Li Yuan, Zhai Yingying, Lin Yuneng, Lu Chengyu, He Zhentao, Wu Shangzhi, Yang Cui, Zhou Rong, Liu Wenkuan, Chen Dehui
Department of Pediatrics, the First Affiliated Hospital of Guangzhou Medical University, Guangzhou, China.
State Key Laboratory of Respiratory Diseases, National Clinical Research Center for Respiratory Disease, Guangdong-Hong Kong-Macao Joint Laboratory of Respiratory Infectious Disease, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou Institute of Respiratory Health, Guangzhou Medical University, Guangzhou, China.
J Thorac Dis. 2023 Mar 31;15(3):967-976. doi: 10.21037/jtd-22-331. Epub 2023 Feb 16.
Respiratory syncytial virus (RSV) is one of the most common virus causing community-acquired pneumonia (CAP) in children. To guide the prevention, diagnosis and treatment of RSV, we aimed to analyze the epidemiology of RSV in hospitalized children with CAP.
A total of 9,837 hospitalized children (≤14 years old) with CAP from January 2010 to December 2019 were reviewed. Using the real-time polymerase chain reaction (RT-PCR), the oropharyngeal swab specimens were collected and tested for RSV, influenza virus A (INFA), influenza virus B (INFB), parainfluenza virus (PIV), enterovirus (EV), coronavirus (CoV), human metapneumovirus (HMPV), human bocavirus (HBoV), human rhinovirus (HRV), and adenovirus (ADV) for each patient.
The detection rate of RSV was 15.3% (1,507/9,837). From 2010 to 2019, the RSV detection rate showed a wavy change (χ=166.982, P<0.001), with the highest detection rate in 2011 (158/636, 24.8%). RSV can be detected throughout the year, with the highest detection rate in February (123/482, 25.5%). Children younger than 0.5 years old had the highest detection rate (410/1,671, 24.5%). The detection rate of RSV in male children (1,024/6,226, 16.4%) was higher than that in female children (483/3,611, 13.4%) (P<0.001). A proportion of 17.7% (266/1,507) of RSV positive cases were also co-infected with other viruses, and INFA (41/266, 15.4%) was the most common coinfection virus. After adjusting for potential confounders, the RSV-positive children were associated with increased risk of severe pneumonia [odds ratio (OR) 1.26, 95% confidence interval (CI): 1.04 to 1.53, P=0.019]. Moreover, children with severe pneumonia had significantly lower cycle threshold (CT) values of RSV than those without severe pneumonia (28.88±3.89 30.42±3.33, P<0.01). Patients with coinfection (38/266, 14.3%) had a higher risk of severe pneumonia than those without coinfection (142/1,241, 11.4%), but the difference was not statistically significant (OR 1.39, 95% CI: 0.94 to 2.05, P=0.101).
The detection rate of RSV in CAP hospitalized children changed by years, months, ages, and sexes. CAP hospitalized children with RSV are more likely to develop severe pneumonia than those without RSV. Policy makers and doctors should make timely adjustments to prevention measures, medical resources and treatment options based on these epidemiological characteristics.
呼吸道合胞病毒（RSV）是引起儿童社区获得性肺炎（CAP）最常见的病毒之一。为指导RSV的预防、诊断和治疗，我们旨在分析住院CAP患儿中RSV的流行病学特征。
回顾性分析2010年1月至2019年12月期间共9837例≤14岁住院CAP患儿。采用实时聚合酶链反应（RT-PCR）对每位患儿的咽拭子标本进行检测，检测RSV、甲型流感病毒（INFA）、乙型流感病毒（INFB）、副流感病毒（PIV）、肠道病毒（EV）、冠状病毒（CoV）、人偏肺病毒（HMPV）、人博卡病毒（HBoV）、人鼻病毒（HRV）和腺病毒（ADV）。
RSV的检出率为15.3%（1507/9837）。2010年至2019年，RSV检出率呈波浪式变化（χ=166.982，P<0.001），2011年检出率最高（158/636，24.8%）。RSV全年均可检出，2月份检出率最高（123/482，25.5%）。0.5岁以下儿童检出率最高（410/1671，24.5%）。男童RSV检出率（1024/6226，16.4%）高于女童（483/3611，13.4%）（P<0.001）。17.7%（266/1507）的RSV阳性病例同时合并其他病毒感染，其中INFA（41/266，15.4%）是最常见的合并感染病毒。校正潜在混杂因素后，RSV阳性患儿发生重症肺炎的风险增加[比值比（OR）1.26，95%置信区间（CI）：1.04至1.53，P=0.019]。此外，重症肺炎患儿RSV的循环阈值（CT）值显著低于非重症肺炎患儿（28.88±3.89对30.
