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Parechovirus infection in infants: Evidence-based parental counselling for paediatricians
Robyn A Silcock1, Rebecca Doyle2, Julia E Clark1
1Infectious Diseases, Queensland Children's Hospital, Brisbane, Queensland, Australia.
Insights
Most infants hospitalized with Human parechovirus (HPeV) infection show normal development by age three. However, early concerns, particularly in communication, may persist, warranting further investigation into long-term neurological impacts.
Area of Science:
- Pediatric Neurology
- Infectious Diseases
- Developmental Pediatrics
Background:
- Human parechovirus (HPeV) is a growing cause of severe infant illness, including central nervous system infections.
- Long-term neurodevelopmental outcomes following HPeV infection in infants are not well understood.
- Understanding these outcomes is crucial for clinical guidance and parental counseling.
Purpose of the Study:
- To assess the neurodevelopmental outcomes of children in their second and third years of life after being hospitalized with HPeV as infants.
- To identify factors associated with developmental delays in this cohort.
- To inform clinical management and follow-up strategies for HPeV-infected infants.
Main Methods:
- A prospective cohort study was conducted with infants hospitalized during a 2017/2018 HPeV outbreak.
- The Ages and Stages Questionnaire (ASQ) was used serially to evaluate development at two and three years of age.
- Clinical follow-up, audiology, and neuroradiology data were integrated into the analysis.
Main Results:
- In their second year, 63% of children exhibited developmental concerns, which decreased to 30% by the third year.
- Prematurity and history of apneas were linked to developmental concerns at 27-36 months.
- Communication was the most frequently affected developmental domain.
Conclusions:
- The majority of infants hospitalized with HPeV demonstrate normalized development by 27-36 months of age.
- Further research is needed to explore potential subtle neurological impairments in later childhood.
- These findings aid clinicians in counseling parents and planning follow-up care.
Aim:
Human parechovirus (HPeV) is an increasingly recognised cause of severe illness and central nervous system infection in infants. Medium- to long-term neurodevelopmental outcomes post-HPeV infection remain unknown. This study aims to assess neurodevelopmental outcomes for children hospitalised as infants with HPeV infection in their second and third years of life.
Methods:
This prospective cohort study followed children hospitalised with HPeV in Brisbane, Queensland during the 2017/2018 outbreak. Serial application of Ages and Stages Questionnaire (ASQ) was used to assess developmental progress in the second and third years of life. Data from clinical follow-up, audiology and neuroradiology were included.
Results:
In the second year of life, 63% (n = 29) of children showed some or significant concerns for developmental delay. This had largely been ameliorated by the third year of life when only 30% (n = 14) reported developmental concerns. Prematurity and apnoeas were associated with developmental concerns at 27-36 months of age. Communication was the most common domain of concern.
Conclusions:
The majority of infants hospitalised with HPeV infection in 2017-2018 showed normalisation of developmental progress by 27-36 months of age. Further investigation into more subtle neurological impairments in later childhood is required. These results can help guide clinicians in counselling parents during the acute illness and in planning appropriate follow-up.
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