1261 Viral etiology of moderate to severe Acute Lower Respiratory Tract Infection in children from a tertiary care Hospital of Eastern India

Abstract

<h3>Background</h3> Viral infections are the common source of lower respiratory tract infection worldwide. Rapid and accurate detection of viral infections can prevent antibiotics abuse therefore could help in implementing rational antibiotics use. But studies determining viral etiologies have not been studied much in developing countries like India. <h3>Objectives</h3> To study viral etiology in children hospitalized with moderate to severe Acute Lower Respiratory Tract Infection (ALRTI) over a period of two years and to detect impact of co-infection on severity and duration of hospitalization. <h3>Methods</h3> We performed a study in children of age group one month to five years admitted in PICU and HDU of a tertiary care hospital of eastern India, with moderate to severe respiratory symptoms from march 2018 to march 2020. Nasopharyngeal swabs were collected at the time of admission and analyzed by using Real time PCR. Eighty two children were enrolled for study, out of which 51 were detected positive for viral infections and they were analyzed for etiological, clinical and laboratory parameters. <h3>Results</h3> The highest positivity rate was observed in children in age group 1- 12 months (58.8%), 1- 5 years (42.2%). Our study confirmed 62 percent viral etiology. Adenovirus was detected in 35.5% of samples; RSV in 25.5%, rhinovirus in 10%, co-infection in (17%) and remaining 18% included metapneumovirus, influenza, human corona and parainfluenza virus. Clustering of cases were observed in the months of september-october and january- february. Comparison between single and co-infection in terms of complications(p value 0.06), average duration of stay( p value 0.2) and inflammatory parameters ( p value 0.47) were not significant. <h3>Conclusions</h3> Adenovirus and RSV are the leading viral pathogens for ALRTI requiring HDU care. Vaccine and antiviral agents are required to reduce ARTI hospitalization.