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Published on: June 28, 2018
Paramyxovirus Infection: Mortality and Morbidity in a Pediatric Intensive Care Unit
Alice S W Tong1, Kam Lun Hon2, Yin Ching K Tsang3
1Department of Paediatrics, Tseung Kwan O Hospital, Tseung Kwan O, Hong Kong.
Objectives:
We investigated mortality and morbidity of patients admitted to a pediatric intensive care unit (PICU) with paramyxovirus infection.
Methods:
A retrospective study between October 2002 and March 2015 of children with a laboratory-confirmed paramyxovirus infection was included.
Results:
In all, 98 (5%) PICU admissions were tested positive to have paramyxovirus infection (respiratory syncytial virus = 66, parainfluenza = 27 and metapneumovirus = 5). The majority of admissions were young patients (median age 1.05 years). Bacteremia and bacterial isolation in any site were present in 10% and 28%, respectively; 41% were mechanically ventilated, and 20% received inotropes. The three respiratory viruses caused similar mortality and morbidity in the PICU. Fatality (seven patients) was associated with malignancy, positive bacterial culture in blood, the use of mechanical ventilation, inotrope use, lower blood white cell count and higher C reactive protein (p = 0.02-0.0005). Backward binary logistic regression for these variables showed bacteremia (odds ratio [OR]: 31.7; 95% CI: 2.3-427.8; p = 0.009), malignancy (OR: 45.5; 95% CI: 1.4-1467.7; p = 0.031) and use of inotropes (OR: 15.0; 95% CI: 1.1-196.1; p = 0.039) were independently associated with non-survival. March and July appeared to be the two peak months for PICU hospitalizations with paramyxovirus infection.
Conclusions:
Infections with paramyxoviruses account for 5% of PICU admissions and significant morbidity. Patient with premorbid history of malignancy and co-morbidity of bacteremia are associated with non-survival. March and July appeared to be the two peak months for PICU admissions with paramyxoviruses.
Insights
Paramyxovirus infections cause 5% of pediatric intensive care unit admissions, leading to significant illness. Factors like malignancy and bacteremia increase mortality risk in these young patients.
Area of Science:
- Pediatric Intensive Care Medicine
- Virology
- Infectious Diseases
Background:
- Paramyxovirus infections represent a notable cause of pediatric intensive care unit (PICU) admissions.
- Understanding the mortality and morbidity associated with these infections is crucial for patient management.
Purpose of the Study:
- To investigate the mortality and morbidity outcomes for patients admitted to the PICU with confirmed paramyxovirus infections.
- To identify risk factors associated with non-survival in pediatric patients with paramyxovirus infections.
Main Methods:
- A retrospective study was conducted from October 2002 to March 2015.
- Data from children with laboratory-confirmed paramyxovirus infections admitted to the PICU were analyzed.
Main Results:
- Paramyxovirus infections accounted for 5% of PICU admissions, with respiratory syncytial virus being the most common.
- Bacteremia, malignancy, and the use of inotropes were independently associated with increased mortality.
- Peak months for PICU admissions due to paramyxovirus infections were identified as March and July.
Conclusions:
- Paramyxovirus infections contribute significantly to PICU admissions and associated morbidity.
- Pre-existing conditions such as malignancy and co-infections like bacteremia are critical indicators for non-survival.
- Seasonal patterns indicate peak hospitalization months in March and July, aiding in resource planning.
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