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Prematurity, a significant predictor for worse outcome in viral bronchiolitis: a comparative study in infancy
Noussa R El Basha1, Huda Marzouk1, May M Sherif2
11Department of Pediatrics, Faculty of Medicine, Cairo University, 2 Atteia Abd El Hadi St., El Maadi, Cairo, 11562 Egypt.
Insights
Premature infants with bronchiolitis experience more severe illness and require more intensive care than term infants. Early identification of preterm infants as high-risk is crucial for managing this common respiratory infection.
Area of Science:
- Pediatrics
- Infectious Diseases
- Neonatology
Background:
- Hospital admissions for bronchiolitis have increased, potentially due to improved survival rates of preterm infants.
- Bronchiolitis is a common respiratory infection in infants, particularly during the first year of life.
Purpose of the Study:
- To compare the severity of viral bronchiolitis in preterm versus term infants admitted to a tertiary hospital.
- To assess clinical outcomes including hospital stay, oxygen therapy, and intensive care unit (ICU) admission.
Main Methods:
- Prospective study of 153 infants (74 preterm, 79 term) diagnosed with bronchiolitis.
- Bronchiolitis Severity Score (BSS) recorded; nasopharyngeal swabs analyzed via RT-PCR for viral identification.
- Clinical course, outcomes, and bacterial co-infections were documented.
Main Results:
- Preterm infants exhibited significantly higher BSS and longer hospital stays compared to term infants.
- Preterm infants required more oxygen therapy, ICU admission, and mechanical ventilation (MV).
- Human metapneumovirus (hMPV), RSV, and parainfluenza-3 infections were more severe in preterm infants; bacterial co-infection correlated with severity.
Conclusions:
- Prematurity is a significant factor influencing bronchiolitis severity.
- Preterm infants with bronchiolitis represent a high-risk group requiring early categorization.
- Physicians must recognize the more severe course of illness in preterm infants, even without underlying disorders.
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 to term infants admitted at a tertiary hospital in Cairo, Egypt, based on the outcome.
Patients 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 polymerase chain reaction (RT-PCR). The clinical course and patient's outcome were recorded.
Results:
This study recorded a significantly more severe BSS for preterm compared to term infants. The preterm group had an increased mean length of hospital stay and oxygen therapy and was more likely to need intensive care unit admission and mechanical ventilation (MV) compared to the term group. The mean (± SD) BSS for infections with h-MPV, RSV, and para-influenza 3 was more significantly severe in preterm compared to 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 as a high-risk group on their first visit. The physician should be aware that their illness runs a more severe course, even if they have no underlying disorders.
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