Journal of the Pediatric Infectious Diseases Society · 2025
Viral Detection in Children <5 Years with Bronchiolitis, Pneumonia, and Croup, New Vaccine Surveillance Network, 2017-2023.
СтатьяМногоцентровое исследованиеНазвание и аннотация: Перевод в очереди
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Teoh Zheyi, Toepfer Ariana P, Rohlfs Chelsea, Harrison Christopher J, Klein Eileen J, Schlaudecker Elizabeth P, Weinberg Geoffrey A, Englund Janet A, Williams John V, Boom Julie A, Sahni Leila C, Michaels Marian G, Halasa Natasha, Stewart Laura S, Szilagyi Peter G, Selvarangan Rangaraj, McMorrow Meredith L, Moline Heidi, Staat Mary Allen
Аннотация
INTRODUCTION: Bronchiolitis, pneumonia, and croup account for a substantial burden of pediatric hospitalizations. We aim to provide an updated, multi-center, multi-pathogen evaluation of viral detections seen with these acute respiratory illness (ARI) syndromes before and after the COVID-19 pandemic.
METHODS: We included children <5 years with a diagnosis of bronchiolitis, pneumonia, or croup during 2017-2023 from the New Vaccine Surveillance Network. Respiratory viruses were detected with a research ± clinical respiratory swabs; demographic and clinical data were obtained from caregiver interview and chart review. Virus-specific proportions across all three ARI syndromes were described, including comparisons stratified by age, surveillance year including pre- (2017-2019) and post (2021-2023) COVID-19 onset periods, and underlying medical condition.
RESULTS: Among 14 340 cases of bronchiolitis, 4423 cases of pneumonia, and 2367 cases of croup, >80% had one or more respiratory virus detected. Respiratory syncytial virus (RSV) was the most frequent virus detected in bronchiolitis (41%) and pneumonia (26%), with a similar distribution across the COVID-19 onset periods. Parainfluenza virus (PIV) was the most frequent virus detected in croup (28%), but detections fell in the post-COVID-19 onset period by 8.4%; there was a comparable proportion of SARS-CoV-2 detections (7.6%) that emerged among croup cases. Rhinoviruses/enteroviruses (RV/EV) were the second most frequently detected virus across all three ARI syndromes and were the predominant virus in children <6 months and children with an underlying medical condition diagnosed with croup. Codetections were present in 17%-19% of bronchiolitis, pneumonia, and croup cases.
DISCUSSION: We found a high proportion of respiratory viral detections in children <5 years with bronchiolitis, pneumonia, or croup, particularly with RSV, RV/EV, and PIV. Most viruses were identified in similar proportions before and after the emergence of SARS-CoV-2, except for PIV and influenza virus. In our cohort, there was a high proportion of viral detection across all three ARI syndromes, with RV/EV frequently detected in certain age groups and among children with underlying conditions.
METHODS: We included children <5 years with a diagnosis of bronchiolitis, pneumonia, or croup during 2017-2023 from the New Vaccine Surveillance Network. Respiratory viruses were detected with a research ± clinical respiratory swabs; demographic and clinical data were obtained from caregiver interview and chart review. Virus-specific proportions across all three ARI syndromes were described, including comparisons stratified by age, surveillance year including pre- (2017-2019) and post (2021-2023) COVID-19 onset periods, and underlying medical condition.
RESULTS: Among 14 340 cases of bronchiolitis, 4423 cases of pneumonia, and 2367 cases of croup, >80% had one or more respiratory virus detected. Respiratory syncytial virus (RSV) was the most frequent virus detected in bronchiolitis (41%) and pneumonia (26%), with a similar distribution across the COVID-19 onset periods. Parainfluenza virus (PIV) was the most frequent virus detected in croup (28%), but detections fell in the post-COVID-19 onset period by 8.4%; there was a comparable proportion of SARS-CoV-2 detections (7.6%) that emerged among croup cases. Rhinoviruses/enteroviruses (RV/EV) were the second most frequently detected virus across all three ARI syndromes and were the predominant virus in children <6 months and children with an underlying medical condition diagnosed with croup. Codetections were present in 17%-19% of bronchiolitis, pneumonia, and croup cases.
DISCUSSION: We found a high proportion of respiratory viral detections in children <5 years with bronchiolitis, pneumonia, or croup, particularly with RSV, RV/EV, and PIV. Most viruses were identified in similar proportions before and after the emergence of SARS-CoV-2, except for PIV and influenza virus. In our cohort, there was a high proportion of viral detection across all three ARI syndromes, with RV/EV frequently detected in certain age groups and among children with underlying conditions.