Comparison of the Severity of Respiratory Disease in Children Testing Positive for Enterovirus D68 and Human Rhinovirus
Comparison of the Severity of Respiratory Disease in Children Testing Positive for Enterovirus D68 and Human Rhinovirus
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DOI：
10.1016/j.jpeds.2018.02.027
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发表时间：
2018-06-01
影响因子：
5.1
通讯作者：
Nolan, Sheila M.
中科院分区：
文献类型：
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作者：
Caylan, Esra;Weinblatt, Ezra;Nolan, Sheila M.
目的比较肠道病毒D 68（EV-D 68）和人鼻病毒（RhV）检测阳性儿童呼吸道疾病的特征和严重程度。研究设计：回顾性单中心研究，对2014年9月1日至2014年10月31日期间出现急性呼吸道症状且RhV/EV聚合酶链反应阳性的儿童进行研究。随后对标本进行EV-D 68特异性检测，并在可能的情况下将鉴定为RhV的标本分型为RhV-A、RhV-B和RhV-C。结果173例患者中，EV-D 68阳性72例，RhV阳性61例，RhV-C阳性30例。EV-D 68组的婴儿数量明显较少。携带EV-D 68的患者比不携带EV-D 68的患者，特别是携带RhV-C的患者更容易出现发热和喘息。EV-D 68患者因呼吸窘迫而接受更多硫酸镁治疗，对重复吸入沙丁胺醇剂量反应不佳。EV-D 68住院患者比RhV患者接受更多的支气管扩张剂治疗。携带EV-D 68的患者更有可能进入重症监护室，并且比没有EV-D 68的患者年龄更大。在儿科重症监护室的总体住院时间或时间的长度没有差异。结论EV-D 68的儿童似乎有更严重的呼吸系统疾病入院比儿童RhV证明了较高的发热率，喘息，支气管扩张剂的使用和儿科重症监护室入院。尽管在严重程度上存在初始差异，但在住院时间上没有发现显著差异，这表明EV-D 68患者与其他组一样迅速恢复。
Objective To compare the characteristics and severity of respiratory disease in children testing positive for enterovirus D68 (EV-D68) and for human rhinovirus (RhV).Study design A retrospective single center study of children presenting with acute respiratory symptoms and positive polymerase chain reaction for RhV/EV from September 1, 2014 through October 31, 2014 was performed. Specimens were subsequently tested specifically for EV-D68 and specimens identified as RhV were subtyped when possible into RhV-A, RhV-B, and RhV-C species. Clinical manifestations in patients with EV-D68 were compared with those with non-EV-D68, RhV, and RhV-C.Results Of the 173 patients included in the analysis, 72 tested positive for EV-D68, 61 for RhV, and 30 for RhV-C. There were significantly fewer infants in the EV-D68 group. Patients with EV-D68 were more likely than those without EV-D68, and specifically with RhV-C, to have fever and wheezing. Patients with EV-D68 received more magnesium sulfate for respiratory distress not responding adequately to repeated doses of inhaled albuterol. Hospitalized patients with EV-D68 received more bronchodilator therapy than patients with RhV. Patients with EV-D68 were more likely to be admitted to the intensive care unit and were older than patients without EV-D68. There was no difference in length of overall hospitalization or time in the pediatric intensive care unit.Conclusions Children with EV-D68 appeared to have more severe respiratory disease on admission than children with RhV as evidenced by higher rates of fever, wheezing, bronchodilator use and pediatric intensive care unit admission. Despite the initial difference in severity, no significant difference in length of stay was found suggesting that patients with EV-D68 recovered as quickly as other groups.