Clinical and laboratory profiles of hospitalized children with acute respiratory virus infection

Choi, Eunjin; Ha, Kee-Soo; Song, Dae Jin; Lee, Jung Hwa; Lee, Kwang Chul

.9 months vs. 13.9 months, P=0.002 for RSV B), there is no age difference between afebrile and febrile hRV cases (23.8 months vs. 25.8 months, P=0.614) in this study, suggesting that pyrogenic immune responses might be different depending on the virus. Some viral respiratory infections are associated with asthma and asthma exacerbation. 20) Cases of RSV and hRV ARI present more commonly with wheezing, but eosi nophilia and a diagnosis of asthma exacerbation are associated only with hRV infection in this study. A study performed in children with acute wheezing illness reports that RSV is the predominant virus in patients with no previous wheezing, whereas hRV is predominant in patients with a history of wheezing. 21) Whether RSV infection causes asthma is still debatable, but it is possible that lower ARI with pathogens such as hRV and RSV could precipitate the development of asthma, especially in children with atopic features. 22) The total leukocyte, neutrophil, lymphocyte and monocyte counts, and specific associations between blood cells, especially the neutrophil-to-lymphocyte ratio have been used as markers of inflammation and infection. 23, 24) Viral ARIs show leukocytosis rather than leukopenia and furthermore, this study shows that IF, hRV, hEV, and AdV are associated with neutrophil-dominant inflammation whereas RSV, PIV, and hMPV are associated with lymphocyte-dominant inflammation. Of note, monocytosis is observed with RSV A, RSV B, and AdV ARIs. Other inflammatory markers such as erythrocyte sedimentation rate and C-reactive protein levels are not significantly increased in most viral ARIs except for AdV infection. Thus, AdV ARI present with neutrophildominant leukocytosis, a high erythrocyte sedimentation rate and a high C-reactive protein level, which mimics the response to bacterial infections.