DISTRIBUTION OF RESPIRATORY VIRUSES IN CHILDREN ADMITTED TO PEDIATRIC INTENSIVE CARE UNIT.

Abstract

Acute lower respiratory tract infection (LRTI) is common in children and associated with high morbidity and mortality. The aim of this study was to determine the distribution of respiratory viruses leading to admission of a child with the diagnosis of LRTI to pediatric intensive care unit (PICU). The distribution of viral pathogens was determined using viral multiplex polymerase chain reaction (PCR) in children with LRTI admitted to PICU at a tertiary-level reference pediatric hospital. The LRTI patients without a positive viral multiplex PCR finding were excluded from the study. Most patients were under 2 years of age (78.3%), and the most common viral pathogen resulting in PICU admission due to viral LRTI was RSV A/B (32.8%). Thirty three patients had an underlying disease. Ten (16.6%) patients required invasive mechanical ventilation (IMV), 37 (61.6%) required high-flow oxygen therapy (HFOT), and two patients (3.3%) progressed to pediatric acute respiratory distress syndrome (PARDS). Underlying chronic disease presence was the highest in the IMV group with 90%, which decreased to 54% and 30.7% in the HFOT and standard oxygen treatment groups, respectively (p=0.018). The patients with IMV requirements had significantly longer hospital stay (median 8 days, range 6-13 days) compared to HFOT group (median 6 days, range 4-7.5 days] and regular oxygen treatment group (median 3 days, range 2-3.5 days) (p<0.001). The use of multiplex PCR for respiratory viruses may help in discriminating etiologic viral agents in patients admitted to PICU and estimating possible complications associated with viral-specific disease. The presence of an underlying disease in a patient with viral LRTI affects the treatment level, and treatment level affects the duration of PICU stay.