Clinical Outcomes of Lower Respiratory Tract Infections: An Epidemiological Study Comparing Viral and Non-Viral Lower Respiratory Tract Infections in Jeddah

Abstract

Objective: The aim of this study is to find if Viral Lower Respiratory Tract Infections (V-LRTI) occurs more common on top of existing Chronic Lung Diseases (CLD) or has no relation. The study also aimed to learn about the clinical presentation V-LRTI in young children in Jeddah.Materials and methods: This was a retrospective study of 136 young patients of 5 years or less who were presented to the department of pediatrics at doctor Soliman Fakeeh hospital, Jeddah. The children diagnosed primarily as LRTI were enrolled in the acute phase and through the chronic stage of the disease. Dr. Soliman Fakeeh Hospital is a private (tertiary care) hospital uniquely located to serve a wide catch population from South and North Districts of Jeddah. A database was developed to provide the information about preliminary diagnosis, clinical examination, laboratory investigations, treatment and final diagnosis. Among the 136 patients, seven patients were lost to follow up and hence, excluded from analysis. Nasopharyngeal Aspirate (NPA) test type was done to identify causative viral infection. End-point was calculated as per protocol on 129 patients.Results: A total number of 34 patients out of 129 had positive NPA Viral Test (26%); 19 patients out of the 34 (56%) had CLD and 15 patients (44%) had no CLD. On the other side, 95 patients out of 129 had negative NPA Viral Test (74%); 59 patients out of the 95 (62%) had CLD and 36 patients (38%) had no CLD. The results are not significant (p-value=0.524). We concluded that there is no significant difference between occurrences of V-LRTI on top of existing CLD. Results show that there is significant difference between V-LRTI and non-V-LRTI presence in the following variables (p-value<0.05): In V-RTIs; Age at time of diagnosis is less (0.36+0.31 vs 0.79+0.07), admission to hospital is more (91.2% vs 55.8%), oxygen saturation is less (92.50+3.72 vs 95.96+0.57), Crackles is more (65.6% vs 40%.0%) Wheezing is more (71.9% vs 43.2%), Dyspnea is more (44.1% vs 9.5%) and Diarrhea is more (5.9% Vs 0.0%).Conclusion: The study shows that V-LRTI constitutes (27%) with RSV being the commonest causative virus (79.4%). V-LRTI statistically occurs in younger age with more hospitalization. Dyspnea, crackles and wheezing are statistically more frequent in V-LRTI with less Oxygen saturation than Non-V-LRTI. CLD is not a predisposing factor in V-LRTI in preschool age.