Methods: Prospective, cross sectional study of patients admitted for ALRI at “R.Gutiérrez” Children Hospital, 2000-2014. Virological diagnosis of respiratory virus: RSV, adenovirus (AV), influenza (IF) and parainfluenza (PIV) was made by fluorescent antibody assay of nasopharyngeal aspirates or real time-PCR (IF).
Results: from a total of 13.309 patients included, 38.6%(5118) had positive samples; RSV was predominant all through the study period 81% (4146/5118) without significant annual variations (71-88). It shows a seasonal epidemic pattern (median of epidemiological weeks of viral activity onset and offset:19-35) and agrees with the lowest average temperature months. RSV was followed by IF: 7.4%, PIF:6% and AV:4.5%.
From 5118 RSV cases the median of age was 7 months (0-216 months), 74%<1 year, 43%<6 months, 20%<3 months; 56.5% males; most frequent clinical feature was bronchiolitis 60.6%; 27% recorded previous admissions for respiratory causes. Comorbidity was found in 41.5% (1717/4146) being the most frequents: recurrent obstructive bronchitis (74%) and congenital heart disease (14%). Complications were detected in 25% of cases, 6.5% had nosocomial infections. Lethality was 1.9 %(78/4108).
From 78 RSV fatal cases the median of age of was 5 months (0-180 months), 27%<3months; most frequent clinical feature was pneumonia 53%. Comorbidity was found in 65.4% (51/78) being the most frequents: recurrent obstructive bronchitis 50.9% (26/51) and congenital heart disease 33%(17/51).Moderate to severe malnourishment OR 2.28 (1.19-4.36) p<0.01, congenital cardiopathy 3.53 (1.95-6.39) p<0.01 and the presence of chronic neurological disease OR 3.25 (1.65-6.39) p<0.01 were the independent predictors for VSR lethality.
Conclusion: RSV showed an epidemic pattern (May-July) and affected mostly young children. RSV lethality was more associated with malnourishment, congenital cardiopathy and the presence of chronic neurological disease.
M. D. V. Juarez, None
A. C. Martinez, None
V. Romanin, None
J. Bakir, None
M. Viegas, None
A. Mistchenko, None