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病毒检测与怀疑社区感染肺炎的儿童的严重疾病有关
Sriram Ramgopal1, Jillian M Cotter2, Nidhya Navanandan3
1From the Division of Emergency Medicine, Ann & Robert H. Lurie Children's Hospital of Chicago, Northwestern University Feinberg School of Medicine, Chicago, IL.
Pediatric emergency care
|June 12, 2023
概括
怀疑患有社区获得性肺炎 (CAP) 的儿童中病毒检测与疾病严重程度的增加有关,特别是呼吸道同胞性病毒 (RSV) 和人类鼻病毒. 病毒检测可以帮助对下呼吸道感染的风险分层.
科学领域:
- 儿童传染病 儿童传染病
- 呼吸系统医学 呼吸系统医学
- 临床病毒学 临床病毒学
背景情况:
- 社区获得性肺炎 (CAP) 是儿童急诊室访问的常见原因之一.
- 在CAP中识别致病原体可以为临床管理和预后提供信息.
- 病毒感染是儿童下呼吸道感染的常见原因.
研究的目的:
- 调查病毒检测和疑似CAP儿童的疾病严重程度之间的关联.
- 为了确定特定的病毒是否与更严重的临床结果相关.
- 评估病毒检测在患有下呼吸道感染的风险分层儿科患者中的有用性.
主要方法:
- 未来的,单一中心的研究,儿童出现在一个儿科急诊室怀疑CAP.
- 在鼻样本上进行的病毒检测.
- 使用四层临床结果衡量标准评估疾病严重程度.
- 多变量模型根据年龄,生物标志物 (前素,C反应蛋白),放射性发现和临床症状进行调整.
主要成果:
- 在60%的入学儿童中检测到病毒.
- 病毒感染与疾病严重程度的增加有关,特别是RSV (aOR 2.50) 和人类犀利病毒 (aOR 2.18).
- 在没有放射性肺炎的患者中,这种关联是显著的,但在放射性肺炎患者中没有.
结论:
- 鼻病毒检测与疑似CAP儿童的更严重疾病有关,即使在调整混因素后也是如此.
- 病毒检测可能成为儿童下呼吸道感染风险分层的一个有价值的工具.
- 进一步的研究可以探索特定病毒病因在CAP管理中的临床影响.
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