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Duration of clinical symptoms in children with acute respiratory infection
Niko Paalanne1,2, Minna Honkila1,2, Suvi Mattila1,2
1Department of Pediatrics and Adolescent Medicine, Oulu University Hospital, Oulu, Finland.
Insights
Persistent respiratory symptoms are common in children after viral infections. Co-detection of viral and bacterial pathogens may prolong illness duration, particularly fever.
Area of Science:
- Pediatric Infectious Diseases
- Respiratory Virology
- Microbiome Research
Background:
- Respiratory viral infections are a leading cause of acute illness in children.
- Understanding the duration of symptoms and factors influencing prolonged illness is crucial for clinical management.
- Co-infections with bacterial pathogens may impact clinical outcomes.
Purpose of the Study:
- To determine the duration of clinical symptoms associated with various respiratory viruses in children.
- To investigate the impact of co-detection of respiratory viral and bacterial pathogens on symptom duration.
Main Methods:
- Prospective cohort study of 737 acutely ill children.
- Multiplex PCR analysis of nasal swabs for 16 viral and 7 bacterial pathogens.
- Parental questionnaires recorded symptoms at presentation and 14 days post-illness.
Main Results:
- 32% of children with coronavirus, 31% with human metapneumovirus, and 25% with rhinovirus reported persistent symptoms at 14 days.
- 3-4% of children experienced symptoms lasting over 4 weeks.
- Viral and bacterial co-detection was associated with a longer duration of fever (3.3 days) compared to viral detection alone (1.6 days).
Conclusions:
- Symptom persistence beyond 2-4 weeks is common in pediatric respiratory viral infections.
- Co-detection of viral and bacterial pathogens may prolong illness duration in children.
Aim:
To investigate duration of clinical symptoms associated with various respiratory viruses and with the co-detection of respiratory viral and bacterial pathogens.
Methods:
This prospective cohort study included 737 acutely ill children treated in a paediatric emergency department prior to the COVID-19 pandemic. Nasal swab samples were analysed with multiplex PCR panels for 16 viral and 7 bacterial respiratory pathogens. Parents filled in a questionnaire about the symptoms at the time of the visit and 14 days afterwards.
Results:
Persistent symptoms 2 weeks after the onset of acute illness were common: 32% of the patients with a coronavirus 229 E, NL63 or OC43 finding, 31% of those with human metapneumovirus and 25% of those with rhinovirus reported ongoing symptoms. At least one symptom lasting more than 4 weeks was observed in 3-4% of the children. Children with viral and bacterial co-detection had a longer duration of fever than those with only viral detection (3.3 days [SD 2.8] vs. 1.6 days [SD 2.4], p < 0.001).
Conclusion:
Symptoms lasting for more than 2 to 4 weeks appear to be relatively frequent in all respiratory viral infections in children. Viral and bacterial co-detection may increase the duration of illness.
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