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Impact of human coronavirus infections on paediatric patients at a tertiary paediatric hospital
A retrospective study of the prepandemic era
Alsulami, A. O., Chahine, R., Kong, M., Kimberlin, D. W., Whitley, R. J., & James, S. H. (2023). Impact of human coronavirus infections on paediatric patients at a tertiary paediatric hospital: A retrospective study of the prepandemic era. Journal of Hospital Infection, 134, 27-34. https://doi.org/10.1016/j.jhin.2022.12.021
BACKGROUND: Human Coronaviruses (HCoV) are important respiratory pathogens in humans and animals. Most HCoVs are emerging pathogens, with five known human pathogens were identified in the last two decades.
AIM: Examine the clinical course of HCoV infection in children to improve our understanding of severity and outcomes.
METHODS: We performed a retrospective review of all encounters of children with known HCoV infection at a tertiary paediatric hospital from January 2015 through January 2018. Electronic medical records were reviewed for demographic data, HCoV type, viral co-pathogens, time to testing, need for hospitalization, requirement for higher-level care (HLC) including intensive care unit management and utilization of supplemental oxygen, as well as radiographic findings suggestive of lower respiratory tract (LRT) disease, and length of stay (LOS).
FINDINGS: We analysed 450 encounters for 430 different patients, with the majority (85%) being inpatient. OC43 was the most common HCoV. Younger patients (<5 years) had higher probability of hospitalization (aOR 2.2, 95% CI 1.2 - 4.1), requiring HLC (aOR 1.8, 95% CI 1.0 - 3.1), and presence of LRT findings on chest radiographs (aOR 1.7, 95% CI 1.01 - 2.9). Clinical outcomes were not different among HCoV types except LOS that was longer for 229E. Fifty-two (11%) of the encounters were detected after 3 days of hospitalization (median of 25.5), suggesting possible nosocomial infections.
CONCLUSION: HCoVs are important respiratory pathogens in the paediatric population, especially patients <5 years of age who are at increased risk for disease severity. The role of HCoVs as hospital-acquired pathogens may be underappreciated.