Epidemiología, División de Promoción y Protección de la Salud, Laboratorio. Hospital de Niños "Ricardo Gutiérrez", Ciudad Autónoma de Buenos Aires.
Virolología, Laboratorio. Hospital de Niños "Ricardo Gutiérrez", Ciudad Autónoma de Buenos Aires.
Arch Argent Pediatr. 2020 Dec;118(6):386-392. doi: 10.5546/aap.2020.eng.386.
Respiratory syncytial virus (RSV) is the leading cause of acute lower respiratory tract infection (ALRTI) in pediatrics. Preterm infants are at a higher risk for complications. We aimed to describe and compare the clinical and epidemiological characteristics associated with ALRTI due to RSV in preterm and term infants and to establish the predictors of fatality among preterm infants.
Prospective, cross-sectional study of patients admitted due to ALRTI in the 2000-2018 period. Viral diagnosis was done by indirect immunofluorescence or reverse transcription polymerase chain reaction in nasopharyngeal aspirates. Clinical and epidemiological characteristics were recorded. A multiple logistic regression model established the predictors of fatality among preterm infants.
A total of 16 018 ALRTI cases were included; 13 545 (84.6 %) were tested; 6047 (45 %) were positive; RSV was prevalent in 81.1 % (4907), with a seasonal epidemic pattern; 14 % (686) were preterm infants. Comorbidities, perinatal respiratory history, congenital heart disease, malnutrition, chronic respiratory disease, bronchopulmonary dysplasia, prior hospitalization due to ALRTI, and chronic neurological disease (p < 0.001) were more common among preterm infants; they required more intensive care and a longer length of stay, and had a higher fatality rate (p < 0.01). Congenital heart disease was an independent predictor of fatality due to RSV among preterm infants (OR: 3.67 [1.25-10.8], p = 0.01).
RSV showed an epidemic pattern and affected more preterm infants with certain comorbidities, with a higher morbidity and mortality, compared to term infants. RSV fatality among preterm infants was associated with congenital heart disease.
呼吸道合胞病毒（RSV）是儿科急性下呼吸道感染（ALRTI）的主要病因。早产儿患并发症的风险更高。我们旨在描述和比较因 RSV 导致的早产儿和足月儿 ALRTI 的临床和流行病学特征，并确定早产儿死亡的预测因素。
这是一项 2000-2018 年期间因 ALRTI 入院的患者的前瞻性、横断面研究。通过间接免疫荧光或鼻咽抽吸物逆转录聚合酶链反应进行病毒诊断。记录临床和流行病学特征。使用多元逻辑回归模型确定早产儿死亡的预测因素。
共纳入 16018 例 ALRTI 病例；其中 13545 例（84.6%）进行了检测；6047 例（45%）呈阳性；RSV 阳性率为 81.1%（4907 例），呈季节性流行模式；14%（686 例）为早产儿。合并症、围产期呼吸史、先天性心脏病、营养不良、慢性呼吸系统疾病、支气管肺发育不良、因 ALRTI 先前住院和慢性神经系统疾病（p<0.001）在早产儿中更为常见；他们需要更多的重症监护和更长的住院时间，死亡率更高（p<0.01）。先天性心脏病是 RSV 导致早产儿死亡的独立预测因素（OR：3.67[1.25-10.8]，p=0.01）。
与足月儿相比，RSV 呈流行模式，影响更多患有某些合并症的早产儿，发病率和死亡率更高。RSV 导致早产儿死亡与先天性心脏病有关。
