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Prevalencia de virus respiratorios en pacientes pediátricos atendidos entre 2020 y 2023 en un hospital de Ciudad de México por sintomatología compatible con infección respiratoria viral
Prevalence of respiratory viruses among pediatric patients treated between 2020 and 2023 at a hospital in Mexico City due to symptoms compatible with viral respiratory infections
DOI:
https://doi.org/10.15446/revfacmed.v74.123203Palabras clave:
COVID-19, Virus Sincitial Respiratorio, Rinovirus, Neumonía viral, Hospitalización, Comorbilidad (es)COVID-19, Respiratory Syncytial Virus, Rhinovirus, Viral Pneumonia, Hospitalization, Comorbidity (en)
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Introducción. Las infecciones respiratorias representan una causa importante de mortalidad en todo el mundo. En México no hay datos oficiales sobre la prevalencia de virus respiratorios en niños y adolescentes con sintomatología de infección respiratoria aguda (IRA) y la literatura sobre el tema es limitada.
Objetivos. Determinar la prevalencia de virus respiratorios en población pediátrica (<17 años) atendida en un hospital público de Ciudad de México (México) por sintomatología compatible con IRA entre 2020 y 2023 y explorar los factores asociados con la presencia de estos virus.
Materiales y métodos. Estudio transversal analítico realizado con datos de 253 pacientes pediátricos llevados entre marzo 30 de 2020 y mayo 9 de 2023 al Hospital Juárez de México a consulta por sintomatología compatible con IRA. Se realizaron análisis bivariados para evaluar diferencias entre los pacientes que dieron positivo para uno o más virus respiratorios y aquellos en los que el resultado fue negativo (chi cuadrado de Pearson o prueba exacta de Fisher y prueba de U de Mann-Whitney); la asociación entre la presencia de diferentes síntomas y la detección de al menos un virus respiratorio, y la asociación entre las variables clínicas y epidemiológicas consideradas y la presencia de los diferentes virus respiratorios (prueba de chi-cuadrado de Pearson y cálculo de RP con sus respectivos IC95%).
Resultados. La mediana de edad de los pacientes fue 3 años (RIQ: 7 años) y 52.17% eran varones. La prueba de RT-PCR fue positiva en 41.89%, y enterovirus/rinovirus (13.04%) y VSR (9.09%) fueron los virus respiratorios más frecuentes. El SARS-CoV-2 solo se detectó en 2.77%. La fiebre (75.10%) y la tos (68.38%) fueron los signos y síntomas compatibles con infección respiratoria viral más comunes. Se encontró una asociación positiva y estadísticamente significativa entre tener neumonía y la presencia de enterovirus/rinovirus (RP: 2.14; p<0.001) y entre tener entre 1 y 4 años y la presencia de enterovirus/rinovirus y parainfluenza (RP: 1.64; p=0.02 y RP: 1.78; p=0.04). El requerimiento de hospitalización y la presencia de SARS-CoV-2 tuvo asociación negativa (RP: 0.75; p=0.004). Los siguientes síntomas o signos clínicos se asociaron significativamente con la detección de al menos un virus respiratorio: tos, disnea, rinorrea, polipnea, vómito (p<0.05).
Conclusión. En aproximadamente 40% de los pacientes se detectó al menos un virus respiratorio, siendo los enterovirus/rinovirus los más frecuentes. Tos, disnea, rinorrea, polipnea y vómito se asociaron con la presencia de virus respiratorios. Se observó una asociación positiva entre el diagnóstico de neumonía y la presencia de rinovirus/enterovirus y entre tener entre 1 y 4 años y la detección de rinovirus/enterovirus y parainfluenza, así como una asociación negativa entre requerimiento de hospitalización y presencia de SARS-CoV-2.
Introduction: Respiratory infections are a major cause of mortality worldwide. The literature on the prevalence of respiratory viruses in children and adolescents with symptoms of acute respiratory infection (ARI) in Mexico is scarce, and there is no official data available.
Objective: To determine the prevalence of respiratory viruses in pediatric population (<17 years) treated at a public hospital in Mexico City for symptoms consistent with ARIs between 2020 and 2023, and to explore the factors associated with the presence of these viruses.
Materials and methods: An analytical cross-sectional study was conducted using data from 253 pediatric patients who were admitted to the Hospital Juárez de México between March 30, 2020, and May 9, 2023, after presenting with symptoms consistent with ARI. Bivariate analyses were performed to evaluate the differences between patients who tested positive for one or more respiratory viruses and those who tested negative (Pearson’s chi-square test or Fisher’s exact test and Mann-Whitney U test), the association between the presence of various symptoms and the detection of at least one respiratory virus, and the association between the clinical and epidemiological variables considered and the presence of different respiratory viruses (Pearson’s chi-square test and calculation of prevalence ratios with their respective 95% confidence intervals).
Results: The median age of the patients was 3 years (IQR: 7 years), and 52.17% were male. The RT-PCR test was positive for 41.89% of patients, and enterovirus/rhinovirus (13.04%) and RSV (9.09%) were the most common respiratory viruses. SARS-CoV-2 was detected in only 2.77%. Fever (75.10%) and cough (68.38%) were the most common signs and symptoms consistent with viral respiratory infection. A positive and statistically significant association was found between having pneumonia and the presence of enterovirus/rhinovirus (PR: 2.14; p<0.001) and between being between 1 and 4 years old and the presence of enterovirus/rhinovirus and parainfluenza (PR: 1.64; p=0.02 and PR: 1.78; p=0.04). Hospitalization requirement and the presence of SARS-CoV-2 were negatively associated (PR: 0.75; p=0.004). The following clinical symptoms or signs were significantly associated with the detection of at least one respiratory virus: cough, dyspnea, rhinorrhea, polypnea, and vomiting (p<0.05).
Conclusion: At least one respiratory virus was detected in approximately 40% of patients, with enteroviruses and rhinoviruses being the most common. Cough, dyspnea, rhinorrhea, polypnea, and vomiting were associated with the presence of respiratory viruses. A positive association was observed between a pneumonia diagnosis and the presence of rhinovirus/enterovirus and between being between 1 and 4 years of age and the detection of rhinovirus/enterovirus and parainfluenza; a negative association was also observed between hospitalization requirement and the presence of SARS-CoV-2.
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