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Published on: December 10, 2013
Age-Related Effect of Viral-Induced Wheezing in Severe Prematurity
Geovanny F Perez1,2,3,4, Amisha Jain5, Bassem Kurdi6
1Division of Pulmonary and Sleep Medicine, Children's National Medical Center, Washington, DC 20010, USA. gperez@childrensnational.org.
Insights
Severely premature children face higher risks of rhinovirus (RV) and respiratory syncytial virus (RSV) infections and wheezing during their first three years. This heightened susceptibility is specific to these viruses and requires further investigation into underlying mechanisms.
Area of Science:
- Pediatrics
- Infectious Diseases
- Neonatology
Background:
- Premature infants are vulnerable to severe viral respiratory infections.
- The specific age ranges for peak susceptibility and pathogen clearance remain unclear.
Purpose of the Study:
- To analyze the age distribution and clinical features of viral respiratory infections in full-term and premature children.
- To determine the age at which susceptibility to specific viral pathogens peaks and subsides in premature infants.
Main Methods:
- Retrospective analysis of 630 hospitalizations in children aged 0-7 years.
- Categorization of children by gestational age: full-term (>37 weeks), preterm (32-37 weeks), and severely premature (<32 weeks).
- Identification of common viruses, including rhinovirus (RV) and respiratory syncytial virus (RSV).
Main Results:
- Severely premature children (<32 weeks) accounted for 21% of hospitalizations.
- Rhinovirus (RV; 60%) and respiratory syncytial virus (RSV; 17%) were the most frequent viruses.
- Severely premature children showed a higher relative frequency of RV and RSV in the first three years, with increased odds of RV/RSV-induced wheezing.
Conclusions:
- Vulnerability to RV and RSV infections in severely premature children persists through the first three years of life.
- This heightened susceptibility is specific to RV and RSV, distinguishing them from other viral pathogens.
- Further research is needed to understand the age-dependent molecular mechanisms behind RV- and RSV-induced wheezing in premature infants.
Abstract:
Premature children are prone to severe viral respiratory infections in early life, but the age at which susceptibility peaks and disappears for each pathogen is unclear. Methods: A retrospective analysis was performed of the age distribution and clinical features of acute viral respiratory infections in full-term and premature children, aged zero to seven years. Results: The study comprised of a total of 630 hospitalizations (n = 580 children). Sixty-seven percent of these hospitalizations occurred in children born full-term (>37 weeks), 12% in preterm (32-37 weeks) and 21% in severely premature children (<32 weeks). The most common viruses identified were rhinovirus (RV; 60%) and respiratory syncytial virus (RSV; 17%). Age-distribution analysis of each virus identified that severely premature children had a higher relative frequency of RV and RSV in their first three years, relative to preterm or full-term children. Additionally, the probability of RV- or RSV-induced wheezing was higher overall in severely premature children less than three years old. Conclusions: Our results indicate that the vulnerability to viral infections in children born severely premature is more specific for RV and RSV and persists during the first three years of age. Further studies are needed to elucidate the age-dependent molecular mechanisms that underlie why premature infants develop RV- and RSV-induced wheezing in early life.
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