Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2019 Jul;91(7):1191-1201.
doi: 10.1002/jmv.25432. Epub 2019 Feb 27.

Prevalence and characteristics of acute respiratory virus infections in pediatric cancer patients

Nadia Soudani  1   2   3 , Miguela A Caniza  4   5 , Aia Assaf-Casals  2   6 , Rouba Shaker  2   6 , Mireille Lteif  2   6 , Yin Su  7 , Li Tang  7 , Imad Akel  2   6 , Samar Muwakkit  6   8 , Ahmad Chmaisse  1   2 , Maysam Homsi  5 , Ghassan Dbaibo  2   6 , Hassan Zaraket  1   2
Affiliations

Prevalence and characteristics of acute respiratory virus infections in pediatric cancer patients

Nadia Soudani et al. J Med Virol. 2019 Jul.

Abstract

Background: Patients with pediatric cancer have a higher risk of morbidity and mortality because of respiratory viral infections than other patient populations.

Objectives: To investigate the causative viruses of respiratory infections and their burden among patients with pediatric cancer in Lebanon.

Study design: Nasopharyngeal swabs along with clinical and demographic data were collected from patients with pediatric cancer presenting febrile episodes with upper respiratory tract symptoms. Total nucleic acid was extracted from specimens followed by the real-time PCR analysis targeting 14 respiratory viruses to estimate the frequency of infections.

Results: We obtained 89 nasopharyngeal swabs from patients with pediatric cancer (mean age, 5.8 ± 4.2 years). Real-time PCR confirmed viral infection in 77 swabs (86.5%). Among these, 151 respiratory viruses were detected. Several viruses cocirculated within the same period; respiratory syncytial virus (RSV) being the most common (45.45%), followed by parainfluenza virus (PIV; 26%), influenza type B (26%), human metapneumovirus (24.6%), and human coronavirus (HCoV; 24.6%). Coinfections were detected in 55% of the subjects, and most of them involved RSV with one or more other viruses. A strong correlation was found between PIV, Flu (influenza of any type), RSV, and HCoV with the incidence of coinfections. RSV was associated with lower respiratory tract infections, nasal congestion, bronchitis, and bacteremia. HCoV was associated with bronchiolitis; rhinovirus was associated with hospital admission.

Conclusion: Patients with pediatric cancer have a high burden of respiratory viral infections and a high incidence of coinfections. Molecular diagnostics can improve management of febrile episodes and reduce antibiotic use.

Keywords: coinfection; patients with pediatric cancer; prevalence; real-time PCR; respiratory tract infections; virus infections.

PubMed Disclaimer

Conflict of interest statement

The authors declare that there are no conflict of interests.

Figures

Figure 1
Figure 1
Viruses detected in the respiratory specimens. The frequency of respiratory viruses detected among cancer patients with monoinfections (n = 28) or coinfections (n = 49; 123 detected viruses among coinfections). (FluA*: influenza A viruses that were not subtyped). AdV, adenovirus; Flu A, influenza A virus, Flu B, influenza B virus, HCoV, human coronaviruses; HMPV, human metapneumovirus; PIV 1 to 4, parainfluenza viruses; RhV, rhinovirus; RSV, respiratory syncytial virus
Figure 2
Figure 2
Monthly distribution of the ARTI cases and the detected viruses. Respiratory viruses were detected throughout the year, with a peak in winter. AdV, adenovirus; ARTI, acute respiratory tract infection; Flu A, influenza A virus; Flu B, influenza B virus; HCoV, human coronaviruses; HMPV, human metapneumovirus; PIV 1 to 4, parainfluenza viruses; RhV, rhinovirus; RSV, respiratory syncytial virus
Figure 3
Figure 3
Heat maps representing (A) correlation matrix of infections (n = 67), (B) correlation between infections and events (n = 67), and (C) correlation between infections and events in follow‐up (n = 67). Negative correlations are shown in yellow, and positive correlations are shown in green. Neutropenia was defined as absolute neutrophil count < 1500 cells/µL, and lymphopenia was defined as lymphocyte count < 2000µL. AdV, adenovirus; Flu, influenza; HCoV, human coronaviruses; HMPV, human metapneumovirus; PIV 1 to 4, parainfluenza viruses; RhV, rhinovirus; RSV, respiratory syncytial virus
See this image and copyright information in PMC

References

    1. Corti M, Palmero D, Eiguchi K. Respiratory infections in immunocompromised patients. Curr Opin Pulm Med. 2009;15(3):209‐217. 10.1097/MCP.0b013e328329bd2c - DOI - PubMed
    1. Hakim H, Dallas R, Zhou Y, et al. Acute respiratory infections in children and adolescents with acute lymphoblastic leukemia. Cancer. 2016;122(5):798‐805. 10.1002/cncr.29833 - DOI - PMC - PubMed
    1. Benites ECA, Cabrini DP, Silva ACB, et al. Acute respiratory viral infections in pediatric cancer patients undergoing chemotherapy. J Pediatr (Rio J). 2014;90(4):370‐376. 10.1016/j.jped.2014.01.006 - DOI - PMC - PubMed
    1. Fazekas T, Eickhoff P, Rauch M, et al. Prevalence and clinical course of viral upper respiratory tract infections in immunocompromised pediatric patients with malignancies or after hematopoietic stem cell transplantation. J Pediatr Hematol Oncol. 2012;34(6):442‐449. 10.1097/MPH.0b013e3182580bc8 - DOI - PubMed
    1. Perlin E, Bang KM, Shah A, et al. The impact of pulmonary infections on the survival of lung cancer patients. Cancer. 1990;66(3):593‐596. - PubMed

Publication types

MeSH terms