호흡기세포융합바이러스 아형에 따른 임상 양상 및 중증도에 영향을 미치는 인자에 대한 분석
Analysis of factors affecting clinical feature and disease severity according to the subtypes of respiratory syncytial virus
1
조회
0
다운로드
0
인용
0
참고문헌
키워드
초록
Purpose: Respiratory syncytial virus (RSV) is one of the most common causes of respiratory tract infections, especially in patients aged <3 years. There are 2 antigenically different RSV subtypes, A and B. This study aimed to assess if the RSV subtype is independently associated with increased disease severity. Methods: We retrospectively collected data from the medical records of children hospitalized with RSV infection, aged <3 years at Dong-A University Hospital between September, 2014 and December, 2018. Results: RSV A and RSV B infections were observed in 111 and 66 cases, respectively. Pneumonia was most commonly observed, followed by bronchiolitis in both subtypes. There were no significant differences between the groups regarding birth weight, gestational age, and incidence of having siblings. The duration of admission, duration of fever, and severity index were similar between the groups. The incidence of high fever (>39°C) was slightly higher in the RSV B group (13.6%) than in the RSV A group (11.7%), although the difference was not statistically significant. Laboratory findings, including the neutrophil-lymphocyte ratio, were similar between the groups. The incidence of systemic steroid therapy was higher in the RSV A group (12.6%) than in the RSV B (3.0%) group (P=0.03). Patients aged <12 months, the incidences of oxygen therapy (P=0.03) and systemic steroid therapy (P=0.04) were higher in the RSV A group, suggesting that patients aged <12 months with RSV A infection may have clinically more severe disease. Conclusion: We recommend intensive monitoring if RSV A infection is detected in young children under 12 months.
Abstract
Purpose: Respiratory syncytial virus (RSV) is one of the most common causes of respiratory tract infections, especially in patients aged <3 years. There are 2 antigenically different RSV subtypes, A and B. This study aimed to assess if the RSV subtype is independently associated with increased disease severity. Methods: We retrospectively collected data from the medical records of children hospitalized with RSV infection, aged <3 years at Dong-A University Hospital between September, 2014 and December, 2018. Results: RSV A and RSV B infections were observed in 111 and 66 cases, respectively. Pneumonia was most commonly observed, followed by bronchiolitis in both subtypes. There were no significant differences between the groups regarding birth weight, gestational age, and incidence of having siblings. The duration of admission, duration of fever, and severity index were similar between the groups. The incidence of high fever (>39°C) was slightly higher in the RSV B group (13.6%) than in the RSV A group (11.7%), although the difference was not statistically significant. Laboratory findings, including the neutrophil-lymphocyte ratio, were similar between the groups. The incidence of systemic steroid therapy was higher in the RSV A group (12.6%) than in the RSV B (3.0%) group (P=0.03). Patients aged <12 months, the incidences of oxygen therapy (P=0.03) and systemic steroid therapy (P=0.04) were higher in the RSV A group, suggesting that patients aged <12 months with RSV A infection may have clinically more severe disease. Conclusion: We recommend intensive monitoring if RSV A infection is detected in young children under 12 months.
참고문헌 (26)
- 윤가현, "호흡기세포융합 바이러스 아형에 따른 영아기 폐렴 및 모세기관지염의 임상 양상: 2010.2012 일개 삼차병원의 경험", Allergy Asthma & Respiratory Disease, 1(1), pp.84~89 (2013), 대한 소아알레르기 호흡기학회
- 박준수, "소아 급성 바이러스 하기도염", Clinical and Experimental Pediatrics, 52(3), pp.269~276 (2009), 대한소아청소년과학회
- Garcia-Barreno B, "Marked differences in the antigenic structure of human respiratory syncytial virus F and G glycoproteins", J Virol, 63, pp.925~932 (1989)
- Welliver RC, "Review of epidemiology and clinical risk factors for severe respiratory syncytial virus(RSV)infection", J Pediatr, 143, pp.112~117 (2003)
- Simoes EAF, "Respiratory syncytial virus infection", Lancet, 354, pp.847~852 (1999)
- Houben ML, "Disease severity and viral load are correlated in infants with primary respiratory syncytial virus infection in the community", J Med Virol, 82, pp.1266~1271 (2010)
- Papadopoulos NG, "Does respiratory syncytial virus subtype influences the severity of acute bronchiolitis in hospitalized infants", Respir Med, 98, pp.879~882 (2004)
- Walsh EE, "Severity of respiratory syncytial virus infection is related to virus strain", J Infect Dis, 175, pp.814~820 (1997)
- Fodha I, "Respiratory syncytial virus infections in hospitalized infants : association between viral load, virus subgroup, and disease severity", J Med Virol, 79, pp.1951~1958 (2007)
- Papadopoulos NG, "Association of rhinovirus infection with increased disease severity in acute bronchiolitis", Am J Respir Crit Care Med, 165, pp.1285~1289 (2002)
- 임연주, "생후 90일 이하의 영아에서 호흡기 바이러스 검출과 관련된 위험인자", Pediatric Infection and Vaccine, 21(1), pp.22~28 (2014), 대한소아감염학회
- Vandini S, "Respiratory syncytial virus : the influence of serotype and genotype variability on clinical course of infection", Int J Mol Sci, 18, pp.1717~ (2017)
- Laham FR, "Clinical profiles of respiratory syncytial virus subtypes A and B among children hospitalized with bronchiolitis", Pediatr Infect Dis J, 36, pp.808~810 (2017)
- Esposito S, "Characteristics and their clinical relevance of respiratory syncytial virus types and genotypes circulating in northern italy in five consecutive winter seasons", PLoS One, 10, pp.e0129369~ (2015)
- Midulla F, "How respiratory syncytial virus genotypes influence the clinical course in infants hospitalized for bronchiolitis", J Infect Dis, 219, pp.526~534 (2019)
- Kliegman RM, "Nelson textbook of pediatrics", pp.2044~2045 (2015), Elsevier Saunders
- De Vincenzo J, "Factors predicting childhood respiratory syncytial virus severity", Pediatr Infect Dis J, 24, pp.177~183 (2005)
- Raiden S, "Respiratory syncytial virus(RSV)infects CD4+ T cells : frequency of circulating CD4+ RSV+ T cells as a marker of disease severity in young children", J Infect Dis, 215, pp.1049~1058 (2017)
- Roe M, "Lymphocyte apoptosis in acute respiratory syncytial virus bronchiolitis", Clin Exp Immunol, 137, pp.139~145 (2004)
- Larranga C, "Impaired immune response in severe human lower tract respiratory infection by respiratory syncytial virus", Pediatr Infect Dis J, 28, pp.867~873 (2009)
- 박용민, "Respiratory Syncytial Virus 감염에 의한 세기관지염의 면역반응", Allergy Asthma & Respiratory Disease, 17(2), pp.97~100 (2007), 대한 소아알레르기 호흡기학회
- Smyth RL, "Respiratory syncytial virus bronchiolitis : disease severity, interleukin-8, and virus genotype", Pediatr Pulmonol, 33, pp.339~346 (2002)
- Schauer U, "RSV bronchiolitis and risk of wheeze and allergic sensitisation in the first year of life", Eur Respir J, 20, pp.1277~1283 (2002)
- Thorburn K, "Transaminase levels reflect disease severity in children ventilated for respiratory syncytial virus(RSV)bronchiolitis", Sci Rep, 8, pp.339~346 (2018)
- Eisenhut M, "Transaminase levels in ventilated children with respiratory syncytial virus bronchiolitis", Intensive Care Med, 30, pp.931~934 (2004)
- Buckingham SC, "Nasal quantity of respiratory syncytial virus correlates with disease severity in hospitalized infants", Pediatr Infect Dis J, 19, pp.113~117 (2000)