క్లినికల్ పీడియాట్రిక్స్: ఓపెన్ యాక్సెస్
అందరికి ప్రవేశం
ISSN: 2572-0775
ISSN: 2572-0775
Hanna Sahhar S, Kristen Turner, Rebecca Raffler, Darcy Luck, Sarah Straka, Diana Vasilakos
Context: Human Parainfluenza Viruses (HPIVs) are among the most common acute respiratory infections in children and contribute significantly to hospitalizations and emergency room visits in the pediatric population. Differences in clinical presentation and sequelae of the four HPIV serotypes have not been thoroughly characterized. This study describes the clinical symptoms, disease severity, and care demands associated with each of the viral serotypes, which may aid in decision making for the most appropriate available treatment modalities for future pediatric patients and improve quality of care.
Objectives:
1. Describe and analyze the heterogeneity of HPIV serotypes in clinical presentation and disease outcome in the pediatric population.
2. Analyze oxygen requirement, length of stay, and potential complications in the context of specific viral serotype.
3. Determine whether or not certain HPIV serotypes are predisposed to a more severe course of infection and require escalation of care to the Pediatric Intensive Care Unit (PICU).
Methods: This single-center, retrospective, observational study reviewed 40 pediatric patients admitted to Spartanburg Regional Healthcare System (SRHS) with parainfluenza virus during a 15-month period. Inclusion criteria consisted of all patients less than 18 years of age admitted to the general pediatric ward or the PICU with a diagnosis of parainfluenza types 1-4 confirmed on a polymerase chain reaction-based test called FilmArray. Demographic and clinical data were collected and analyzed.
Results: The collected data found 75% of patients across all serotypes displayed nonspecific upper respiratory symptoms, while only 35% of patients (primarily HPIV-1 and 2 cases), manifested traditional croup symptoms. The most frequently diagnosed serotype was HPIV-3 and these patients experienced higher rates of bronchiolitis, pneumonia and Upper Respiratory Infection (URI) symptoms compared to other serotypes. While no statistical significance was observed in our small population, serotypes 1 and 4 necessitated greater care demands; with HPIV-1 resulting in the most PICU admissions (50%) and HPIV-4 patients averaging the longest length of stay and requiring the most supplemental oxygen.
Conclusion: This single-center, retrospective, observational study suggests that understanding the differences in symptomatology and severity of each serotype may proactively aid in the proper treatment and care of parainfluenza virus in the pediatric population. Further investigative studies with an increased sample size, multiple sites, and longer duration would be beneficial to support the data and further delineate preemptive actions when caring for the pediatric population with HPIV.