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Viral etiology of life-threatening pediatric pneumonia: A matched case-control study
Jianxing Yu1, Suyun Qian2, Chunyan Liu2
1National Health Commission Key Laboratory of Systems Biology of Pathogens and Christophe Merieux Laboratory, Institute of Pathogen Biology, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China.
Insights
Influenza A virus (IFV-A) significantly increases the risk of life-threatening pediatric pneumonia. Preventing IFV-A infection is crucial for reducing severe outcomes in children with pneumonia.
Area of Science:
- Pediatric Infectious Diseases
- Respiratory Virology
- Critical Care Medicine
Background:
- Pediatric pneumonia poses a significant global health burden.
- Viral etiologies and their association with severe outcomes in pediatric pneumonia require further elucidation.
- Understanding risk factors is essential for developing targeted prevention and treatment strategies.
Purpose of the Study:
- To investigate the association between specific viral infections and the development of life-threatening pediatric pneumonia.
- To identify viral risk factors contributing to severe outcomes in pediatric pneumonia cases.
- To inform public health interventions for preventing severe pediatric pneumonia.
Main Methods:
- A matched case-control study was conducted in Beijing, China (2007-2015).
- Intensive care unit (ICU) patients with life-threatening pneumonia (cases, n=334) were matched with pneumonia patients (controls, n=522).
- Nasopharyngeal aspirates were analyzed using PCR for 18 common respiratory viruses.
Main Results:
- No significant difference in the prevalence of 17 respiratory viruses was found between cases and controls.
- Influenza A virus (IFV-A) was detected more frequently in cases (7%) than controls (4%), P=.036.
- IFV-A was independently associated with life-threatening pneumonia (aOR=2.55), with young age and congenital heart disease also identified as risk factors.
Conclusions:
- Influenza A virus (IFV-A) is a significant risk factor for severe pediatric pneumonia.
- Preventing IFV-A infection is critical for reducing the incidence of life-threatening pneumonia in children.
- Early identification and management of risk factors like congenital heart disease are important in pediatric pneumonia care.
Background:
Pediatric pneumonia remains a significant health challenge, while the viral risk factors for adverse outcomes in pediatric pneumonia are not yet fully clear.
Methods:
A matched case-control study of pediatric patients with pneumonia was carried out in Beijing, China, between 2007 and 2015. The study enrolled 334 intensive care unit patients who developed life-threatening diseases and 522 controls matched to the sex, age, ethnicity, admission dates, and residing district of the cases suffered from pneumonia. Nasopharyngeal aspirates were taken from all participants and tested by PCR for 18 common respiratory viruses.
Results:
At least, one virus was detected in 257 (77%) of the cases and 409 (78%) of the controls. We observed no difference in the prevalence of 17 respiratory viruses between cases and controls but found a higher frequency of influenza A virus (IFV-A) in the cases than in the controls (7% vs 4%, P = .036). After adjusting for comorbid conditions and a history of reactive airway diseases, IFV-A was associated with an increase in life-threatening pneumonia (adjusted odds ratio = 2.55, 95% CI = 1.24-5.24). Young age and congenital heart disease (aOR = 10.16-10.27, P < .001) were also independent risk factors.
Conclusions:
The prevention of IFV infection is critical in decreasing the risk of life-threatening pneumonia in children.
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