PURPOSE: The aim of this study was to evaluate the severity of
disease in
children with acute
bronchiolitis according to the type of infected
virus .
METHODS: From November 2007 to May 2015, 768
patients under 2 years of age
who underwent real
time -
polymerase chain reaction of nasopharyngeal aspirates admitted to the Department of
Pediatrics of Dongguk
University Ilsan
Hospital for acute
bronchiolitis were enrolled. Severe
bronchiolitis was defined as presence of one or more kinds among
tachypnea ,
chest retraction,
needs of O2
inhalation or
ventilator care.
RESULTS: The severity of
bronchiolitis was increased with shorter
fever duration (P < 0.001) and previous
wheezing episodes (P = 0.005). In the case of single
infection ,
respiratory syncytial virus (RSV) A only increased the severity of acute
bronchiolitis (P = 0.012). However, the
severity of illness decreased when RSV A coinfected with
adenovirus (P = 0.034),
human rhinovirus (P = 0.038), or
human coronavirus NL63 (P = 0.042). On the other
hand , when
human rhinovirus was coinfected with
enterovirus (P = 0.013) or
parainfluenza 3 (P = 0.019), the severity was increased. When
human metapneumovirus coinfected with
human bocavirus , the severity was increased (P = 0.038).
CONCLUSION: Acute
bronchiolitis was associated with increased severity only when RSV A infected solely, but several
viruses increased or decreased the severity when
coinfection occurred. Therefore, it may be helpful in predicting the
course of the acute
bronchiolitis according to the affected
virus .