Prematurity is a significant predictor of worse outcomes in viral bronchiolitis: A comparative study in infancy.

BACKGROUND

The rate of admissions to hospital with bronchiolitis has increased over the past years. The reasons for this are likely to be multifactorial including improved survival of preterm infants.

AIM

To assess the severity of viral bronchiolitis in preterm compared with term infants admitted at a tertiary hospital in Cairo, Egypt, based on the outcome.

MATERIALS AND METHODS

This prospective study was conducted throughout a 3-year period from September 2011 to October 2014. It included 153 infants, 74 healthy preterm and 79 healthy term infants, admitted with clinical diagnosis of bronchiolitis at a tertiary hospital in Cairo, Egypt. Bronchiolitis severity score (BSS) was recorded, and nasopharyngeal swabs were obtained from each patient at the time of presentation. Viruses were identified using reverse transcription PCR. The clinical course and patient's outcome were recorded.

RESULTS

This study recorded a significantly more severe BSS for preterm compared with term infants. The preterm group had an increased mean length of hospital stay and oxygen therapy and were more likely to need ICU admission and mechanical ventilation compared with the term group. The mean ±SD BSS for infections with human metapneumovirus, respiratory syncytial virus, parainfluenza 3 was more significantly severe in preterm compared with term infants. Bacterial co-infection was significantly correlated with severity scoring in both groups.

CONCLUSION

Prematurity significantly affects the severity of bronchiolitis, and this underscores the importance of early categorization of these infants as a high-risk group on their first visit. Physician should be aware that their illness runs a more severe course, even if they have no underlying disorders.