bachelorThesis
Factores asociados a infección respiratoria severa por virus Sincitial respiratorio, adenovirus o influenza, en menores de 3 años en un hospital pediátrico de Bogotá entre septiembre 2017 y marzo de 2018
Fecha
2018Autor
Villamil Osorio, Milena
Aponte Barrios, Nelson Hernando
Institución
Resumen
Introduction and objectives: Acute lower respiratory tract infection (aLRTI) is a major cause morbidity and mortality worldwide in childhood under three years, mainly caused by viruses. Only few studies have evaluated predictors of severity in children hospitalized for adenovirus, respiratory syncytial virus (RSV) or influenza viruses in our region. The objective was analyze possible factors associated with severity in patients with infection by adenovirus, respiratory syncytial virus (RSV) or influenza. Methods and Materials: Analytical, cross-sectional study in children under three years admitted by aLRTI in a period of 7 months with a positive viral panel for at least one these viruses: adenovirus, RSV or influenza in a reference Hospital center in a low and middle-income country. Multivariate analysis and binary logistic regression for severity measured by admission to the risk unit (intensive and/or intermediate care unit, required invasive mechanical ventilation and need to ambulatory oxygen). Results: A total 213 patients, mean age 8 months (range interquartile: 12), 59% (137) were men, 74.5% (172) were infected by RSV, 19.2% (41) adenovirus, 13.5% (14) Influenza A. Independent predictors of severity: admission to risk unit: had a pneumonia diagnostic to the admission, OR: 2,69 (95% CI: 1,18-6,14) p<0.05, and coinfection OR: 2,28 (95% CI: 1,02-5,06) p<0.05. Required invasive mechanical ventilation OR: 11.75 (95% CI: 2,13-64,7) p: 0.00, ground-glass pattern in chest x-ray OR: 12,08 (95% CI: 1,92-73,72) p:0.01 and pneumonia OR: 8,91 (CI 1,75–45,24) p: 0.0. Need to ambulatory oxygen by RSV OR 2.51 (95% CI: 1,24-5,09) p<0.05. Bronchopulmonary Dysplasia OR: 6,57 (95% CI: 1,75-24,6) p<0.05. <3 months OR 4,8 (95% CI: 1,84-12,54) p<0.05, <6 months OR 3,49 (95% CI: 1,99-6,12) p 0.00. Conclusions: In our patients evaluated with aLRTI by RSV, adenovirus and/or influenza, additionally having pneumonia, coinfection, bronchopulmonary dysplasia, ground-glass pattern in chest x-ray o had age <6 months are independent predictors of severity, special attention should be paid to this group patients during their treatment and establish prevention strategies with emphasis on this population.