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Comparison of the Severity of Respiratory Disease in Children Testing Positive for Enterovirus D68 and Human Rhinovirus.
J Pediatr. 2018 06; 197:147-153.e1.JPed

Abstract

OBJECTIVE

To compare the characteristics and severity of respiratory disease in children testing positive for enterovirus D68 (EV-D68) and for human rhinovirus (RhV).

STUDY DESIGN

A retrospective single center study of children presenting with acute respiratory symptoms and positive polymerase chain reaction for RhV/EV from September 1, 2014 through October 31, 2014 was performed. Specimens were subsequently tested specifically for EV-D68 and specimens identified as RhV were subtyped when possible into RhV-A, RhV-B, and RhV-C species. Clinical manifestations in patients with EV-D68 were compared with those with non-EV-D68, RhV, and RhV-C.

RESULTS

Of the 173 patients included in the analysis, 72 tested positive for EV-D68, 61 for RhV, and 30 for RhV-C. There were significantly fewer infants in the EV-D68 group. Patients with EV-D68 were more likely than those without EV-D68, and specifically with RhV-C, to have fever and wheezing. Patients with EV-D68 received more magnesium sulfate for respiratory distress not responding adequately to repeated doses of inhaled albuterol. Hospitalized patients with EV-D68 received more bronchodilator therapy than patients with RhV. Patients with EV-D68 were more likely to be admitted to the intensive care unit and were older than patients without EV-D68. There was no difference in length of overall hospitalization or time in the pediatric intensive care unit.

CONCLUSIONS

Children with EV-D68 appeared to have more severe respiratory disease on admission than children with RhV as evidenced by higher rates of fever, wheezing, bronchodilator use and pediatric intensive care unit admission. Despite the initial difference in severity, no significant difference in length of stay was found suggesting that patients with EV-D68 recovered as quickly as other groups.

Authors+Show Affiliations

Division of Pediatric Pulmonology, Allergy, Immunology, and Sleep Medicine, New York Medical College, Valhalla, NY.Pediatrics, New York Medical College, Valhalla, NY.Division of Pediatric Pulmonology, Allergy, Immunology, and Sleep Medicine, New York Medical College, Valhalla, NY. Electronic address: john_welter@nymc.edu.Division of Pediatric Pulmonology, Allergy, Immunology, and Sleep Medicine, New York Medical College, Valhalla, NY.Pathology and Clinical Laboratories, New York Medical College/ Westchester Medical Center, Valhalla, NY.Pediatric Infectious Diseases, New York Medical College, Valhalla, NY.

Pub Type(s)

Comparative Study
Journal Article

Language

eng

PubMed ID

29655864

Citation

Caylan, Esra, et al. "Comparison of the Severity of Respiratory Disease in Children Testing Positive for Enterovirus D68 and Human Rhinovirus." The Journal of Pediatrics, vol. 197, 2018, pp. 147-153.e1.
Caylan E, Weinblatt E, Welter J, et al. Comparison of the Severity of Respiratory Disease in Children Testing Positive for Enterovirus D68 and Human Rhinovirus. J Pediatr. 2018;197:147-153.e1.
Caylan, E., Weinblatt, E., Welter, J., Dozor, A., Wang, G., & Nolan, S. M. (2018). Comparison of the Severity of Respiratory Disease in Children Testing Positive for Enterovirus D68 and Human Rhinovirus. The Journal of Pediatrics, 197, 147-e1. https://doi.org/10.1016/j.jpeds.2018.02.027
Caylan E, et al. Comparison of the Severity of Respiratory Disease in Children Testing Positive for Enterovirus D68 and Human Rhinovirus. J Pediatr. 2018;197:147-153.e1. PubMed PMID: 29655864.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Comparison of the Severity of Respiratory Disease in Children Testing Positive for Enterovirus D68 and Human Rhinovirus. AU - Caylan,Esra, AU - Weinblatt,Ezra, AU - Welter,John, AU - Dozor,Allen, AU - Wang,Guiqing, AU - Nolan,Sheila M, Y1 - 2018/04/11/ PY - 2017/08/09/received PY - 2018/02/05/revised PY - 2018/02/12/accepted PY - 2018/4/16/pubmed PY - 2019/2/27/medline PY - 2018/4/16/entrez KW - asthma KW - children KW - respiratory disease KW - wheezing SP - 147 EP - 153.e1 JF - The Journal of pediatrics JO - J Pediatr VL - 197 N2 - OBJECTIVE: To compare the characteristics and severity of respiratory disease in children testing positive for enterovirus D68 (EV-D68) and for human rhinovirus (RhV). STUDY DESIGN: A retrospective single center study of children presenting with acute respiratory symptoms and positive polymerase chain reaction for RhV/EV from September 1, 2014 through October 31, 2014 was performed. Specimens were subsequently tested specifically for EV-D68 and specimens identified as RhV were subtyped when possible into RhV-A, RhV-B, and RhV-C species. Clinical manifestations in patients with EV-D68 were compared with those with non-EV-D68, RhV, and RhV-C. RESULTS: Of the 173 patients included in the analysis, 72 tested positive for EV-D68, 61 for RhV, and 30 for RhV-C. There were significantly fewer infants in the EV-D68 group. Patients with EV-D68 were more likely than those without EV-D68, and specifically with RhV-C, to have fever and wheezing. Patients with EV-D68 received more magnesium sulfate for respiratory distress not responding adequately to repeated doses of inhaled albuterol. Hospitalized patients with EV-D68 received more bronchodilator therapy than patients with RhV. Patients with EV-D68 were more likely to be admitted to the intensive care unit and were older than patients without EV-D68. There was no difference in length of overall hospitalization or time in the pediatric intensive care unit. CONCLUSIONS: Children with EV-D68 appeared to have more severe respiratory disease on admission than children with RhV as evidenced by higher rates of fever, wheezing, bronchodilator use and pediatric intensive care unit admission. Despite the initial difference in severity, no significant difference in length of stay was found suggesting that patients with EV-D68 recovered as quickly as other groups. SN - 1097-6833 UR - https://www.unboundmedicine.com/medline/citation/29655864/Comparison_of_the_Severity_of_Respiratory_Disease_in_Children_Testing_Positive_for_Enterovirus_D68_and_Human_Rhinovirus_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0022-3476(18)30215-4 DB - PRIME DP - Unbound Medicine ER -