Bedside clinical assessment predicts recurrence after hospitalization due to viral lower respiratory tract infection in young children

• Published in: Journal of investigative medicine 2020-03, Vol.68 (3), p.756-761
• Main Authors: Arroyo, Maria, Salka, Kyle P, Perez, Geovanny F, Rodriguez-Martinez, Carlos E, Castro-Rodriguez, Jose A, Nino, Gustavo
• Format: Article
• Language: English
• Subjects: Age; Asthma; Cardiovascular disease; Congenital diseases; Family medical history; Hypoxemia; Illnesses; Infections; Pathogens; Respiratory diseases; Respiratory syncytial virus; Risk factors; Ventilators; Viral infections; Viruses
• ISSN: 1081-5589; 1708-8267
• DOI: 10.1136/jim-2019-001024

Infants requiring hospitalization due to a viral lower respiratory tract infection (LRTI) have a high risk of developing recurrent respiratory illnesses in early life and asthma beyond childhood. Notably, all validated clinical scales for viral LRTI have focused on predicting acute severity instead of recurrence. We present a novel clinical approach combining individual risk factors with bedside clinical parameters to predict recurrence after viral LRTI hospitalization in young children. A retrospective longitudinal cohort of young children (≤3 years) designed to define clinical predictive factors of recurrent respiratory illnesses within 12 months after hospitalization due to PCR-confirmed viral LRTI. Data collection was through electronic medical record. We included 138 children hospitalized with viral LRTI. Using automatic stepwise logistic model selection, we found that the strongest predictors of recurrence in infants hospitalized for the first time were severe prematurity (≤32 weeks’ gestational age, OR=5.19; 95% CI 1.76 to 15.32; p=0.002) and a clinical score that weighted hypoxemia, subcostal retractions and wheezing (OR=3.33; 95% CI 1.59 to 6.98; p