Clinical impact of respiratory virus in pulmonary exacerbations of children with Cystic Fibrosis

PLoS One. 2020 Oct 28;15(10):e0240452. doi: 10.1371/journal.pone.0240452. eCollection 2020.

Abstract

Backgrounds: Cystic Fibrosis (CF) is a genetic, multisystemic, progressive illness that causes chronic suppurative lung disease. A major cause of morbimortality in this condition are pulmonary exacerbations. Although classically attributed to bacterial infections, respiratory virus have been increasingly recognized in its ethiopathogeny.

Methods: Nasopharyngeal swab samples were collected from children < 18 years old with CF in Rio de Janeiro, Brazil, with pulmonary exacerbation criteria. Samples were submitted to RT-PCR for Adenovirus, Influenza A and B, Parainfluenza Virus, Respiratory Syncytial Virus (RSV), Metapneumovirus and Rhinovirus. Virus positive and virus negative groups were compared in regards to clinical presentation, severity of exacerbation and bacterial colonization.

Results: Out of 70 samples collected from 48 patients, 35.7% were positive for respiratory viruses. Rhinovirus were the most common (28% of all positive samples), followed by RSV. The virus positive group was associated with change in sinus discharge (p = 0.03). Considering only patients younger than five years old, positive virus detection was also associated with fever (p = 0.01). There was no significant difference in clinical severity or in bacterial colonization between virus positive and negative groups.

Conclusions: Prospective studies are still needed to assess the long term impact of viral infections in patients with CF, and their interaction with the bacterial microbiome in these patients.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Brazil / epidemiology
  • Child
  • Child, Preschool
  • Cystic Fibrosis / virology*
  • Female
  • Humans
  • Infant
  • Infant, Newborn
  • Male
  • Nasopharynx / virology
  • Prevalence
  • Prospective Studies
  • Respiratory Syncytial Virus, Human / isolation & purification*
  • Respiratory Tract Infections / epidemiology
  • Respiratory Tract Infections / virology*
  • Rhinovirus / isolation & purification*

Grants and funding

This study was supported by the Brazilian Ministry of Health and Fundação Oswaldo Cruz - FIOCRUZ (projects 25030.000964/2014 and 25030.000932/2017-82; National Health Foundation). The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.