Respiratory syncytial virus and human rhinovirus causing pneumonia during the COVID-19 pandemic in hospitalized children in a northeastern Brazilian capital
DOI:
https://doi.org/10.11606/issn.2176-7262.rmrp.2024.214744Palabras clave:
Respiratory syncytial virus infections, Rhinovirus, Severe acute respiratory syndrome, Viral pneumoniaResumen
Introduction: Acute respiratory infections are one of the main causes of morbidity and mortality in Brazil. Pneumonia is largely responsible for this high rate, and children are the most affected age group. Objective: To characterize the clinical and epidemiological profile of children infected with respiratory syncytial virus (RSV) and human rhinovirus (HR) treated at public hospitals in the city of São Luís, Maranhão, Brazil. Methods: Retrospective research with a quantitative approach carried out using the medical records of 1,658 pediatric patients from March 2020 to March 2021 admitted to three public hospitals. Collection was a check list aiming to obtain sociodemographic information, symptomatology, exams, treatment, and outcome (viral panel). The Chi-square test was performed for the association between the variable viral panel and the clinical and epidemiological data, with p<0.20. For Poisson regression fitted for significant variables,
a p<0.05 was adopted. Results: 91.93% of cases were caused by RSV, with 83.87% occurring in São Luís (p=0.02 when associated with the viral panel), frequent in women (56.45%), and prevalent in the age group between two to 11 months (46.77%). Cough (91.94%) and fever (75.81%) were the most common signs and symptoms. Abdominal pain was statistically associated with the viral panel (p=0.02). Prematurity was the most frequent comorbidity (9.68%). Imaging, X-ray (54.84%), laboratory tests, blood count (93.55%) are the most common. Antibiotic therapy was used in 96.77%, and all cases led to death, associated with hemorrhage (96.77%). However, the fitted regression analysis showed no association between RSV and HR and clinical and epidemiological variables. Conclusion: RSV is an agent that causes severe respiratory infections in children and infants. It circulated during the COVID-19 pandemic period, making it extremely important to differentiate between the agents. The data obtained make it possible to plan effective strategies for the prevention, control, and treatment of these diseases, avoiding the abusive use of medication and reducing morbidity and mortality rates in children.
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Nascimento-Carvalho CM. Community-acquired pneumonia among children: the latest evidence for an updated management. J Pediatr (Rio J) [Internet]. 2020;96:29-38. DOI: 10.1016/j.jped.2019.08.003.
Espinoza R, Silva JRL, Bergmann A, Oliveira Melo U, Calil FE, Santos RC et al. Factors associated with mortality in severe community-acquired pneumonia: A multicenter cohort study. J Crit Care [Internet]. 2019;50:82-86. DOI: 10.1016/j.jcrc.2018.11.024.
Freitas Júnior DS, Sales MCL, Zanella ME. O clima e as condições socioeconômicas de Fortaleza: suas interferências nos casos de pneumonia em crianças. Rev GeoUECE [Internet]. 2019;8(14):117-133. Available from: https://revistas.uece.br/index.php/GeoUECE/article/view/1491.
Silveira JDO, Pegoraro MG, Ferranti JF, Bousso A, Renattini TSM. Infecção por Influenza B e doença de Kawasaki em adolescente durante a pandemia da COVID-19: relato de caso. Rev Bras Ter Intensiva [Internet]. 2021;33:320-324. DOI: 10.5935/0103-507X.20210041.
Faria R. Geografia da mortalidade infantil do Brasil: variações espaciais e desigualdades territoriais. Geousp – Espaço e Tempo [Internet]. 2016;20(3):602-618. DOI: 10.11606/issn.2179-0892.
Lanks CW, Musani AI, Hsia DW. Community-acquired pneumonia and hospital-acquired pneumonia. Med Clin North Am. [Internet]. 2019;103(3):487-501. DOI: 10.1016/j.mcna.2018.12.008.
Bedran RM, Andrade CRD, Ibiapina CDC, Fonseca MTM, Alvim CG, Bedran MBM. Pneumonias adquiridas na comunidade na infância e adolescência. Rev Med Minas Gerais [Internet]. 2012;22:40-47. Available from: https://rmmg.org/artigo/detalhes/643.
Toraih EA, Hussein MH, Elshazli RM, Kline A, Munshi R, Sultana N et al. Multisystem inflammatory syndrome in pediatric COVID-19 patients: a meta-analysis. World J Pediatr. [Internet]. 2021;17(2):141-151. DOI: 10.1007/s12519-021-00419-y.
Frauches DO, Lopes IBC, Giacomin HTA, Pacheco JPG, Costa RF, Lourenço CB. Doenças respiratórias em crianças e adolescentes: um perfil dos atendimentos na atenção primária em Vitória/ES. Rev Bras Med Fam Comunidade. [Internet]. 2017;12(39):1-11. DOI: 10.5712/rbmfc12(39)1450.
Rodrigues RR, Nogueira JJR, Viana ABS, Lima CNA, Lima GA. A síndrome respiratória aguda grave e a importância da imunização contra H1N1. Braz Ap Sci Rev. [Internet]. 2019;3(5):2149-2161. DOI: 10.34117/basrv3n5-018.
Oliveira FR, Souza R, Martins RS, Centeville M, Nascimento CA, Martins FS. Perfil clínico de crianças internadas com vírus sincicial respiratório (VSR): análise em uma cidade do interior paulista de 2016 a 2017. REAS. [Internet]. 2021;13(4):e6496. DOI: 10.25248/reas.e6496.2021.
Rady HI, Kholy AE. Prevalence of Human rhinovirus infection in young children with acute wheezing. Gaz Egypt Paediatr Assoc. [Internet]. 2018;66(2):35-38. DOI: 10.1016/j.epag.2018.05.001.
Jacobs SE, Lamson DM, Kirsten S, Walsh TJ. Human rhinoviruses. Clin Microbiol Rev. [Internet]. 2013;26(1):135-162. DOI: 10.1128/CMR.00077-12.
Mendes MHM, Jo GG, Brianezi GC, Barragan I, Correia VP, Wandalsen NF. O Papel do rinovírus e do vírus sincicial respiratório durante a infância na gênese e exarcebação da asma. In: Molin RSD, Lopes AN. Infectologia: bases epidemiológicas e clínicas. Editora Cientifica Digital, [Internet]. 2021. DOI: 10.37885/978-65-89826-10-1.
Rossi GA, Colin AA. Infantile respiratory syncytial virus and human rhinovirus infections: respective role in inception and persistence of wheezing. Eur Respir J. [Internet]. 2015;45(3):774-789. DOI: 10.1183/09031936.00062714.
García-García ML, Calvo C, Rey C, Díaz B, Mollinero MM, Pozo F et al. Human metapnuemovirus infections in hospitalized children and comparison with other respiratory viruses. 2005-2014 prospective study. PLoS One. [Internet]. 2017;12(3):e0173504. DOI:10.1371/journal.pone.0173504.
Leotte J, Trombetta H, Faggion HZ, Almeida BM, Nogueira MB, Vidal LR et al. Impact and seasonality of human rhinovirus infection in hospitalized patients for two consecutive years. J Pediatr (Rio J). [Internet]. 2017;93:294-300. DOI: 10.1016/j.jped.2016.07.004.
Aurilio RB, Sant’Anna CC, March MDFBP. Perfil clínico de crianças com e sem comorbidades hospitalizadas com pneumonia adquirida na comunidade. Rev Paul Pediatr. [Internet]. 2020;38:1-7. DOI: 10.1590/1984-0462/2020/38/2018333.
Souza PGD, Cardoso AM, Sant’Anna CC, March MDFBP. Infecção respiratória aguda baixa em crianças indígenas Guarani, Brasil. Rev Paul Pediatr. [Internet]. 2018;36(2):123-131. DOI: 10.1590/1984-0462/;2018;36;2;00017.
Jackson DJ, Gern JE, Lemanske Júnior RF. The contributions of allergic sensitization and respiratory pathogens to asthma inception. J Allergy Clin Immunol. [Internet]. 2016;13(3):659-65. DOI: 10.1016/j.jaci.2016.01.002.
Simões MCRDS, Inoue Y, Matsunaga NY, Carvalho MR, Ribeiro GL, Morais EO et al. Recurrent wheezing in preterm infants: Prevalence and risk factors. J Pediatr (Rio J). [Internet]. 2019;95(6):720-727. DOI: 10.1016/j.jped.2018.06.007.
Elenius V, Jartti T. Vaccines: could asthma in young children be a preventable disease?. Pediatr Allergy Immunol. [Internet]. 2016;27(7):682-686. DOI: 10.1111/pai.12598.
Sheridan-Pereira M, Murphy J, Sloan J, Crispino G, Leahy A, Corcoran JD et al. Respiratory Syncytial Virus Preterm (32–36 Completed Weeks of Gestation) Risk Estimation Measure for RSV Hospitalization in Ireland: A Prospective Study. Pediatr Infect Dis J. [Internet]. 2016;35(1):19-24. DOI: 10.1097/INF.0000000000000918.
Richtmann R. O palivizumabe na prevenção do vírus sincicial respiratório em prematuros com menos de 32 semanas. Experiência & Evidência, [Internet]. 2022. Available from: https://www.azmed.com.br/content/dam/multibrand/br/pt/new-azmed/images/respiratorio_e_imunologia/synagis/medicos/pdfs/11740%20-%20Synagis%20-%20Dra%20Rosana%20-%20Astrazeneca_04-04-22_G.pdf.
Lima MJ, Archondo ME, Silva A. Imunoprofilaxia do vírus sincicial respiratório com palivizumabe em crianças em hospital da zona sul de São Paulo. Rev OFIL. [Internet]. 2020;30(1):33-36. DOI: 10.4321/s1699-714x20200001000010.
Amorim DS, Lira JLM, Silva Moreira R, Fernandes FN, Matos RA, Calado MF et al. Infecção pelo SARS-CoV-2 e Tromboembolismo Pulmonar: Importância do diagnóstico por imagem. Res Soc Dev. [Internet]. 2021;10(5):e36110514989-e36110514989. DOI: 10.33448/rsd-v10i5.14989.
Trombetta GBW, Rosa Fröhlich W, Rigo SJ, Rodrigues CA. Aplicação de Deep Learning para Diagnóstico de Pneumonia Causada por COVID-19 a partir de Imagens de Raio X. J Health Inform. [Internet]. 2020;12:286-291. Available from: https://jhi.sbis.org.br/index.php/jhi-sbis/article/view/828.
Mendes ET, Paranhos HL, Santos I, Souza LBD, Aquino JLBD, Leandro-Merhi VA et al. Prognóstico de crianças hospitalizadas menores de 2 anos com codetecção de influenza A e vírus sincicial respiratório no local de atendimento. Rev bras saúde mater infant. [Internet]. 2021;21(2):531-537. DOI: 10.1590/1806-93042021000200010.
Sociedade Brasileira de Pneumologia e Tisiologia. Diretrizes brasileiras em pneumonia adquirida na comunidade em pediatria - 2007. J Bras Pneumol. [Internet]. 2007;33:S31-50. DOI: 10.1590/S1806-37132007000700002.
Custódio ACD, Ribas FV, Toledo LV, Carvalho CJD, Lima LM, Freitas BACD. Internações hospitalares e mortalidade por síndrome respiratória aguda grave: comparação entre os períodos pré-pandêmico e pandêmico. Rev Bras Epidemiol. [Internet]. 2021;24:1-15. DOI: 10.1590/1980-549720210052.
Silva MD, Dourado TC, Silva AF, Cardoso CML, Brito ECS, Gonçalves EL et al. Panorama epidemiológico da Síndrome Respiratória Aguda Grave em crianças e adolescentes hospitalizados em unidades de referências do estado de Pernambuco. Braz J Dev. [Internet]. 2022;8(6):47630-47639. DOI: 10.34117/bjdv8n6-321.
Goncalves JRS, Bhering CA. Vírus Sincicial Respiratório (VSR): Avanços Diagnósticos. Rev Saude. [Internet]. 2021;12(1):55-63. DOI: 10.21727/rs.v12i1.2399.
Canducci F, Debiaggi M, Sampaolo M, Marinozzi MC, Berrè S, Terulla C et al. Two-year prospective study of single infections and co-infections by respiratory syncytial virus and viruses identified recently in infants with acute respiratory disease. J Med Virol. [Internet]. 2008;80:716-723. DOI: 10.1002/jmv.21108.
Sanders SL, Agwan S, Hassan M, Van Driel ML, Del Mar CB. Immunoglobulin treatment for hospitalised infants and young children with respiratory syncytial virus infection. Cochrane Database Syst Rev. [Internet]. 2019;8(8):CD009417. DOI: 10.1002/14651858.CD009417.pub2.
Virkki R, Juven T, Rikalainen H, Svedström E, Mertsola J, Ruuskanen O. Differentiation of bacterial and viral pneumonia in children. Thorax. [Internet]. 2002;57(5):438-441. DOI: 10.1136/thorax.57.5.438.
Kapadia SN, Abramson EL, Carter EJ, Loo AS, Kaushal R, Calfee DP et al. The Expanding Role of Antimicrobial Stewardship Programs in Hospitals in the United States: Lessons Learned from a Multisite Qualitative Study. Jt Comm J Qual Patient Saf. [Internet]. 2018;44(2):68-74. DOI: 10.1016/j.jcjq.2017.07.007.
Leonardi GP. Evaluation of Rapid, Molecular-Based Assays for the Detection of Respiratory Syncytial Virus. Intervirology. [Internet]. 2019;62(3):101-104. DOI: 10.1159/000502995.
Távora PF, Bernandes SI, Macedo IM. A prevalência de infecções respiratórias agudas e seus agentes etiológicos diagnosticados por exames rápidos em público infanto-juvenil de Belo Horizonte. RICM. [Internet]. 2020;4(2):56-59. Available from: http://revista.fcmmg.br/index.php/RICM/article/view/109.
Gill MA, Long K, Kwon T, Muniz L, Mejias A, Connolly J et al. Differential recruitment of dendritic cells and monocytes to respiratory mucosal sites in children with influenza virus or respiratory syncytial virus infection. J Infect Dis. [Internet]. 2008;198(11):1667-1676. DOI: 10.1086/593018.
Vieira RA, Diniz EMA, Ceccon MEJR. Correlação entre mediadores inflamatórios na secreção nasofaríngea e no soro de crianças com infecção do trato respiratório inferior por vírus sincicial respiratório e a gravidade da doença. J Bras Pneumol. [Internet]. 2010;36(1):59-66. DOI: 10.1590/S1806-37132010000100011.
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Derechos de autor 2024 Diana Karla Lourenço Bastos, Rodrigo Sevinhago, Gustavo Thales Bringel Vieira, Wyllyane Rayana Chaves Carvalho, Francisca Bruna Arruda Aragão, Márcio Anderson Sousa Nunes, Adriana Sousa Rêgo, Amanda Silva dos Santos Aliança, Rita de Cassia Mendonça de Miranda, Wellyson da Cunha Araújo Firmo
Esta obra está bajo una licencia internacional Creative Commons Atribución 4.0.
