Uusitupa Erika, Waris Matti, Heikkinen Terho
Department of Pediatrics, University of Turku, Turku, Finland.
Department of Clinical Microbiology, Turku University Hospital, Turku, Finland.
J Infect Dis. 2020 Jun 29;222(2):298-304. doi: 10.1093/infdis/jiaa076.
There are scarce data on whether viral load affects the severity of respiratory syncytial virus (RSV) disease in outpatient children.
We analyzed the association between viral load and disease severity among children who participated in a prospective cohort study of respiratory infections. The children were examined and nasal swabs for the detection of RSV were obtained during each respiratory illness. Quantification of RSV load was based on the cycle threshold (Ct) value. For the primary analysis, the children were divided into 2 groups: higher (Ct < 27) and lower viral load (Ct ≥ 27).
Among 201 episodes of RSV infection, children with higher viral load had significantly longer median durations of rhinitis (8 vs 6 days; P = .0008), cough (8 vs 6 days; P = .034), fever (2 vs 1 days; P = .018), and any symptom (10 vs 8 days; P = .024) than those with lower viral load. There were statistically significant negative correlations between the Ct values and durations of all measured symptoms.
Our findings support the concept that viral load drives the severity of RSV disease in children. Reducing the viral load by RSV antivirals might provide substantial benefits to outpatient children.
关于病毒载量是否会影响门诊儿童呼吸道合胞病毒（RSV）疾病的严重程度，相关数据较少。
我们分析了参与呼吸道感染前瞻性队列研究的儿童中病毒载量与疾病严重程度之间的关联。在每次呼吸道疾病发作期间对儿童进行检查，并采集鼻拭子以检测RSV。RSV载量的定量基于循环阈值（Ct）值。在初步分析中，将儿童分为两组：病毒载量较高（Ct < 27）和较低（Ct≥27）。
在201次RSV感染发作中，病毒载量较高的儿童鼻炎（8天对6天；P = 0.0008）、咳嗽（8天对6天；P = 0.034）、发热（2天对1天；P = 0.018）及任何症状（10天对8天；P = 0.024）的中位持续时间均显著长于病毒载量较低的儿童。Ct值与所有测量症状的持续时间之间存在统计学显著的负相关。
我们的研究结果支持病毒载量决定儿童RSV疾病严重程度这一概念。使用RSV抗病毒药物降低病毒载量可能会给门诊儿童带来实质性益处。
