Respiratory syncytial virus genomic load and disease severity among children hospitalized with bronchiolitis: multicenter cohort studies in the United States and Finland.
Respiratory syncytial virus genomic load and disease severity among children hospitalized with bronchiolitis: multicenter cohort studies in the United States and Finland.
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呼吸道合胞病毒基因组载荷和疾病的严重程度患有细支气管炎的儿童：美国和芬兰的多中心队列研究。
DOI：
10.1093/infdis/jiu658
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发表时间：
2015-05-15
期刊：
影响因子：
--
通讯作者：
Camargo CA Jr
中科院分区：
文献类型：
--
作者：
Hasegawa K;Jartti T;Mansbach JM;Laham FR;Jewell AM;Espinola JA;Piedra PA;Camargo CA Jr
背景。 我们调查了呼吸道合胞病毒 (RSV) 基因组载量较高的儿童患更严重细支气管炎的风险是否较高。 方法。 美国和芬兰的两项多中心前瞻性队列研究使用相同的方案来招募因细支气管炎住院的 2 岁以下儿童并收集鼻咽抽吸物。通过使用实时聚合酶链反应分析，将患者分为 3 个基因组负荷状态组：低、中和高。结果指标为住院时间 (LOS) ≥3 天和使用重症监护，定义为入住重症监护病房或使用机械通气。 结果。 在 2615 名登记儿童中，1764 名 (67%) 患有 RSV 细支气管炎。与中等基因组负荷和高基因组负荷的儿童（分别为 42% 和 51%）相比，低基因组负荷的儿童住院时间≥3 天的未调整风险较高（52%）。在多变量模型中，中等（比值比 [OR]，1.43；95% 置信区间 [CI]，1.20–1.69）和高（OR，1.58；95% CI，1.29–1.94）基因组负荷组的住院时间≥3 天的风险仍然显着较高。同样，基因组负荷高的儿童接受重症监护的风险较高（20%，而基因组负荷低和中等的组分别为 15% 和 16%）。在多变量模型中，高基因组负荷组的风险仍然显着较高（OR，1.43；95% CI，1.03-1.99）。 结论。 RSV 基因组负载较高的儿童患更严重细支气管炎的风险较高。
Background. We investigated whether children with a higher respiratory syncytial virus (RSV) genomic load are at a higher risk of more-severe bronchiolitis. Methods. Two multicenter prospective cohort studies in the United States and Finland used the same protocol to enroll children aged <2 years hospitalized for bronchiolitis and collect nasopharyngeal aspirates. By using real-time polymerase chain reaction analysis, patients were classified into 3 genomic load status groups: low, intermediate, and high. Outcome measures were a length of hospital stay (LOS) of ≥3 days and intensive care use, defined as admission to the intensive care unit or use of mechanical ventilation. Results. Of 2615 enrolled children, 1764 (67%) had RSV bronchiolitis. Children with a low genomic load had a higher unadjusted risk of having a length of stay of ≥3 days (52%), compared with children with intermediate and those with high genomic loads (42% and 51%, respectively). In a multivariable model, the risk of having a length of stay of ≥3 days remained significantly higher in the groups with intermediate (odds ratio [OR], 1.43; 95% confidence interval [CI], 1.20–1.69) and high (OR, 1.58; 95% CI, 1.29–1.94) genomic loads. Similarly, children with a high genomic load had a higher risk of intensive care use (20%, compared with 15% and 16% in the groups with low and intermediate genomic loads, respectively). In a multivariable model, the risk remained significantly higher in the group with a high genomic load (OR, 1.43; 95% CI, 1.03–1.99). Conclusion. Children with a higher RSV genomic load had a higher risk for more-severe bronchiolitis.
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