Unidade de Urgencia e Emergencia Referenciada Infantil, Divisao de Pediatria, Hospital Universitario, Universidade de Sao Paulo, Sao Paulo, SP, BR.
Unidade de Pronto Atendimento, Hospital Israelita Albert Einstein, Sao Paulo, SP, BR.
Clinics (Sao Paulo). 2021 Dec 6;76:e3192. doi: 10.6061/clinics/2021/e3192. eCollection 2021.
The relationship between viral load and the clinical evolution of bronchiolitis is controversial. Therefore, we aimed to analyze viral loads in infants hospitalized for bronchiolitis.
We tested for the presence of human respiratory syncytial virus (HRSV) or human rhinovirus (HRV) using quantitative molecular tests of nasopharyngeal secretions and recorded severity outcomes.
We included 70 infants [49 (70%) HRSV, 9 (13%) HRV and 12 (17%) HRSV+HRV]. There were no differences among the groups according to the outcomes analyzed individually. Clinical scores showed greater severity in the isolated HRSV infection group. A higher isolated HRSV viral load was associated with more prolonged ventilatory support, oxygen therapy, and hospitalization days, even after adjustment for the age and period of nasopharyngeal secretion collection. In the co-infection groups, there was a longer duration of oxygen therapy when the HRSV viral load was predominant. Isolated HRV infection and co-infection with a predominance of HRV were not associated with severity.
Higher HRSV viral load in isolated infections and the predominance of HRSV in co-infections, independent of viral load, were associated with greater severity. These results contribute to the development of therapeutic and prophylactic approaches and a greater understanding of the pathophysiology of bronchiolitis.
病毒载量与细支气管炎临床演变之间的关系存在争议。因此，我们旨在分析因细支气管炎住院的婴儿的病毒载量。
我们使用鼻咽分泌物的定量分子检测来检测人呼吸道合胞病毒（HRSV）或人类鼻病毒（HRV）的存在，并记录严重程度结果。
我们纳入了 70 名婴儿[49 名（70%）为 HRSV，9 名（13%）为 HRV，12 名（17%）为 HRSV+HRV]。根据单独分析的结果，各组之间没有差异。临床评分显示，单纯 HRSV 感染组的严重程度更高。单纯 HRSV 病毒载量较高与通气支持、氧疗和住院天数的延长有关，即使在调整鼻咽分泌物采集的年龄和时期后也是如此。在合并感染组中，当 HRSV 病毒载量占主导地位时，氧疗时间更长。单纯 HRV 感染和以 HRV 为主导的合并感染与严重程度无关。
单纯感染时 HRSV 病毒载量较高，合并感染时 HRSV 占主导地位，与严重程度增加有关，这一结果有助于制定治疗和预防方法，并加深对细支气管炎病理生理学的理解。
