2191. Children with severe human rhinovirus lower respiratory tract infection

Abstract

Abstract Background Human rhinovirus (HRV) infection can also cause lower respiratory tract infections (LRTIs). We aimed to investigate the proportion and characteristics of severe HRV infection among children under 5 years who were hospitalized due to HRV LRTI. Methods The medical records were reviewed retrospectively in patients hospitalized caused by HRV LRTI from January 1, 2016 to December 31, 2020, at Samsung Medical Center, Seoul, Korea. Patients who were older than 90 days and younger than 5 years old were included. Patients with co-infection of other respiratory viruses or bacteria were excluded. Patients with cancer were excluded. Severe HRV LRTI was defined as the following: need for high flow oxygenation, mechanical ventilation, or intensive care unit (ICU) admission. Results A total of 116 cases were identified. The median age was 17 months (range, 3-56 months), and their median hospital days were four days (range, 2-31 days). Of 116 cases, 18 cases (15.5%) showed a severe course. The median age was younger in severe group compared to non-severe group (9.5 months vs. 19.5 months, p=0.001). In 18 patients with severe HRV LRTI, 11 (11/18, 61%) had underlying diseases; bronchopulmonary dysplasia and bronchiolitis obliterans accounted for the largest proportion (7/11, 63.6%). Six patients (6/18, 33.3%) required mechanical ventilation. Of note, there were seven previously healthy children (7/18, 38.9%) were diagnosed with severe HRV LRTI. Of those seven, three were diagnosed with asthma later during follow-up. When 116 cases were divided into previously healthy (n=61) and underlying disease (n=55) groups, severe course of HRV LRTI was observed in 11% and 20%, respectively (p=0.205). There was no fatal case. Conclusion HRV can cause severe LRTI in certain pediatric patient, especially with underlying diseases and young-aged children. One out of ten hospitalized children even without previously diagnosed underlying diseases, showed severe course of HRV LRTI. Disclosures Doo Ri Kim, MD, Korean Society of Pediatric Infectious Diseases: Grant/Research Support Yae-Jean Kim, MD, PhD, Janssen: Grant/Research Support|Korean Society of Pediatric Infectious Diseases: Grant/Research Support|Ministry of Trade, Industry and Energy: Grant/Research Support|MSD: Grant/Research Support.