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Severe viral respiratory infections in the pre-COVID era: A 5-year experience in two pediatric intensive care units in Italy.
De Luca, Maia; D'Amore, Carmen; Romani, Lorenza; Tripiciano, Costanza; Clemente, Vitangelo; Mercadante, Stefania; Perrotta, Daniela; Nunziata, Joseph; Cecchetti, Corrado; Rossetti, Emanuele; Bianchi, Roberto; Perno, Carlo Federico; Bernaschi, Paola; Russo, Cristina; Lancella, Laura; Raponi, Massimiliano; Ciofi Degli Atti, Marta Luisa.
  • De Luca M; Academic Department of Pediatrics (DPUO), Infectious Disease Unit, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy.
  • D'Amore C; Clinical Pathways and Epidemiology Unit, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy.
  • Romani L; Academic Department of Pediatrics (DPUO), Infectious Disease Unit, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy.
  • Tripiciano C; Academic Department of Pediatrics, University of Rome Tor Vergata, Rome, Italy.
  • Clemente V; Pediatric Emergency Department, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy.
  • Mercadante S; Academic Department of Pediatrics, University of Rome Tor Vergata, Rome, Italy.
  • Perrotta D; Department of Anesthesia and Critical Care, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy.
  • Nunziata J; Pediatric Emergency Department Pediatric Intensive Care Unit, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy.
  • Cecchetti C; Pediatric Emergency Department Pediatric Intensive Care Unit, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy.
  • Rossetti E; Pediatric Intensive Care Unit, Paediatric Emergency, Anaesthesia and Intensive Care Department, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy.
  • Bianchi R; Pediatric Intensive Care Unit, Paediatric Emergency, Anaesthesia and Intensive Care Department, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy.
  • Perno CF; Microbiology and Diagnostic Immunology Unit, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy.
  • Bernaschi P; Multimodal Medicine Research Area, Bambino Gesù Children's Hospital, Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS), Rome, Italy.
  • Russo C; Microbiology and Diagnostic Immunology Unit, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy.
  • Lancella L; Microbiology and Diagnostic Immunology Unit, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy.
  • Raponi M; Academic Department of Pediatrics (DPUO), Infectious Disease Unit, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy.
  • Ciofi Degli Atti ML; Medical Direction, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy.
Influenza Other Respir Viruses ; 2022 Oct 03.
Article in English | MEDLINE | ID: covidwho-2229358
ABSTRACT

BACKGROUND:

Viral respiratory infections are one of the main causes of hospitalization in children. Even if mortality rate is low, 2% to 3% of the hospitalized children need mechanical ventilation. Risk factors for admission to the pediatric intensive care unit (PICU) are well known, while few studies have described risk factors for invasive ventilator support and prolonged hospitalization.

METHODS:

A retrospective study including all patients aged between 2 and 18 months with a confirmed viral respiratory infection, requiring admission to PICU from September to March between 2015 and 2019, was conducted at Bambino Gesù Children's Hospital in Rome, Italy.

RESULTS:

One hundred ninety patients were enrolled, with a median age of 2.7 months; 32.1% had at least one comorbidity, mainly prematurity. The most frequent isolated viruses were RSV-B, rhinovirus, and RSV-A; 38.4% needed mechanical ventilation. This subgroup of patients had lower median birth weight compared with patients not requiring mechanical ventilation (2800 g vs. 3180 g, p = 0.02); moreover, comorbidities were present in 43.8% of intubated patients and in 24.8% of patients treated with non-invasive ventilation (p = 0.006). Viral coinfection did not result to be a risk factor for mechanical support, while virus-bacteria coinfection was significantly associated with mechanical ventilation (p < 0.001). Similar risk factors were identified for prolonged hospitalization.

CONCLUSIONS:

Early identification of patients who could have a sudden respiratory deterioration and need of mechanical ventilation is crucial to reduce complications due to orotracheal intubation and prolonged hospitalization in PICU. Further studies are needed to define high-risk group of patients and to design targeted interventions.
Keywords

Full text: Available Collection: International databases Database: MEDLINE Type of study: Observational study / Prognostic study Language: English Journal subject: Virology Year: 2022 Document Type: Article Affiliation country: Irv.13038

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Full text: Available Collection: International databases Database: MEDLINE Type of study: Observational study / Prognostic study Language: English Journal subject: Virology Year: 2022 Document Type: Article Affiliation country: Irv.13038