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Respiratory syncytial virus genomic load and disease severity among children hospitalized with bronchiolitis: multicenter cohort studies in the United States and Finland.
- Source :
-
The Journal of infectious diseases [J Infect Dis] 2015 May 15; Vol. 211 (10), pp. 1550-9. Date of Electronic Publication: 2014 Nov 25. - Publication Year :
- 2015
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Abstract
- Background: We investigated whether children with a higher respiratory syncytial virus (RSV) genomic load are at a higher risk of more-severe bronchiolitis.<br />Methods: Two multicenter prospective cohort studies in the United States and Finland used the same protocol to enroll children aged <2 years hospitalized for bronchiolitis and collect nasopharyngeal aspirates. By using real-time polymerase chain reaction analysis, patients were classified into 3 genomic load status groups: low, intermediate, and high. Outcome measures were a length of hospital stay (LOS) of ≥3 days and intensive care use, defined as admission to the intensive care unit or use of mechanical ventilation.<br />Results: Of 2615 enrolled children, 1764 (67%) had RSV bronchiolitis. Children with a low genomic load had a higher unadjusted risk of having a length of stay of ≥3 days (52%), compared with children with intermediate and those with high genomic loads (42% and 51%, respectively). In a multivariable model, the risk of having a length of stay of ≥3 days remained significantly higher in the groups with intermediate (odds ratio [OR], 1.43; 95% confidence interval [CI], 1.20-1.69) and high (OR, 1.58; 95% CI, 1.29-1.94) genomic loads. Similarly, children with a high genomic load had a higher risk of intensive care use (20%, compared with 15% and 16% in the groups with low and intermediate genomic loads, respectively). In a multivariable model, the risk remained significantly higher in the group with a high genomic load (OR, 1.43; 95% CI, 1.03-1.99).<br />Conclusion: Children with a higher RSV genomic load had a higher risk for more-severe bronchiolitis.<br /> (© The Author 2014. Published by Oxford University Press on behalf of the Infectious Diseases Society of America. All rights reserved. For Permissions, please e-mail: journals.permissions@oup.com.)
- Subjects :
- Child, Preschool
Cohort Studies
Critical Care statistics & numerical data
Female
Finland
Humans
Infant
Length of Stay
Male
Nasopharynx virology
Prospective Studies
RNA, Viral genetics
Real-Time Polymerase Chain Reaction
Respiration, Artificial statistics & numerical data
Respiratory Syncytial Virus, Human genetics
Statistics as Topic
United States
Bronchiolitis pathology
Bronchiolitis veterinary
RNA, Viral analysis
Respiratory Syncytial Virus Infections pathology
Respiratory Syncytial Virus Infections virology
Respiratory Syncytial Virus, Human isolation & purification
Viral Load
Subjects
Details
- Language :
- English
- ISSN :
- 1537-6613
- Volume :
- 211
- Issue :
- 10
- Database :
- MEDLINE
- Journal :
- The Journal of infectious diseases
- Publication Type :
- Academic Journal
- Accession number :
- 25425699
- Full Text :
- https://doi.org/10.1093/infdis/jiu658