Clinical Epidemiological Characteristics and Risk Factors for Severe Bronchiolitis Caused by Respiratory Syncytial Virus in Vietnamese Children

Sang Ngoc Nguyen, Thuy Ngoc Thi Nguyen, Lam Tung Vu, Thap Duc Nguyen, Sang Ngoc Nguyen, Thuy Ngoc Thi Nguyen, Lam Tung Vu, Thap Duc Nguyen

Abstract

Introduction: Bronchiolitis is the most prevalent cause of hospitalization in infants under the age of 12 months. The disease is caused by respiratory syncytial virus (RSV) infection, which can cause breathing difficulties and respiratory failure. Therefore, it is necessary to discover the risk factors of severe bronchiolitis to diagnose and treat promptly. This study is aimed at describing the epidemiological characteristics and clinical features of acute bronchiolitis caused by RSV and assessing the related factors to severe acute bronchiolitis in studied patients.

Methods: A descriptive cross-sectional study was carried out in Haiphong Children's Hospital, Haiphong, Vietnam, for one year, from October 1, 2016, to September 30, 2017. All bronchiolitis admissions < 2 years were included.

Results: 377 children were evaluated, including 261 boys and 116 girls; children under 6 months accounted for the highest proportion (57%), and 47 (12.5%) of all patients had severe disease. Wheezing was the main reason to be taken to the hospital 261 (69.2%). Clinical symptoms of acute bronchiolitis such as cough, tachypnea, and runny nose were found in all patients. Bronchiolitis cases increased in the winter-spring season, and the highest registered number of patients was 42 in March. Image of bronchiolitis on chest X-ray was found in all patients, and air trapping lung was found in 124 (32.9%) patients. The risk factors included age (≤6 months), low birth weight, preterm birth, nonbreastfeeding for the first six months, early weaning, and exposition to cigarette smoke increased the severe disease (p < 0.05).

Conclusion: The number of hospitalized infants with bronchiolitis caused by RSV has an upward trend during the winter-spring season (from October to March). This study confirms that age, preterm birth, breastfeeding under 6 months, history of exposure to cigarette smoking, low birth weight, having sibling(s) under five years old going to kindergarten, history of undergoing cesarean section, history of mechanical ventilation, poor living condition, and maternal education are 10 risk factors of severe bronchiolitis caused by RSV.

Conflict of interest statement

The authors declare that they have no competing interests.

Copyright © 2021 Sang Ngoc Nguyen et al.

Figures

Figure 1
Figure 1
Monthly distribution of bronchiolitis patients in a one-year period.

References

    1. Castro-Rodriguez J. A., Rodriguez-Martinez C. E., Sossa-Briceno M. P. Principal findings of systematic reviews for the management of acute bronchiolitis in children. Paediatric Respiratory Reviews . 2015;16(4):267–275. doi: 10.1016/j.prrv.2014.11.004.
    1. House S. A., Ralston S. L. Diagnosis, prevention, and management of bronchiolitis in children: review of current controversies. Minerva Pediatrica . 2017;69(2):141–155.
    1. O'Brien S., Borland M. L., Cotterell E., et al. Australasian bronchiolitis guideline. Journal of Paediatrics and Child Health . 2019;55(1):42–53. doi: 10.1111/jpc.14104.
    1. Jartti T., Smits H. H., Bønnelykke K., et al. Bronchiolitis needs a revisit: distinguishing between virus entities and their treatments. Allergy . 2019;74(1):40–52. doi: 10.1111/all.13624.
    1. Homaira N., Wiles L. K., Gardner C., et al. Assessing the quality of health care in the management of bronchiolitis in Australian children: a population-based sample survey. BMJ Quality and Safety . 2019;28(10):817–825. doi: 10.1136/bmjqs-2018-009028.
    1. Bakalovic G., Dzinovic A., Baljic R., Dizdar S., Selimovic A. Epidemiological features of bronchiolitis in the Pediatric Clinic of Clinical center of Sarajevo University. Materia Socio-Medica . 2015;27(3):p. 154. doi: 10.5455/msm.2015.27.154-157.
    1. Bem R. A., Bont L. J., van Woensel J. B. M. Life-threatening bronchiolitis in children: eight decades of critical care. The Lancet Respiratory Medicine . 2020;8(2):142–144. doi: 10.1016/S2213-2600(19)30445-X.
    1. Azkur D., Özaydın E., Dibek-Mısırlıoğlu E., et al. Viral etiology in infants hospitalized for acute bronchiolitis. The Turkish Journal of Pediatrics . 2014;56(6):592–596.
    1. Wolfler A., Raimondi G., Pagan de Paganis C., Zoia E. The infant with severe bronchiolitis: from high flow nasal cannula to continuous positive airway pressure and mechanical ventilation. Minerva Pediatrica . 2018;70(6):612–622. doi: 10.23736/S0026-4946.18.05358-6.
    1. Thorburn K., Fulton C., King C., Ramaneswaran D., Alammar A., McNamara P. S. Transaminase levels reflect disease severity in children ventilated for respiratory syncytial virus (RSV) bronchiolitis. Scientific Reports . 2018;8(1) doi: 10.1038/s41598-018-20292-6.
    1. Smith D. K., Seales S., Budzik C. Respiratory syncytial virus bronchiolitis in children. American Family Physician . 2017;95(2):94–99.
    1. Vandini S., Biagi C., Lanari M. Respiratory syncytial virus: the influence of serotype and genotype variability on clinical course of infection. International Journal of Molecular Sciences . 2017;18(8) doi: 10.3390/ijms18081717.
    1. Griffiths C., Drews S. J., Marchant D. J. Respiratory syncytial virus: infection, detection, and new options for prevention and treatment. Clinical Microbiology Reviews . 2017;30(1):277–319. doi: 10.1128/CMR.00010-16.
    1. Jha A., Jarvis H., Fraser C., Openshaw P. J. M. Respiratory syncytial virus. In: Hui D. S., Rossi G. A., Johnston S. L., editors. SARS, MERS and Other Viral Lung Infections . Sheffield, UK: European Respiratory Society; 2016.
    1. Borchers A. T., Chang C., Gershwin M. E., Gershwin L. J. Respiratory syncytial virus--a comprehensive review. Clinical Reviews in Allergy and Immunology . 2013;45(3):331–379. doi: 10.1007/s12016-013-8368-9.
    1. Fitzgerald D. A., Kilham H. A. Bronchiolitis: assessment and evidence-based management. The Medical Journal of Australia . 2004;180(8):399–404. doi: 10.5694/j.1326-5377.2004.tb05993.x.
    1. Allen D. Bronchiolitis. Nursing Children and Young People . 2016;28(8):p. 11. doi: 10.7748/ncyp.28.8.11.s11.
    1. Stensballe L. G., Devasundaram J. K., Simoes E. A. F. Respiratory syncytial virus epidemics: the ups and downs of a seasonal virus. The Pediatric Infectious Disease Journal . 2003;22(Supplement):S21–S32. doi: 10.1097/01.inf.0000053882.70365.c9.
    1. Robledo-Aceves M., Moreno-Peregrina M. J., Velarde-Rivera F., et al. Risk factors for severe bronchiolitis caused by respiratory virus infections among Mexican children in an emergency department. Medicine . 2018;97(9, article e0057) doi: 10.1097/MD.0000000000010057.
    1. Ralston S. L., Lieberthal A. S., Meissner H. C., et al. Clinical practice guideline: the diagnosis, management, and prevention of bronchiolitis. Pediatrics . 2014;134(5):e1474–e1502. doi: 10.1542/peds.2014-2742.
    1. Nicolai A., Ferrara M., Schiavariello C., et al. Viral bronchiolitis in children: a common condition with few therapeutic options. Early Human Development . 2013;89(Supplement 3):S7–11.
    1. Ghazaly M., Nadel S. Characteristics of children admitted to intensive care with acute bronchiolitis. European Journal of Pediatrics . 2018;177(6):913–920. doi: 10.1007/s00431-018-3138-6.
    1. Leem J. H., Kim H. C., Lee J. Y., Sohn J. R. Interaction between bronchiolitis diagnosed before 2 years of age and socioeconomic status for bronchial hyperreactivity. Environmental Health and Toxicology . 2011;26, article e2011012 doi: 10.5620/eht.2011.26.e2011012.

Source: PubMed

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