Clinical and laboratory features of viral lower respiratory tract infections in children

Abstract

Purpose: to give a comparative characteristic of the clinical and laboratory manifestations of viral lower respiratory tract infections of various etiologies.Object and methods: Medical information of 385 patients, who were hospitalized in the clinic of Pediatric Research and Clinical Center for Infectious Diseases in the period from 2016 to 2022, was retrospectively analyzed. Inclusion criteria: age from 1 month to 17 years; infectious diseases of the lower respiratory tract; extraction of respiratory viral nucleic acids in nasopharyngeal swabs by polymerase chain reaction. Upon admission, all children underwent: a physical examination, an examination by an otorhinolaryngologist, a complete blood test with a leucogram, determination of the level of C-reactive protein, and, if it necessary, a chest X-ray in two projections.Results: Respiratory syncytial virus and rhinovirus dominated in the etiological structure of lower respiratory tract infection. Differences in the duration and severity of fever and manifestations of catarrhal syndrome in respiratory viral infections of various etiologies were established. Boca-virus and rhinovirus infections often caused severe damage of the lower respiratory tract with acute respiratory failure. Viral lower respiratory tract infections have such changes in the leucogram as an increase in neutrophils and band cells, which persist for 4-5 days of the disease. The severity of inflammatory changes in the haemogram depends on the etiology of the disease. The most significant changes, such as leukocytosis and an increase in the absolute count of neutrophils, were detected in adenovirus and rhinovirus infections.Conclusion: There were age and clinical features of viral lower respiratory tract infections in children. Prolonged fever and identified inflammatory changes in the hemogram, often in combination with an increase in the level of C-reactive protein, in children with viral lesions of the lower respiratory tract explain the frequency of prescribing antibacterial drugs at any stage of medical care. To select the optimal therapy tactics, it is necessary to take into account the clinical and laboratory features of respiratory viral infections in patients with diseases of the lower respiratory tract.