Affiliations: Division of Asthma, Allergy and Lung Biology, King's
College London School of Medicine at Guy's, King's and St Thomas' Hospitals,
London, UK | London South Specialist Virology Center, King's
College Hospital, London, UK | Department of Child Health, Guy's and St Thomas'
Hospital, London, UK
Note: [] Correspondence: Professor Anne Greenough, M.D., Neonatal
Intensive Care Centre, 4th Floor Golden Jubilee Wing, King's College Hospital,
Denmark Hill, London, SE5 9RS, UK. Tel.: +20 7346 3037; Fax: +20 7346 8284;
E-mail: [email protected]
Abstract: Human meta-pneumovirus (hMPV) and rhinovirus (RV) lower respiratory
tract infections (LRTIs) may result in acute symptoms similar to those of
respiratory syncytial virus (RSV) LRTI. We, therefore, tested the hypothesis
that other viral LRTI, as RSV LRTI, will increase healthcare utilization and
chronic respiratory morbidity in prematurely born infants. One hundred and
twelve prematurely born infants were followed prospectively. Hospital
admissions and general practitioner (GP) attendances were recorded and cough
and wheeze documented by diary card. Nasopharyngeal aspirates (NPA) were
obtained for every LRTI and analyzed to identify RSV (A and B), hMPV, RV,
parainfluenza (1 and 2) and influenza (A and B) viruses. Eighty-four infants
suffered 126 LRTIs; 94 viruses [41 RSV, 36 RV, seven hMPV, five parainfluenza
(1, 2 or 3) and five influenza (A or B) viruses] were identified from 82 of the
126 NPAs. Compared to the no viral LRTI group, infants with only RSV infection
had more (P=0.038) and longer (P=0.045)
hospital admissions, more GP attendances (P=0.024), more
cough (P=0.030) and wheeze at follow up
(P=0.018). If infants with dual infections are also
considered, however, infants with a hMPV LRTI, with or without other viral RNA
being detected, compared to the no viral group, had more hospital admissions
(P=0.005), longer admissions (P<0.001),
more GP visits (P=0.029), more days of cough
(P=0.008) and more days of wheeze
(P=0.004). RSV and possibly hMPV, but not RV, LRTI increase
healthcare utilization and respiratory morbidity in prematurely born
infants.
