Prematurity is a significant predictor of worse outcomes in viral bronchiolitis: A comparative study in infancy
Noussa El Basha1, Huda Marzouk1, May Sherif2
1Department of Pediatrics, Faculty of Medicine, Cairo University, Cairo, Egypt.
Insights
Premature infants experience more severe bronchiolitis, requiring longer hospital stays and increased medical interventions. This highlights the need to identify high-risk preterm infants early for better management of viral bronchiolitis.
Area of Science:
- Pediatrics
- Infectious Diseases
- Neonatology
Background:
- Hospital admissions for bronchiolitis are rising, potentially due to increased survival rates of preterm infants.
- Bronchiolitis is a common respiratory infection in infants, particularly those born prematurely.
Purpose of the Study:
- To compare the severity of viral bronchiolitis in preterm versus term infants.
- To assess outcomes of bronchiolitis in a tertiary hospital in Cairo, Egypt.
Main Methods:
- Prospective study of 153 infants (74 preterm, 79 term) diagnosed with bronchiolitis.
- Utilized Bronchiolitis Severity Score (BSS) and nasopharyngeal swabs for viral identification via RT-PCR.
- Monitored clinical course, length of stay, oxygen therapy, ICU admission, and mechanical ventilation.
Main Results:
- Preterm infants exhibited significantly higher BSS compared to term infants.
- Preterm infants had longer hospital stays, increased oxygen use, and higher rates of ICU admission and mechanical ventilation.
- Human metapneumovirus, RSV, and parainfluenza 3 infections were more severe in preterm infants; bacterial co-infection correlated with severity in both groups.
Conclusions:
- Prematurity is a significant factor in bronchiolitis severity, necessitating early identification of preterm infants as high-risk.
- Physicians should recognize that preterm infants face a more severe course of bronchiolitis, even without other underlying conditions.
Background:
The rate of admissions to hospital with bronchiolitis has increased over the past years. The reasons for this are likely to be multifactorial including improved survival of preterm infants.
Aim:
To assess the severity of viral bronchiolitis in preterm compared with term infants admitted at a tertiary hospital in Cairo, Egypt, based on the outcome.
Materials And Methods:
This prospective study was conducted throughout a 3-year period from September 2011 to October 2014. It included 153 infants, 74 healthy preterm and 79 healthy term infants, admitted with clinical diagnosis of bronchiolitis at a tertiary hospital in Cairo, Egypt. Bronchiolitis severity score (BSS) was recorded, and nasopharyngeal swabs were obtained from each patient at the time of presentation. Viruses were identified using reverse transcription PCR. The clinical course and patient's outcome were recorded.
Results:
This study recorded a significantly more severe BSS for preterm compared with term infants. The preterm group had an increased mean length of hospital stay and oxygen therapy and were more likely to need ICU admission and mechanical ventilation compared with the term group. The mean ±SD BSS for infections with human metapneumovirus, respiratory syncytial virus, parainfluenza 3 was more significantly severe in preterm compared with term infants. Bacterial co-infection was significantly correlated with severity scoring in both groups.
Conclusion:
Prematurity significantly affects the severity of bronchiolitis, and this underscores the importance of early categorization of these infants as a high-risk group on their first visit. Physician should be aware that their illness runs a more severe course, even if they have no underlying disorders.
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