Clinical Characteristics and Factors Associated with Severity of Lower Respiratory Tract Infection from Respiratory Syncytial Virus (RSV) in Pediatric Patients at Chaoprayayommarat Hospital

Abstract

The lower respiratory tract infection (LRTI) caused by the respiratory syncytial virus (RSV) is a leading cause of hospitalization in children. This study aimed to determine clinical characteristics and factors associated with the severity of LRTI from RSV in children and recurrent wheezing at one year after RSV infection. This retrospective analytic cross-sectional study was conducted by reviewing the medical records of pediatric patients aged 0 to 6 years who have been diagnosed with LRTI from RSV. Specimens were collected from nasal cavity and tested using a rapid antigen detection test for RSV. These pediatric patients were admitted to the pediatrics department between October and December 2020. The patients were categorized into two groups: the severe group with pneumonia and bronchiolitis; and the non-severe group with bronchitis. Multiple logistic regression analysis was used to determine the factors associated with severity. The study found that, of the 157 children with LRTI from RSV, 102 (65%) had pneumonia and bronchiolitis, whereas 55 (35%) had bronchitis. Children aged below 6 months with RSV infection were 18.6 times more likely to develop severe disease than children aged 1-6 years (ORadj 18.6, 95% CI 2.37-145.71, p=0.005) and abnormal lung auscultation of wheezing was associated with the severity of RSV equal to 4.5 times (ORadj 4.5, 95% CI 1.68-11.93, p=0.003). This study demonstrated that children below 6 months old and those who had clinical pulmonary signs of wheezing were associated with the severity of LRTI from RSV.