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The importance of viral load in the severity of acute bronchiolitis in hospitalized infants

OBJECTIVE: The relationship between viral load and the clinical evolution of bronchiolitis is controversial. Therefore, we aimed to analyze viral loads in infants hospitalized for bronchiolitis. METHODS: We tested for the presence of human respiratory syncytial virus (HRSV) or human rhinovirus (HRV)...

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Autores principales: De Paulis, Milena, Oliveira, Danielle Bruna Leal, Thomazelli, Luciano Matsumiya, Ferraro, Alexandre Archanjo, Durigon, Edison Luiz, Vieira, Sandra E.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Faculdade de Medicina / USP 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8610217/
https://www.ncbi.nlm.nih.gov/pubmed/34878030
http://dx.doi.org/10.6061/clinics/2021/e3192
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author De Paulis, Milena
Oliveira, Danielle Bruna Leal
Thomazelli, Luciano Matsumiya
Ferraro, Alexandre Archanjo
Durigon, Edison Luiz
Vieira, Sandra E.
author_facet De Paulis, Milena
Oliveira, Danielle Bruna Leal
Thomazelli, Luciano Matsumiya
Ferraro, Alexandre Archanjo
Durigon, Edison Luiz
Vieira, Sandra E.
author_sort De Paulis, Milena
collection PubMed
description OBJECTIVE: The relationship between viral load and the clinical evolution of bronchiolitis is controversial. Therefore, we aimed to analyze viral loads in infants hospitalized for bronchiolitis. METHODS: We tested for the presence of human respiratory syncytial virus (HRSV) or human rhinovirus (HRV) using quantitative molecular tests of nasopharyngeal secretions and recorded severity outcomes. RESULTS: We included 70 infants [49 (70%) HRSV, 9 (13%) HRV and 12 (17%) HRSV+HRV]. There were no differences among the groups according to the outcomes analyzed individually. Clinical scores showed greater severity in the isolated HRSV infection group. A higher isolated HRSV viral load was associated with more prolonged ventilatory support, oxygen therapy, and hospitalization days, even after adjustment for the age and period of nasopharyngeal secretion collection. In the co-infection groups, there was a longer duration of oxygen therapy when the HRSV viral load was predominant. Isolated HRV infection and co-infection with a predominance of HRV were not associated with severity. CONCLUSION: Higher HRSV viral load in isolated infections and the predominance of HRSV in co-infections, independent of viral load, were associated with greater severity. These results contribute to the development of therapeutic and prophylactic approaches and a greater understanding of the pathophysiology of bronchiolitis.
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spelling pubmed-86102172021-11-26 The importance of viral load in the severity of acute bronchiolitis in hospitalized infants De Paulis, Milena Oliveira, Danielle Bruna Leal Thomazelli, Luciano Matsumiya Ferraro, Alexandre Archanjo Durigon, Edison Luiz Vieira, Sandra E. Clinics (Sao Paulo) Original Article OBJECTIVE: The relationship between viral load and the clinical evolution of bronchiolitis is controversial. Therefore, we aimed to analyze viral loads in infants hospitalized for bronchiolitis. METHODS: We tested for the presence of human respiratory syncytial virus (HRSV) or human rhinovirus (HRV) using quantitative molecular tests of nasopharyngeal secretions and recorded severity outcomes. RESULTS: We included 70 infants [49 (70%) HRSV, 9 (13%) HRV and 12 (17%) HRSV+HRV]. There were no differences among the groups according to the outcomes analyzed individually. Clinical scores showed greater severity in the isolated HRSV infection group. A higher isolated HRSV viral load was associated with more prolonged ventilatory support, oxygen therapy, and hospitalization days, even after adjustment for the age and period of nasopharyngeal secretion collection. In the co-infection groups, there was a longer duration of oxygen therapy when the HRSV viral load was predominant. Isolated HRV infection and co-infection with a predominance of HRV were not associated with severity. CONCLUSION: Higher HRSV viral load in isolated infections and the predominance of HRSV in co-infections, independent of viral load, were associated with greater severity. These results contribute to the development of therapeutic and prophylactic approaches and a greater understanding of the pathophysiology of bronchiolitis. Faculdade de Medicina / USP 2021-11-23 2021 /pmc/articles/PMC8610217/ /pubmed/34878030 http://dx.doi.org/10.6061/clinics/2021/e3192 Text en Copyright © 2021 CLINICS https://creativecommons.org/licenses/by/4.0/This is an Open Access article distributed under the terms of the Creative Commons License (http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) ) which permits unrestricted use, distribution, and reproduction in any medium or format, provided the original work is properly cited.
spellingShingle Original Article
De Paulis, Milena
Oliveira, Danielle Bruna Leal
Thomazelli, Luciano Matsumiya
Ferraro, Alexandre Archanjo
Durigon, Edison Luiz
Vieira, Sandra E.
The importance of viral load in the severity of acute bronchiolitis in hospitalized infants
title The importance of viral load in the severity of acute bronchiolitis in hospitalized infants
title_full The importance of viral load in the severity of acute bronchiolitis in hospitalized infants
title_fullStr The importance of viral load in the severity of acute bronchiolitis in hospitalized infants
title_full_unstemmed The importance of viral load in the severity of acute bronchiolitis in hospitalized infants
title_short The importance of viral load in the severity of acute bronchiolitis in hospitalized infants
title_sort importance of viral load in the severity of acute bronchiolitis in hospitalized infants
topic Original Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8610217/
https://www.ncbi.nlm.nih.gov/pubmed/34878030
http://dx.doi.org/10.6061/clinics/2021/e3192
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