The Impact of Multiple Viral Infection in Children with Severe Lower Respiratory Tract Infections

Aim:We aimed to compare the clinical features and outcomes between single and multiple viral pathogens in children with severe lower respiratory tract infections (LRTIs) in a pediatric intensive care unit (PICU).Materials and Methods:This study was conducted retrospectively in patients who were admitted to a PICU between March, 2018 and March, 2020. The subjects were divided into two groups, single viral infection and multiple viral infection. The epidemiologic characteristics, clinical features, disease severity and outcomes were compared between these single and multiple viral infection groups.Results:During this study period, positive polymerase chain reaction (PCR) tests were carried out on 136 (29%) children among the 468 children admitted to the PICU with the diagnosis of LRTI. Rhinovirus and Respiratory Syncytial Virus (RSV) were the most commonly identified viruses (44.1% and 35.2%, respectively). Two viruses were detected in thirty-nine (28.6%) of samples via PCR tests. Rhinovirus and RSV co-infection was the most common combination (10/39, 25.6%) in our cohort. The multiple viral infection group had higher PRISM scores than the single virus infection group (10 vs. 7, respectively, p=0.009). In the multiple viral infection group, the invasive ventilatory support rate (56.4% vs 36.1%, p=0.030) and the non-invasive ventilatory (NIV) support rate (43.5% vs 6.1%, p=0.018) were significantly higher than in the single viral infection group.Conclusion:Lower respiratory multi-viral infections are associated with increased invasive and NIV support requirements. Close monitoring in a unit where support can be provided is essential for those infants with multi-viral LRTIs

A snapshot of pediatric inpatients and outpatients with COVID-19: a point prevalence study from Turkey

This multi-center point prevalence study evaluated children who were diagnosed as having coronavirus disease 2019 (COVID-19). On February 2nd, 2022, inpatients and outpatients infected with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) were included in the study from 12 cities and 24 centers in Turkey. Of 8605 patients on February 2nd, 2022, in participating centers, 706 (8.2%) had COVID-19. The median age of the 706 patients was 92.50 months, 53.4% were female, and 76.7% were inpatients. The three most common symptoms of the patients with COVID-19 were fever (56.6%), cough (41.3%), and fatigue (27.5%). The three most common underlying chronic diseases (UCDs) were asthma (3.4%), neurologic disorders (3.3%), and obesity (2.6%). The SARS-CoV-2-related pneumoniae rate was 10.7%. The COVID-19 vaccination rate was 12.5% in all patients. Among patients aged over 12 years with access to the vaccine given by the Republic of Turkey Ministry of Health, the vaccination rate was 38.7%. Patients with UCDs presented with dyspnea and pneumoniae more frequently than those without UCDs (p < 0.001 for both). The rates of fever, diarrhea, and pneumoniae were higher in patients without COVID-19 vaccinations (p = 0.001, p = 0.012, and p = 0.027). Conclusion: To lessen the effects of the disease, all eligible children should receive the COVID-19 vaccine. The illness may specifically endanger children with UCDs. What is Known: • Children with COVID-19 mainly present with fever and cough, as in adults. • COVID-19 may specifically threaten children with underlying chronic diseases. What is New: • Children with obesity have a higher vaccination rate against COVID-19 than children without obesity. • Among unvaccinated children, fever and pneumoniae might be seen at a higher ratio than among vaccinated children