1. Defining Age-specific Relationships of Respiratory Syncytial Virus and Rhinovirus Species in Hospitalized Children With Acute Wheeze.
- Author
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Oo SWC, Khoo SK, Cox DW, Chidlow G, Franks K, Prastanti F, Bochkov YA, Borland ML, Zhang G, Gern JE, Smith DW, Bizzintino JA, Laing IA, and Le Souëf PN
- Subjects
- Acute Disease, Adolescent, Age Factors, Child, Child, Preschool, Cohort Studies, Female, Humans, Infant, Infant, Newborn, Male, Nose virology, Oxygen Saturation, Picornaviridae Infections complications, Picornaviridae Infections virology, Prospective Studies, Respiratory Syncytial Virus Infections complications, Respiratory Syncytial Virus Infections virology, Hospitalization statistics & numerical data, Respiratory Sounds etiology, Respiratory Syncytial Virus, Human pathogenicity, Rhinovirus pathogenicity
- Abstract
Background: Acute wheezing is one of the most common hospital presentations for young children. Respiratory syncytial virus (RSV) and rhinovirus (RV) species A, B and the more recently described species C are implicated in the majority of these presentations. However, the relative importance and age-specificities of these viruses have not been defined. Hence, this study aimed to establish these relationships in a large cohort of prospectively recruited hospitalized children., Methods: The study cohort was 390 children 0-16 years of age presenting with acute wheezing to a children's emergency department, 96.4% being admitted. A nonwheezing control population of 190 was also recruited. Nasal samples were analyzed for viruses., Results: For the first 6 months of life, RSV was the dominant virus associated with wheezing (P < 0.001). From 6 months to 2 years, RSV, RV-A and RV-C were all common but none predominated. From 2 to 6 years, RV-C was the dominant virus detected (50-60% of cases), 2-3 times more common than RV-A and RSV, RSV decreasing to be absent from 4 to 7 years. RV-B was rare at all ages. RV-C was no longer dominant in children more than 10 years of age. Overall, RV-C was associated with lower mean oxygen saturation than any other virus (P < 0.001). Controls had no clear age distribution of viruses., Conclusion: This study establishes a clear profile of age specificity of virus infections causing moderate to severe wheezing in children: RSV as the dominant cause in the first 6 months and RV-C in preschool-age children., Competing Interests: Supported by an NHMRC program grant (#458513), NHMRC project grant (#1045760), the West Australian Institute of Medical Research and the Asthma Foundation of Western Australia (AFWA). Fellowship support was also provided for S.W.C.O. (Telethon Research Fellowship and Princess Margaret Hospital Foundation Clinical Fellowship), I.A.L. (Australian Respiratory Council Ann Woolcock Research Fellowship) and J.A.B. (Thoracic Society of Australia and New Zealand/AstraZeneca Respiratory Research Fellowship and AFWA). The other authors have no conflicts of interest to disclose., (Copyright © 2021 Wolters Kluwer Health, Inc. All rights reserved.)
- Published
- 2021
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