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Prevalence of respiratory viruses using polymerase chain reaction in children with wheezing, a systematic review and

Cyprien Kengne-Nde¹, Sebastien Kenmoe², Abdou Fatawou Modiyinji^2,3

¹National AIDS Control Committee, Epidemiological Surveillance, Evaluation and Research Unit, Yaounde, Cameroon.

|December 14, 2020

Insights

Rhinovirus and respiratory syncytial virus are the most common causes of wheezing in children. This systematic review clarifies the prevalence of various respiratory viruses in pediatric wheezing cases.

Area of Science:

Pediatrics
Virology
Public Health

Background:

Wheezing is a common pediatric respiratory issue, often linked to viral infections.
Molecular detection methods have improved identification of respiratory viruses in children with wheezing.
The precise association between specific viruses and pediatric wheezing requires further clarification.

Purpose of the Study:

To systematically review and clarify the prevalence of different respiratory viruses in children experiencing wheezing.
To assess the role of common respiratory viruses in the etiology of pediatric wheezing.

Main Methods:

Systematic review of studies published up to July 2019, including electronic and manual searches.
Inclusion of studies detecting common respiratory viruses in children (≤18 years) with wheezing using polymerase chain reaction (PCR) assays.
Statistical analyses including sensitivity, subgroup, publication bias, and heterogeneity analyses using a random effects model.

Main Results:

The review included 33 studies.
Rhinovirus (35.6%) and respiratory syncytial virus (31.0%) were the most prevalent viruses detected in children with wheezing.
Other detected viruses included human bocavirus (8.1%), adenovirus (7.7%), influenza virus (6.5%), human metapneumovirus (5.8%), enterovirus (4.3%), human parainfluenza virus (3.8%), and human coronavirus (2.2%).

Conclusions:

Rhinovirus and respiratory syncytial virus are strongly suggested to contribute to the causes of wheezing in children.
This systematic review provides insight into the potential role of various respiratory viruses in pediatric wheezing.
Further research is warranted to understand the clinical implications of molecular detection of respiratory viruses in wheezing children.

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Abstract

Introduction:

Wheezing is a major problem in children, and respiratory viruses are often believed to be the causative agent. While molecular detection tools enable identification of respiratory viruses in wheezing children, it remains unclear if and how these viruses are associated with wheezing. The objective of this systematic review is to clarify the prevalence of different respiratory viruses in children with wheezing.

Methods:

We performed an electronic in Pubmed and Global Index Medicus on 01 July 2019 and manual search. We performed search of studies that have detected common respiratory viruses in children ≤18 years with wheezing. We included only studies using polymerase chain reaction (PCR) assays. Study data were extracted and the quality of articles assessed. We conducted sensitivity, subgroup, publication bias, and heterogeneity analyses using a random effects model.

Results:

The systematic review included 33 studies. Rhinovirus, with a prevalence of 35.6% (95% CI 24.6-47.3, I2 98.4%), and respiratory syncytial virus, at 31.0% (95% CI 19.9-43.3, I2 96.4%), were the most common viruses detected. The prevalence of other respiratory viruses was as follows: human bocavirus 8.1% (95% CI 5.3-11.3, I2 84.6%), human adenovirus 7.7% (95% CI 2.6-15.0, I2 91.0%), influenza virus6.5% (95% CI 2.2-12.6, I2 92.4%), human metapneumovirus5.8% (95% CI 3.4-8.8, I2 89.0%), enterovirus 4.3% (95% CI 0.1-12.9, I2 96.2%), human parainfluenza virus 3.8% (95% CI 1.5-6.9, I2 79.1%), and human coronavirus 2.2% (95% CI 0.6-4.4, I2 79.4%).

Conclusions:

Our results suggest that rhinovirus and respiratory syncytial virus may contribute to the etiology of wheezing in children. While the clinical implications of molecular detection of respiratory viruses remains an interesting question, this study helps to illuminate the potential of role respiratory viruses in pediatric wheezing.

Review Registration:

PROSPERO, CRD42018115128.

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