Viral Load Dynamics and Clinical Disease Severity in Infants With Respiratory Syncytial Virus Infection.
Viral Load Dynamics and Clinical Disease Severity in Infants With Respiratory Syncytial Virus Infection.
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DOI：
10.1093/infdis/jiy655
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发表时间：
2019-04-08
期刊：
影响因子：
--
通讯作者：
Mejias A
中科院分区：
文献类型：
--
作者：
Garcia-Mauriño C;Moore-Clingenpeel M;Thomas J;Mertz S;Cohen DM;Ramilo O;Mejias A
呼吸道合胞病毒（RSV）载量与儿童临床结局之间的关系仍有待确定。在大多数研究中，病毒载量（VL）是在住院儿童和在一个单一的时间点进行评估。我们调查了呼吸道合胞病毒感染的门诊和住院患者中病毒标志物与疾病严重程度的关系。我们招募了先前健康的RSV感染儿童。根据护理水平（门诊患者vs病房vs儿科重症监护病房[PICU]）和临床疾病严重程度评分（CDSS）定义疾病严重程度。在入组时和住院患者中每天通过聚合酶链反应和CDSS测量鼻咽VL。使用线性混合模型分析根据疾病严重程度的VL衰减。从2015年2月至2017年3月，我们招募了150名婴儿：39名门诊患者和111名住院患者。门诊患者的VL高于年龄匹配的住院患者。在住院患者中，病房和PICU患者的初始VL相当，并且先于CDSS峰值。然而，在排除接受类固醇治疗的婴儿后，病房住院的婴儿的VL高于需要PICU护理的婴儿（P <0.001）。动态分析表明，VL衰减延迟PICU患者，特别是在那些用类固醇治疗。在儿童中，较高的VL和更快且一致的VL下降均与较轻的RSV疾病相关。患有不太严重的呼吸道合胞病毒（RSV）疾病的婴儿在就诊时具有较高的病毒载量（VL），并且VL下降更快且一致。相反，VL衰减和总体病毒暴露延长，并在婴儿严重RSV疾病接受类固醇更高。
The association between respiratory syncytial virus (RSV) loads and clinical outcomes in children remains to be defined. In most studies, viral loads (VL) were evaluated in hospitalized children and at a single time-point. We investigated the relationship between VLs and disease severity in both outpatients and inpatients with RSV infection. We enrolled previously healthy children with RSV infection. Disease severity was defined by level of care (outpatients vs ward vs pediatric intensive care unit [PICU]), and a clinical disease severity score (CDSS). Nasopharyngeal VLs by polymerase chain reaction and CDSS were measured at enrollment and daily in inpatients. VL decay according to disease severity was analyzed using linear mixed modeling. From February 2015 to March 2017, we enrolled 150 infants: 39 outpatients and 111 inpatients. VLs were higher in outpatients than in age-matched inpatients. Among inpatients, initial VLs were comparable in ward and PICU patients, and preceded the peak CDSS. However, after excluding infants treated with steroids, those hospitalized in the ward had higher VLs than infants requiring PICU care (P < .001). Dynamic analyses showed that VL decay was delayed in PICU patients, especially in those treated with steroids. Higher VLs at presentation and a faster and consistent VL decline were both associated with less severe RSV disease in children. Infants with less severe respiratory syncytial virus (RSV) disease had higher viral loads (VL) at presentation, and faster and consistent VL decline. Conversely, VL decay and overall viral exposure were prolonged and higher in infants severe RSV disease receiving steroids.
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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
发表时间：
2015-05-15
期刊：
The Journal of infectious diseases
影响因子：
--
作者：
Hasegawa K;Jartti T;Mansbach JM;Laham FR;Jewell AM;Espinola JA;Piedra PA;Camargo CA Jr
通讯作者：
Camargo CA Jr
DOI：
10.1016/j.diagmicrobio.2008.08.002
发表时间：
2008-12
影响因子：
2.9
作者：
Martin ET;Kuypers J;Heugel J;Englund JA
通讯作者：
Englund JA
影响因子：
168.9
作者：
Lozano, Rafael;Naghavi, Mohsen;Murray, Christopher J. L.
通讯作者：
Murray, Christopher J. L.
DOI：
10.1056/nejmoa0804877
发表时间：
2009-02-05
期刊：
The New England journal of medicine
影响因子：
--
作者：
Hall CB;Weinberg GA;Iwane MK;Blumkin AK;Edwards KM;Staat MA;Auinger P;Griffin MR;Poehling KA;Erdman D;Grijalva CG;Zhu Y;Szilagyi P
通讯作者：
Szilagyi P
影响因子：
6.4
作者：
Wright, PF;Gruber, WC;Graham, BS
通讯作者：
Graham, BS