Pediatr Infect Vaccine.  2023 Dec;30(3):111-120. 10.14776/piv.2023.30.e17.

Severe Human Rhinovirus Lower Respiratory Tract Infections in Young Children

Affiliations
  • 1Department of Pediatrics, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, the Republic of Korea
  • 2Department of Pediatrics, Gyeongsang National University Changwon Hospital, Gyeongsang National University College of Medicine, Changwon, the Republic of Korea
  • 3Department of Pediatrics, Soonchunhyang University Bucheon Hospital, Soonchunhyang University College of Medicine, Bucheon, the Republic of Korea
  • 4Department of Critical Care, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, the Republic of Korea
  • 5Department of Pediatrics, Jeonbuk National University Children’s Hospital, Jeonju, the Republic of Korea
  • 6Department of Laboratory Medicine and Genetics, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, the Republic of Korea
  • 7Samsung Advanced Institute for Health Sciences and Technology (SAIHST), Seoul, the Republic of Kore

Abstract

Purpose
Human rhinovirus (HRV) infections can result in lower respiratory tract infections (LRTIs). We aimed to investigate the characteristics of severe HRV LRTI in young children.
Methods
Medical records were reviewed retrospectively in patients who were hospitalized for HRV LRTIs from 2016 to 2020 at the Samsung Medical Center in Seoul, Korea. Patients aged 90 days or older and younger than 5 years were included. Patients with co-infections with other respiratory pathogens were excluded. Severe HRV LRTI was defined as the following: the need for high-flow oxygenation, mechanical ventilation, or intensive care unit admission.
Results
A total of 115 cases were identified. The median age was 17 months (range, 3–56 months) and the median hospital days were 4 days (range, 2–31 days). Of the 115 cases, 18 patients (15.7%) developed severe HRV LRTI. The median age was younger in the severe group compared to the non-severe group (9.5 months vs. 19.0 months, P=0.001). Of 18 patients with severe HRV LRTI, 11 (61.1%) had underlying diseases – chronic lung diseases accounted for the largest proportion (63.6%). Six patients (33.3%) required mechanical ventilation. Of note, 7 previously healthy children were diagnosed with severe HRV LRTI. Of those 7 children, 4 of them were diagnosed with asthma later. When the 115 cases were divided into previously healthy (n=60) and underlying disease (n=55) groups, severe courses of HRV LRTI were observed in 11.7% and 20.0% of children, respectively (P=0.219).
Conclusions
HRV can cause severe LRTI even in previously healthy children as well as in children with comorbidities.

Keyword

Rhinovirus; Child; Respiratory tract infection; Intensive care units
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