Zaid Haddadin1, Danielle A Rankin2, Loren Lipworth3, Mina Suh4, Rendie McHenry5, Anna Blozinski5, Seifein Salib George5, Kailee N Fernandez5, Rebekkah Varjabedian5, Andrew J Spieker6, Donald S Shepard7, Natasha B Halasa5. 1. Department of Pediatrics, Vanderbilt University Medical Center, Nashville, TN. Electronic address: zaid.haddadin@vumc.org. 2. Department of Pediatrics, Vanderbilt University Medical Center, Nashville, TN; Vanderbilt Epidemiology PhD Program, Vanderbilt University School of Medicine, Nashville, TN. 3. Department of Medicine, Division of Epidemiology, Vanderbilt University Medical Center, Nashville, TN. 4. EpidStrategies, Rockville, MD. 5. Department of Pediatrics, Vanderbilt University Medical Center, Nashville, TN. 6. Department of Biostatistics, Vanderbilt University Medical Center, Nashville, TN. 7. Heller School for Social Policy and Management, Brandeis University, Waltham, MA.
Abstract
OBJECTIVES: We aimed to evaluate the distribution, clinical presentations and severity of common acute respiratory infections (ARI) viruses in infants across 3 clinical settings. STUDY DESIGN: In a prospective virus surveillance study, infants under 1 year with fever and/or respiratory symptoms were enrolled from outpatient, emergency department, and inpatient settings from December 16, 2019 through April 30, 2020. Demographic and clinical characteristics were collected through parent/guardian interviews, medical chart abstractions, and follow-up surveys. Nasal swabs were collected and tested for viruses using quantitative reverse-transcription polymerase chain reaction. RESULTS: We enrolled 366 infants and tested nasal swabs on 360 (98%); median age was 6.3 months, 50% male. In total, 295 (82%) had at least 1 virus detected; rhinovirus/enterovirus (RV/EV; 42%), respiratory syncytial virus (RSV; 34%), and influenza (15%) were the most common. RSV was the most frequently detected virus in the inpatient (63%) and emergency department (37%) settings, and RV/EV was most frequently detected virus in the outpatient setting (54%). RSV-positive infants had a lower median age (4.9 months) and were more likely to have respiratory distress, and RV/EV-positive infants were less likely to have respiratory distress. Influenza-positive infants had a higher median age (8 months) and were more likely to have systemic symptoms. RSV infection and younger age were associated with higher odds of hospitalization in multivariable logistic regression. CONCLUSIONS: Across 3 clinical settings, and combining virologic, patient, and health-system information, our results highlight the burden of viral ARI among infants. Overall, RSV, RV/EV, and influenza were most commonly detected, with RSV having the highest disease severity.
OBJECTIVES: We aimed to evaluate the distribution, clinical presentations and severity of common acute respiratory infections (ARI) viruses in infants across 3 clinical settings. STUDY DESIGN: In a prospective virus surveillance study, infants under 1 year with fever and/or respiratory symptoms were enrolled from outpatient, emergency department, and inpatient settings from December 16, 2019 through April 30, 2020. Demographic and clinical characteristics were collected through parent/guardian interviews, medical chart abstractions, and follow-up surveys. Nasal swabs were collected and tested for viruses using quantitative reverse-transcription polymerase chain reaction. RESULTS: We enrolled 366 infants and tested nasal swabs on 360 (98%); median age was 6.3 months, 50% male. In total, 295 (82%) had at least 1 virus detected; rhinovirus/enterovirus (RV/EV; 42%), respiratory syncytial virus (RSV; 34%), and influenza (15%) were the most common. RSV was the most frequently detected virus in the inpatient (63%) and emergency department (37%) settings, and RV/EV was most frequently detected virus in the outpatient setting (54%). RSV-positive infants had a lower median age (4.9 months) and were more likely to have respiratory distress, and RV/EV-positive infants were less likely to have respiratory distress. Influenza-positive infants had a higher median age (8 months) and were more likely to have systemic symptoms. RSVinfection and younger age were associated with higher odds of hospitalization in multivariable logistic regression. CONCLUSIONS: Across 3 clinical settings, and combining virologic, patient, and health-system information, our results highlight the burden of viral ARI among infants. Overall, RSV, RV/EV, and influenza were most commonly detected, with RSV having the highest disease severity.
Authors: Diana M Bowser; Katharine R Rowlands; Dhwani Hariharan; Raíssa M Gervasio; Lauren Buckley; Yara Halasa-Rappel; Elizabeth L Glaser; Christopher B Nelson; Donald S Shepard Journal: J Infect Dis Date: 2022-08-15 Impact factor: 7.759
Authors: Danielle A Rankin; Zaid Haddadin; Loren Lipworth; Anna L Stahl; Jon Fryzek; Mina Suh; Donald S Shepard; Rebekkah Varjabedian; Kailee N Fernandez; Seifein Salib; Jessica Villarreal; Mercedes Bruce; Rendie McHenry; Andrew J Spieker; Christopher B Nelson; Natasha B Halasa Journal: Ther Adv Infect Dis Date: 2022-07-18