Pediatric Research Institute, Children's Hospital of Chongqing Medical University, Ministry of Education Key Laboratory of Child Development and Disorders, China International Science and Technology Cooperation Base of Child Development and Critical Disorders, Chongqing Key Laboratory of Pediatrics, Chongqing, China.
Department of Respiratory Medicine, Children's Hospital of Chongqing Medical University, Chongqing, China.
J Med Virol. 2018 Feb;90(2):219-228. doi: 10.1002/jmv.24850. Epub 2017 Oct 27.
To determine the prevalence of human rhinovirus (HRV) infection in children with acute asthma exacerbations, investigation of HRV viral load and severity of asthma exacerbations is also required. Nasopharyngeal aspirates and swabs were collected and assessed for respiratory viruses. HRV-positive samples were sequenced to identify types and determine viral load. Outpatients with asthma exacerbations underwent follow-up evaluations, their swabs were collected and clinical outcomes were recorded at their next clinic visit 4 weeks later. One hundred forty-three inpatients and 131 outpatients, including 88 patients with asthma exacerbations and 43 controls with stable asthma were recruited. HRV-A was mainly detected in September and February (45.5% and 33.3%, respectively), while HRV-C was mainly detected in November and April (70.0% and 55.6%, respectively). HRV-C was the primary type and was primarily found in inpatients with severe asthma exacerbations. HRV-A viral load in the group of inpatients with severe exacerbations was higher than in the mild and moderate groups (P < 0.001 and P = 0.022). The HRV-A viral load of both inpatients and outpatients was higher than that of HRV-C (P < 0.001 and P = 0.036). The main genotypes were HRV-C53 and HRV-A20 among inpatients, and this genotype caused more severe clinical manifestations. HRV persisted for no more than 4 weeks, and their symptoms or signs of disease were well-controlled well. HRV-C was most frequently detected in asthma exacerbations. HRV-A with high viral load led to severe asthma exacerbations.
为了确定急性哮喘加重患儿中人鼻病毒(HRV)感染的流行情况,还需要调查 HRV 病毒载量和哮喘加重的严重程度。采集鼻咽抽吸物和拭子并进行呼吸道病毒检测。对 HRV 阳性样本进行测序以鉴定型别并确定病毒载量。门诊哮喘加重患者进行随访评估,在 4 周后的下次就诊时采集其拭子并记录临床结果。共纳入 143 例住院患者和 131 例门诊患者,包括 88 例哮喘加重患者和 43 例病情稳定的哮喘对照者。主要在 9 月和 2 月检测到 HRV-A(分别为 45.5%和 33.3%),而 HRV-C 主要在 11 月和 4 月检测到(分别为 70.0%和 55.6%)。HRV-C 是主要型别,主要存在于重症哮喘加重的住院患者中。重症组住院患者 HRV-A 病毒载量高于轻、中度组(P<0.001 和 P=0.022)。住院患者和门诊患者的 HRV-A 病毒载量均高于 HRV-C(P<0.001 和 P=0.036)。住院患者的主要基因型为 HRV-C53 和 HRV-A20,这种基因型导致更严重的临床表现。HRV 持续时间不超过 4 周,且其症状或疾病体征得到良好控制。HRV-C 在哮喘加重中最常被检出。高病毒载量的 HRV-A 可导致严重哮喘加重。