Papan Cihan, Argentiero Alberto, Adams Ortwin, Porwoll Marian, Hakim Ummaya, Farinelli Edoardo, Testa Ilaria, Pasticci Maria B, Mezzetti Daniele, Perruccio Katia, Simon Arne, Liese Johannes G, Knuf Markus, Stein Michal, Yacobov Renata, Bamberger Ellen, Schneider Sven, Esposito Susanna, Tenenbaum Tobias
Paediatric Infectious Diseases, Department of Paediatrics, University Children's Hospital Mannheim, Heidelberg University, Mannheim, Germany.
Centre for Infectious Diseases, Institute of Medical Microbiology and Hygiene, Saarland University, Homburg, Germany.
J Med Virol. 2023 Jan;95(1):e28113. doi: 10.1002/jmv.28113. Epub 2022 Sep 9.
To investigate the association of viral load (VL) with (i) tumor necrosis factor-related apoptosis-inducing ligand (TRAIL), interferon gamma-induced protein-10, C-reactive protein, and a combinatorial score (BV score), and (ii) clinical severity.
In this prospective, multicentre cohort substudy, children with respiratory tract infection or fever without source were enrolled. VL for influenza virus, rhinovirus, respiratory syncytial virus, and adenovirus was measured from nasopharyngeal swabs. The reference standard diagnosis was established based on expert panel adjudication.
Of 1140 recruited patients, 333 had a virus monodetection. VL for the aggregated data set correlated with TRAIL and IP-10 levels, with the length of oxygen therapy, and inversely with the BV score. At a single viral level, only the influenza VL yielded a correlation with TRAIL, IP-10 levels, and the BV score. Children with a viral reference standard diagnosis had significantly higher VL than those with bacterial infection (p = 0.0005). Low TRAIL (incidence rate ratio [IRR] 0.6, 95% confidence interval [CI] 0.39-0.91) and young age (IRR 0.62, 95% CI 0.49-0.79) were associated with a longer hospital stay, while young age (IRR 0.33, 95% CI 0.18-0.61), low TRAIL (IRR 0.25, 95% CI 0.08-0.76), and high VL (IRR 1.16, 95% CI 1.00-1.33) were predictive of longer oxygen therapy.
These findings indicate that VL correlates with biomarkers and may serve as a complementary tool pertaining to disease severity.
研究病毒载量（VL）与（i）肿瘤坏死因子相关凋亡诱导配体（TRAIL）、干扰素γ诱导蛋白10、C反应蛋白及综合评分（BV评分），以及（ii）临床严重程度之间的关联。
在这项前瞻性多中心队列子研究中，纳入了患有呼吸道感染或不明原因发热的儿童。通过鼻咽拭子检测流感病毒、鼻病毒、呼吸道合胞病毒和腺病毒的病毒载量。基于专家小组判定建立参考标准诊断。
在1140名招募的患者中，333例为单一病毒检测阳性。汇总数据集的病毒载量与TRAIL和IP - 10水平、氧疗时间相关，与BV评分呈负相关。在单一病毒水平上，只有流感病毒载量与TRAIL、IP - 10水平及BV评分相关。病毒参考标准诊断的儿童病毒载量显著高于细菌感染的儿童（p = 0.0005）。低TRAIL（发病率比[IRR] 0.6，95%置信区间[CI] 0.39 - 0.91）和低龄（IRR 0.62，95% CI 0.49 - 0.79）与住院时间延长相关，而低龄（IRR 0.33，95% CI 0.18 - 0.61）、低TRAIL（IRR 0.25，95% CI 0.08 - 0.76）和高病毒载量（IRR 1.16，95% CI 1.00 - 1.33）可预测氧疗时间延长。
这些发现表明病毒载量与生物标志物相关，可作为疾病严重程度的补充工具。
