背景:在台湾,人类副流感病毒(HPIV)通常会导致儿童呼吸道疾病,需要住院治疗。本研究旨在调查HPIV感染住院患儿的临床严重程度并确定易患严重疾病的危险因素。
方法:我们纳入了2007年至2018年实验室确诊的HPIV感染的住院患者,并收集了他们的人口统计学和临床特征。有呼吸机支持的患者,静脉内致力剂,体外膜氧合被定义为严重病例。
结果:有554名儿童因HPIV感染住院。中位年龄为1.2岁;518例患者有非重度HPIV感染,而36例患者(6.5%)有严重的HPIV感染。266名(48%)患者有基础疾病,190例患者(34.3%)进行了细菌共检测。患有严重HPIV感染的儿童比没有感染的儿童更有可能进行细菌联合检测(52.8%vs33.0%,p=0.02)。与没有补片或巩固的患者相比,有肺补片或巩固的患者有更多的侵袭性细菌共感染或共检(43%vs33%,p=0.06)。患有神经系统疾病的患者(校正OR4.77,95%CI1.94-11.68),肺实变/补片(校正OR6.64,95%CI2.80-15.75),和积液(校正OR11.59,95%CI1.52-88.36)发生严重HPIV感染的风险显着升高。
结论:神经系统疾病和肺实变/斑块或积液是严重HPIV感染的最重要预测因素。
BACKGROUND: Human parainfluenza viruses (HPIVs) commonly cause childhood respiratory illness requiring hospitalization in Taiwan. This study aimed to investigate clinical severity and identify risk factors predisposing to severe disease in hospitalized children with HPIV infection.
METHODS: We included hospitalized patients with lab-confirmed HPIV infection from 2007 to 2018 and collected their demographic and clinical characteristics. Patients with ventilator support, intravenous inotropic agents, and extracorporeal membrane oxygenation were defined as severe cases.
RESULTS: There were 554 children hospitalized for HPIV infection. The median age was 1.2 years; 518 patients had non-severe HPIV infection, whereas 36 patients (6.5%) had severe HPIV infection. 266 (48%) patients had underlying diseases, and 190 patients (34.3%) had bacterial co-detection. Children with severe HPIV infection were more likely to have bacterial co-detection than those without (52.8% vs 33.0%, p = 0.02). Patients with lung patch or consolidation had more invasive bacterial co-infection or co-detection than those without patch or consolidation (43% vs 33%, p = 0.06). Patients with neurological disease (adjusted OR 4.77, 95% CI 1.94-11.68), lung consolidation/patch (adjusted OR 6.64, 95% CI 2.80-15.75), and effusion (adjusted OR 11.59, 95% CI 1.52-88.36) had significantly higher risk to have severe HPIV infection.
CONCLUSIONS: Neurological disease and lung consolidation/patch or effusion were the most significant predictors of severe HPIV infection.