Clinical presentation of flu coinfections in children
Acknowledgements
Editorial Board are grateful to LLC “Feron” for technical edition.
About the authors:
Svetlana V. Nikolaeva — Cand. of Sci. (Med.), Senior Researcher, Central Research Institute of Epidemiology of the Russian Federal Service for Supervision of Consumer Rights Protection and Human Well-Being, 3A, Novogireevskaya str., Moscow, 111123, Russian Federation; ORCID iD 0000-0003-3880-8112.
Denis V. Usenko — Doct. of Sci. (Med.), Leading Researcher, Central Research Institute of Epidemiology of the Russian Federal Service for Supervision of Consumer Rights Protection and Human Well-Being, 3A, Novogireevskaya str., Moscow, 111123, Russian Federation; ORCID iD 0000-0001-5232-7337.
Svetlana V. Shabalina — Doct. of Sci. (Med.), Leading Researcher, Central Research Institute of Epidemiology of the Russian Federal Service for Supervision of Consumer Rights Protection and Human Well-Being, 3A, Novogireevskaya str., Moscow, 111123, Russian Federation; ORCID iD 0000-0001-7102-5414.
Yuliya N. Khlypovka — Cand. of Sci. (Med.), Junior Researcher, Central Research Institute of Epidemiology of the Russian Federal Service for Supervision of Consumer Rights Protection and Human Well-Being, 3A, Novogireevskaya str., Moscow, 111123, Russian Federation; doctor in Children’s Infectious Department, Central Clinical Hospital and Polyclinic, 17, Marshal Timoshenko str., Moscow, 121359, Russian Federation; ORCID iD 0000-0003-4821-676X.
Alisa Yu. Medkova — Cand. of Sci. (Med.), Head of Children’s Infectious Department, Central Clinical Hospital and Polyclinic, 17, Marshal Timoshenko str., Moscow, 121359, Russian Federation; ORCID iD 0000-0002-1509-0622.
Aleksandr V. Gorelov — Doct. of Sci. (Med.), Professor, Corresponding Member of RAS, Deputy Director for Scientific Work, Central Research Institute of Epidemiology of the Russian Federal Service for Supervision of Consumer Rights Protection and Human Well-Being, 3A, Novogireevskaya str., Moscow, 111123, Russian Federation; professor of the Department of Children’s Diseases, I.M. Sechenov First Moscow State Medical University (Sechenov University), 8 Build. 2, Trubetskaya str., Moscow, 119991, Russian Federation; ORCID iD 0000-0001-9257-0171.
Contact information: Svetlana V. Nikolaeva, e-mail: nikolaeva008@list.ru. Financial Disclosure: no authors have a financial or property interest in any material or method mentioned. There is no conflict of interests. Received 12.08.2020, revised 07.09.2020, accepted 26.09.2020.
DOI: 10.32364/2587-6821-2020-4-11-665-669
S.V. Nikolaeva1, D.V. Usenko1, S.V. Shabalina1, Yu.N. Khlypovka1,2,
A.Yu. Medkova2, A.V. Gorelov1,3
1Central Research Institute of Epidemiology of the Russian Federal Service for Supervision of Consumer Rights Protection and Human Well-Being, Moscow, Russian Federation
2Central Clinical Hospital and Polyclinic, Moscow, Russian Federation
3I.M. Sechenov First Moscow State Medical University (Sechenov University), Moscow, Russian Federation
Aim: to identify the clinical laboratory features of coinfection with flu and other respiratory viral infections.
Patients and Methods: case records (inpatient files) of 139 children aged 2 months — 18 years who were admitted to Moscow hospitals from October 2017 to February 2020 with the clinical manifestations of acute respiratory infections (ARI) were analyzed. All children were divided into two groups. Group 1 included children with coexisted flu and other ARI (n=31). Group 2 included children with flu alone (n=108). The etiology of ARI was discovered by polymerase chain reaction (oral or nasal smears and/or discharge, sputum) and enzyme immunoassay (antibodies to herpesvirus type 1, 2, and 6, cytomegalovirus, Epstein-Barr virus, Chlamydia, and Mycoplasma).
Results: respiratory syncytial virus and rhinovirus were the most common viruses coexisted with flu (8/31 and 5/31, respectively). The onset of ARI occurred 2.60±1.6 days before hospital admission in group 1 and 3.35±1.72 days before hospital admission in group 2 (p>0.05). In group 1, febrile temperature lasted for 4.72±1.25 days that is almost 2 days longer than in group 2 (p<0.01). The rate of complications in coinfection with flu and ARI vs. flu alone was different, i.e., acute (catarrhal, medium) otitis was diagnosed in 35.5% and 8.3.% (p<0.01), respectively, acute sinusitis in 12.9% and 8.3%, respectively, and pneumonia in 22.6% and 7.4%, respectively.
Conclusion: in children, coinfection with flu and other respiratory virus is generally more severe as demonstrated by higher temperature, more severe intoxication symptoms, more common complications (e.g., otitis, sinusitis, pneumonia etc.), and a greater need in infusion therapy. Co-infected children are admitted to hospital more rapidly and stay in hospital for a longer period.
Keywords: acute respiratory infections, flu, rhinovirus, children, fever, intoxication, severity.
For citation: Nikolaeva S.V., Usenko D.V., Shabalina S.V. et al. Clinical presentation of flu coinfections in children. Russian Medical Inquiry. 2020;4(11):665–669. DOI: 10.32364/2587-6821-2020-4-11-665-669.
2. Shkarin V.V., Sergeeva A.V. Epidemiological and clinical features of combined respiratory infections in children. Detskiye infektsii. 2017;16(1):51–56 (in Russ.). DOI: 10.22627/2072-8107-2017-16-1-51-56.
3. Kalyuzhin O.V. Acute respiratory viral infections: modern challenges, antiviral response, immunoprophylaxis and immunotherapy. M.: Medical Information Agency; 2014 (in Russ.).
4. Debiaggi M., Canducci F., Ceresola E.R., Clementi M. The role of infections and coinfections with newly identified and emerging respiratory viruses in children. Virol J. 2012;(9):247. DOI: 10.1186/1743-422X-9-247.
5. Hoffmann J., Rabezanahary H., Randriamarotia M. et al. Viral and atypical bacterial etiology of acute respiratory infections in children under 5 years old living in a rural tropical area of Madagascar. PLoS ONE. 2012;7(8): e43666. DOI: 10.1371/journal.pone.0043666.
6. Fadeeva T.V., Vereshchagina S.A., Gabriel E.A., Kogan A.S. Actual problems of hospital infection: reinfection, superinfection and resistance of pathogens to antimicrobial drugs. Bulletin VSNTS SB RAMS. 2006;(5):178–182 (in Russ.).
7. Mahony J.B. Detection of respiratory viruses by molecular methods. Clin Microbiol Rev. 2008;21(4):716–747.
8. Mazunik N.N. Clinical features, diagnosis and treatment of mixed forms of acute respiratory viral infections in children. Thesis. M.; 2007 (in Russ.).
9. Petri A., Sabin K. Visual medical statistics. M.: GEOTAR-MED; 2019 (in Russ.).
10. Kalyuzhin O.V. Acute respiratory viral infections: modern challenges, antiviral response, immunoprophylaxis and immunotherapy. M.: MIA; 2014 (in Russ.).
11. Karaulov A.V., Kalyuzhin O.V. Immunotherapy of infectious diseases: problems and prospects. Terapevticheskiy arkhiv. 2013;85(11):100–108 (in Russ.).
12. Ruzhentsova T.A., Levitskaya D.S. Treatment of acute respiratory viral infections and influenza in children: results of a meta-analysis. Lechashchiy vrach. 2020;3:52–57 (in Russ.).
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