Acute viral respiratory tract infections and wheezing at follow-up in children < 3 years

Abstract

Background: Acute viral respiratory tract infections (ARTIs) are the most frequent diseases in children.

Aim: To analyze risk factors for ARTIs, to evaluate clinical differences among children with different viral respiratory infection and to study virological risk factors for recurrent wheezing at 3 years follow-up.

Methods: We studied 273 children (median age 2.9 months, 167M) hospitalized at the Paediatric Emergency Department, “Sapienza” University of Rome (Oct 2009-May 2014) with ARTIs (148 had RSV infection, 67 hRV, 13 hMPV, 10 hBoV, 29 co-infections and 6 other viruses) and 101 control children. We performed a follow-up after 3 years.

Results: Risk factors for ARTIs were the presence of siblings (p<0.001), parent's asthma (p=0.008) and smoking cohabitants (p=0.002). RSV was the main cause of bronchiolitis (118) followed by wheezing bronchitis (23), pneumonia (5), URTIs (2). HRV caused 29 bronchiolitis, 22 wheezing bronchitis, 11 pneumonia, 5 URTIs. HBoV caused 3 bronchiolitis, 5 wheezing bronchitis, 1 pneumonia and URTIs. HMPV caused 8 bronchiolitis, 3 URTIs, 1 pneumonia and wheezing bronchitis. No differences were found according to the virus etiology in clinical severity score and other clinical symptoms. 77.6% of eligible families answered to the follow-up interview. RSV infants had wheezing more frequently than hRV infants (p=0.04).

Conclusions: Environmental and genetic factors contribute to ARTIs. Clinical entities depend on viral etiology. RSV is the virus. RSV infants had more often long lasting sequelae.