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住院和非住院儿童的呼吸道病毒感染:疾病严重程度的决定因素。

Respiratory virus infections in hospitalized and non-hospitalized children: determinants of severe course of the disease.

机构信息

Goiás State University, Institute of Health and Biological Sciences, Laboratory of Ecology, Health and Education, Quirinópolis, Goiás State, Brazil.

Clinic Hospital, Federal University of Uberlândia, Brazil.

出版信息

J Infect Dev Ctries. 2022 Jan 31;16(1):196-205. doi: 10.3855/jidc.15117.

Abstract

INTRODUCTION

Viral respiratory disease constitutes a great burden worldwide mainly among children.

OBJECTIVE

One pursued to compare disease characteristics of children who required hospitalization from those who did not require hospitalization due to a viral respiratory disease.

METHODOLOGY

Medical and demographic data were collected through questionnaires and nasopharyngeal aspirates were tested for detection of respiratory disease viruses of in and outpatients up to five years old, presenting acute respiratory infection.

RESULTS

Respiratory syncytial virus predominated among hospitalized children while other viruses (Human rhinovirus, Influenza virus, Parainfluenza virus, Adenovirus, and Human metapneumovirus) together predominated among non-hospitalized patients. Although children with underlying risk condition required longer hospitalization, previously healthy children presented severe disease and required hospitalization as well. Also, clinical characteristics were not found that may distinguish RSV infected children who had comorbidities from those previously healthy.

CONCLUSIONS

Children who were hospitalized due to respiratory distress had well defined characteristics: early age, respiratory syncytial virus infection, bronchiolitis and presence of comorbidity. Nevertheless, rapid respiratory syncytial virus identification among early age children may be of great value in order to avoid medical misconduct, such as unnecessary antibiotic prescription and preventive health care before an eventual clinical worsening encompassing previous health status.

摘要

引言

病毒性呼吸道疾病在全球范围内构成了巨大负担,主要发生在儿童中。

目的

本研究旨在比较因病毒性呼吸道疾病住院和未住院患儿的疾病特征。

方法

通过问卷调查收集了医疗和人口统计学数据,并对 0 至 5 岁出现急性呼吸道感染的门诊和住院患者的鼻咽抽吸物进行了呼吸道疾病病毒检测。

结果

住院患儿以呼吸道合胞病毒为主,而非住院患儿则以其他病毒(人鼻病毒、流感病毒、副流感病毒、腺病毒和人偏肺病毒)为主。尽管有基础风险条件的患儿需要更长的住院时间,但既往健康的患儿也会出现严重疾病并需要住院治疗。此外,尚未发现可区分有合并症的 RSV 感染患儿与既往健康患儿的临床特征。

结论

因呼吸窘迫而住院的患儿具有明确的特征:年龄较小、呼吸道合胞病毒感染、细支气管炎和合并症存在。然而,对年龄较小的患儿进行快速呼吸道合胞病毒检测可能具有重要价值,可以避免医疗不当行为,例如不必要的抗生素处方和预防性保健,以免病情恶化,包括既往健康状况。

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