-e197e81c1d8c42f8a13d1ea324026437 |
| institution | Directory Open Access Journal |
| issn | 1743-422X |
| language | English |
| last_indexed | 2024-03-09T15:29:41Z |
| publishDate | 2023-10-01 |
| publisher | BMC |
| record_format | Article |
| series | Virology Journal |
| spelling | doaj.art-e197e81c1d8c42f8a13d1ea3240264372023-11-26T12:20:30ZengBMCVirology Journal1743-422X2023-10-0120111010.1186/s12985-023-02197-7Outcomes of viral coinfections in infants hospitalized for acute bronchiolitisLorena Bermúdez-Barrezueta0Pablo López-Casillas1Silvia Rojo-Rello2Laura Sáez-García3José Manuel Marugán-Miguelsanz4María de la Asunción Pino-Vázquez5División of Pediatric and Neonatal Intensive Care, Department of Pediatrics, Hospital Clínico Universitario de ValladolidDivisión of Pediatric and Neonatal Intensive Care, Department of Pediatrics, Hospital Clínico Universitario de ValladolidMicrobiology and Immunology Department, Hospital Clínico Universitario de ValladolidDivision of Pediatric Intensive Care, Reina Sofía HospitalDepartment of Pediatrics, Faculty of Medicine, Valladolid UniversityDivisión of Pediatric and Neonatal Intensive Care, Department of Pediatrics, Hospital Clínico Universitario de ValladolidAbstract Background and Objective The clinical relevance of the detection of multiple respiratory viruses in acute bronchiolitis (AB) has not been established. Our goal was to evaluate the effect of viral coinfections on the progression and severity of AB. Methods A retrospective observational study was conducted in a tertiary hospital in Spain from September 2012 to March 2020. Infants admitted for AB with at least one respiratory virus identified by molecular diagnostic techniques were included. A comparison was made between single-virus infections and viral coinfections. The evolution and severity of AB were determined based on the days of hospitalization and admission to the pediatric intensive care unit (PICU). Results Four hundred forty-five patients were included (58.4% male). The median weight was 5.2 kg (IQR 4.2–6.5), and the median age was 2.5 months (IQR 1.4–4.6). A total of 105 patients (23.6%) were admitted to the PICU. Respiratory syncytial virus (RSV) was the most frequent etiological agent (77.1%). A single virus was detected in 270 patients (60.7%), and viral coinfections were detected in 175 (39.3%), of which 126 (28.3%) had two viruses and 49 (11%) had three or more viruses. Hospital length of stay (LOS) increased in proportion to the number of viruses detected, with a median of 6 days (IQR 4–8) for single infections, 7 days (IQR 4–9) for coinfections with two viruses and 8 days (IQR 5–11) for coinfections with ≥ 3 viruses (p = 0.003). The adjusted Cox regression model showed that the detection of ≥ 3 viruses was an independent risk factor for a longer hospital LOS (HR 0.568, 95% CI 0.410–0.785). No significant association was observed between viral coinfections and the need for PICU admission (OR 1.151; 95% CI 0.737–1.797). Conclusions Viral coinfections modified the natural history of AB, prolonging the hospital LOS in proportion to the number of viruses detected without increasing the need for admission to the PICU.https://doi.org/10.1186/s12985-023-02197-7Acute bronchiolitisViral coinfectionSeverityLength of stayPediatric intensive care unit. |
| spellingShingle | Lorena Bermúdez-Barrezueta Pablo López-Casillas Silvia Rojo-Rello Laura Sáez-García José Manuel Marugán-Miguelsanz María de la Asunción Pino-Vázquez Outcomes of viral coinfections in infants hospitalized for acute bronchiolitis Virology Journal Acute bronchiolitis Viral coinfection Severity Length of stay Pediatric intensive care unit. |
| title | Outcomes of viral coinfections in infants hospitalized for acute bronchiolitis |
| title_full | Outcomes of viral coinfections in infants hospitalized for acute bronchiolitis |
| title_fullStr | Outcomes of viral coinfections in infants hospitalized for acute bronchiolitis |
| title_full_unstemmed | Outcomes of viral coinfections in infants hospitalized for acute bronchiolitis |
| title_short | Outcomes of viral coinfections in infants hospitalized for acute bronchiolitis |
| title_sort | outcomes of viral coinfections in infants hospitalized for acute bronchiolitis |
| topic | Acute bronchiolitis Viral coinfection Severity Length of stay Pediatric intensive care unit. |
| url | https://doi.org/10.1186/s12985-023-02197-7 |
| work_keys_str_mv | AT lorenabermudezbarrezueta outcomesofviralcoinfectionsininfantshospitalizedforacutebronchiolitis AT pablolopezcasillas outcomesofviralcoinfectionsininfantshospitalizedforacutebronchiolitis AT silviarojorello outcomesofviralcoinfectionsininfantshospitalizedforacutebronchiolitis AT laurasaezgarcia outcomesofviralcoinfectionsininfantshospitalizedforacutebronchiolitis AT josemanuelmaruganmiguelsanz outcomesofviralcoinfectionsininfantshospitalizedforacutebronchiolitis AT mariadelaasuncionpinovazquez outcomesofviralcoinfectionsininfantshospitalizedforacutebronchiolitis |