Journal List > Allergy Asthma Respir Dis > v.3(6) > 1059140

Kwak, Kim, and Choi: Clinical characteristics of respiratory viral infection in children during spring/summer: focus on human bocavirus

Abstract

Purpose

We evaluated the clinical characteristics of respiratory viruses that were frequently found in children during spring/summer, namely, human bocavirus (hBoV), human metapneumovirus (hMPV), parainfluenza virus (PIV), and human rhinovirus (hRV).

Methods

This study enrolled patients with acute lower respiratory infection in whom respiratory virus reverse transcriptase polymerase chain reaction was performed between March 2013 and August of 2013. We retrospectively reviewed the medical records to collect the patients' data.

Results

A total of 96 patients were enrolled and divided into 5 categories: hBoV in 19 patients (19.8%), hMPV in 18 patients (18.8%), PIV in 16 patients (16.7%), hRV in 20 patients (20.8%), and negative result in 23 patients (24.0%). The mean age of the patients was 8.2±5.9 months (median, 7.5 months; range, 1-24 months), and the male-to-female ratio was 1.1:1. The most common diagnoses were acute bronchiolitis (62.5%) and pneumonia (30.2%). Compared to other patients, those with hBoV were older (12.3±4.9 months, P=0.001) and more frequently diagnosed with acute bronchiolitis (P=0.005). In addition, they showed higher incidences of tachypnea and rales (P=0.039 and P=0.035, respectively), and were more frequently treated with oxygen and systemic steroids (P=0.044 and P=0.001, respectively) than the other patients.

Conclusion

We compared respiratory viruses in children during spring/summer and found that hBoV may have more severe clinical manifestations than other viruses.

Figures and Tables

Fig. 1

Diagnosis of the patients according to causing virus. The most common clinical diagnosis was acute bronchiolitis, and the other diagnoses were pneumonia, bronchitis and croup. hBoV, human bocavirus; hMPV, human metapneumonvirus; PIV, parainfluenza virus; hRV, human rhinovirus.

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Fig. 2

Age (A) and gender (B) of the patients with human bocavirus (hBoV) and the others. The patients with human bocavirus were older than other patients (P=0.001) (A), but there was no gender difference (B).

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Fig. 3

The percentage of the patients with human bocavirus (hBoV) and the other patients according to clinical manifestations. The patients with human bocavirus showed more incidence of tachypnea and rale than other patients (P=0.039, P=0.035).

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Fig. 4

The percentage of the patients with human bocavirus (hBoV) and the other patients according to management. The patients with human bocavirus were more commonly treated with oxygen and systemic steroid than other patients (P=0.044, P=0.001).

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Table 1

Comparison of clinical manifestations according to causing viruses

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Variable hBoV hMPV PIV hRV Negative Total
No. of patients 19 (19.8) 18 (18.8) 16 (16.7) 20 (20.8) 23 (24.0) 96 (100)
Age (mo) 12.3 ± 4.9†§∥ 6.6 ± 6.1 8.8 ± 5.7 7.9 ± 6.1 5.9 ± 5.1 8.2 ± 5.9
Sex
 Male:female 9:10 11:7 11:5 11:9 8:15 50:46
Clinical findings
 Fever (> 38℃) 10 10 10 9 15 54
 Duration of fever prior to admission (day) 1.3 ± 1.4 1.8 ± 1.8 2.1 ± 1.8 1.0 ± 1.6 2.1 ± 2.6 1.7 ± 1.9
 Duration until fever subside (day) 0.6 ± 0.8 0.7 ± 0.9 0.8 ± 1.2 0.8 ± 1.2 1.1 ± 1.1 0.8 ± 1.0
 Duration of cough (day) 5.4 ± 6.4 6.2 ± 3.2*‡ 3.6 ± 2.2 8.4 ± 9.7 7.0 ± 6.7 6.3 ± 6.5
 Tachypnea 9†∥ 2 6 6 4 27
 Grunting 4 1 3 2 1 11
 Stridor 1 1 2 2 3 9
 Rale 15‡§ 12 7 8 14 56
 Wheezing 12 8 7 10 9 46
 Decreased aeration 11 10 8 7 12 48
 Abnormal chest radiography 11 11 12 12 15 61
Treatment
 Oxygen supply 7†‡ 1 1 4 6 19
 Duration of oxygen use (day) 0.9 ± 1.4 0.1 ± 0.5 0.3 ± 0.8 0.7 ± 1.7 1.3 ± 2.5 0.7 ± 1.6
 Systemic steroid 14†‡§∥ 5 5 8 7 39
 Inhaled steroid 11 13 9 13 12 58
 Ventilator use 0 0 0 1 0 1
 ICU care 3 1 2 7 6 19
Admission duration (day) 5.2 ± 1.3 5.3 ± 1.5 4.6 ± 1.4 5.9 ± 2.8 6.3 ± 5.0 5.5 ± 2.9

Values are presented as number (%), mean±standard deviation or number.

hBoV, human bocavirus; hMPV, humanmetapneumonvirus; PIV, parainfluenza virus; hRV, human rhinovirus; ICU, intensive care unit.

*P<0.05, compared with hBoV. P<0.05, compared with hMPV. P<0.05, compared with PIV. §P<0.05, compared with hRV. P<0.05, compared with negative result.

Table 2

Comparison of laboratory findings according to causing viruses

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Variable hBoV hMPV PIV hRV Negative
No. of patients 19 (19.8) 18 (18.8) 16 (16.7) 20 (20.8) 23 (24.0)
O2 saturation (SpO2) (%) 96.3 ± 4.5 92.3 ± 23.1 92.0 ± 24.6 97.9 ± 2.4 78.6 ± 38.3
White blood cell count (/mm3) 12,915 ± 4,765 12,004 ± 3,914 10,459 ± 9,275 12,271 ± 3,588 10,954 ± 4,107
Neutrophil proportion (%) 52.7 ± 19.0†‡ 39.0 ± 16.3 35.6 ± 18.6 43.4 ± 21.5 42.4 ± 14.3
Lymphocyte proportion (%) 31.1 ± 16.2†‡∥ 47.4 ± 15.0 48.7 ± 16.9 42.6 ± 16.8 44.6 ± 12.4
Eosinophil proportion (%) 3.1 ± 2.2†‡§∥ 1.1 ± 1.1 2.0 ± 2.4 1.7 ± 1.5 2.0 ± 1.7
Erythrocyte sedimentation rate (mm/hr) 14.8 ± 9.5 33.9 ± 28.8* 24.8 ± 20.5 18.2 ± 15.9 19.9 ± 14.1
C-reactive protein (mg/dL) 1.2 ± 2.1 1.0 ± 1.4 2.0 ± 2.2 1.0 ± 1.3 1.1 ± 1.3

Values are presented as number (%) or mean±standard deviation

hBoV, human bocavirus; hMPV, humanmetapneumonvirus; PIV, parainfluenza virus; hRV, human rhinovirus.

*P<0.05, compared with hBoV. P<0.05, compared with hMPV. P<0.05, compared with PIV. §P<0.05, compared with hRV. P<0.05, compared with negative result.

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