Sobkowiak Paulina, Mikoś Marcin, Bręborowicz Anna, Szczepankiewicz Aleksandra
Department of Pneumonology, Allergology and Clinical Immunology, Poznań University of Medical Sciences, Poznan, Poland.
Laboratory of Molecular and Cell Biology, Department of Pneumonology, Allergology and Clinical Immunology, Poznań University of Medical Sciences, Poznan, Poland.
Clin Respir J. 2020 Dec;14(12):1201-1207. doi: 10.1111/crj.13261. Epub 2020 Sep 7.
Viral respiratory tract infections are the leading cause of acute wheezing in children with a significant risk of hospital admission, risk of recurrence and subsequent asthma. Human respiratory syncytial virus (RSV) and human rhinovirus (RV) in childhood wheezing are widely studied; however, accessible PCR assays enabled diagnosis of other pathogens, including bocavirus (hBOV) and metapneumovirus (hMPV).
The aim of the study was to evaluate the prevalence of respiratory viruses in children hospitalized for acute wheezing along with demographic and clinical data.
We enrolled 101 children, n = 50 (49.5%) with wheezy bronchitis, n = 34 (33.7%) with acute bronchiolitis and n = 17 (16.8%) with exacerbation of asthma; (median age 1.41 ± 2.84 years). Multiplex real-time PCR assay was used for virus detection.
One or more viruses were detected in 83.2% subjects: RSV in 44.6%, followed by RV (23.8%), hBOV and hMPV (both 11.9%); other viruses were less frequent (<8%). Viral coinfection was found in 38 (37.6%) of children. ANCOVA analysis revealed significantly higher total IgE concentrations in the hMPV-positive subgroup compared to RSV (34 kU/L vs 12.7 kU/L; P = .009) and RV (13.3 kU/L, P = .022). For both hMPV and hBOV an association with atopic dermatitis (AD) was observed: aOR for hMPV and AD was 5.6 (95%CI: 1.4-22.7; P = .016) and 4.7 for hBOV and AD (95%CI: 1.3-18; P = .024).
Viral detection ratio in wheezy respiratory tract infections in Polish children is high (83.2%), with both hBOV and hMPV at 11.9% The results also suggest possible relationship of hBOV wheezy infection with nonspecific markers of atopy in children.
病毒性呼吸道感染是导致儿童急性喘息的主要原因，这些儿童有较高的住院风险、复发风险以及后续患哮喘的风险。人类呼吸道合胞病毒（RSV）和人类鼻病毒（RV）在儿童喘息中的情况已得到广泛研究；然而，可用的聚合酶链反应（PCR）检测方法能够诊断其他病原体，包括博卡病毒（hBOV）和人偏肺病毒（hMPV）。
本研究的目的是评估因急性喘息住院儿童中呼吸道病毒的流行情况以及相关的人口统计学和临床数据。
我们招募了101名儿童，其中50名（49.5%）患有喘息性支气管炎，34名（33.7%）患有急性细支气管炎，17名（16.8%）患有哮喘加重；（中位年龄1.41±2.84岁）。采用多重实时PCR检测法进行病毒检测。
83.2%的受试者检测到一种或多种病毒：RSV占44.6%，其次是RV（23.8%）、hBOV和hMPV（均为11.9%）；其他病毒较少见（<8%）。38名（37.6%）儿童存在病毒合并感染。协方差分析显示，hMPV阳性亚组的总IgE浓度显著高于RSV阳性亚组（34 kU/L对12.7 kU/L；P = 0.009）和RV阳性亚组（13.3 kU/L，P = 0.022）。观察到hMPV和hBOV均与特应性皮炎（AD）有关：hMPV与AD的调整后比值比（aOR）为5.6（95%置信区间：1.4 - 22.7；P = 0.016），hBOV与AD的aOR为4.7（95%置信区间：1.3 - 18；P = 0.024）。
波兰儿童喘息性呼吸道感染中的病毒检出率很高（83.2%），hBOV和hMPV均为11.9%。结果还提示hBOV喘息感染与儿童特应性非特异性标志物之间可能存在关联。
