Multicenter study to describe viral etiologies, clinical profiles, and outcomes of hospitalized children with severe acute respiratory infections, Egypt 2022

In late 2022, severe acute respiratory infections (SARI) surveillance reported an abrupt increase in non-COVID-19 infections among children after three years of drastic reductions. Signals of increased absenteeism due to respiratory symptoms among primary and preparatory school children were detecte...

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Bibliographic Details
Published in:	Scientific reports Vol. 13; no. 1; p. 21860
Main Authors:	Kandeel, Amr, Fahim, Manal, Deghedy, Ola, H. Roshdy, Wael, K. Khalifa, Mohamed, El Shesheny, Rabeh, Kandeil, Ahmed, Wagdy, Saly, Naguib, Amel, Afifi, Salma, Abdelghaffar, Khaled
Format:	Journal Article
Language:	English
Published:	London Nature Publishing Group UK 09-12-2023 Nature Publishing Group Nature Portfolio
Subjects:	692/308/174 692/499 Adenoviridae Infections Adenovirus Adenoviruses Adolescent Bacteria Bacterial diseases Bacterial Infections Child Child, Hospitalized Child, Preschool Children COVID-19 Demography Egypt - epidemiology Female Humanities and Social Sciences Humans Infant Infections Influenza Influenza, Human Male Medical records multidisciplinary Pathogens Patients Pneumonia Public health Respiratory diseases Respiratory tract infection Respiratory Tract Infections - epidemiology Rhinovirus Science Science (multidisciplinary) Surveillance Surveys Viral infections Virus Diseases Viruses Egypt
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Summary:	In late 2022, severe acute respiratory infections (SARI) surveillance reported an abrupt increase in non-COVID-19 infections among children after three years of drastic reductions. Signals of increased absenteeism due to respiratory symptoms among primary and preparatory school children were detected by Event-Based Surveillance. We conducted a hospital-based survey of children who were admitted with SARI to identify the causative pathogen(s) and estimate the burden of infection. A survey was conducted among children < 16 years in 21 referral hospitals in the three governorates with the highest SARI rates. Patients’ demographics, clinical symptoms, and severity were collected from medical records using a line list. Patients were swabbed and tested for a panel of 33 respiratory pathogens by RT-PCR at the Central Laboratory in Cairo. Descriptive data analysis was performed for demographic data. Patients’ characteristics were compared by causative agents’ clinical picture and severity using Chi2 with a p < 0.05 significance. Overall, 317 patients were enrolled, 58.3% were ≤ 1 year of age, 61.5% were males. Of 229 (72.7%) of positively tested patients, viruses caused 92.1% including RSV 63.8%, Rhinovirus 10.0%, Influenza 9.2%, Adenovirus 5.2%, and 1.3% co-infected with two viruses. Bacteria caused 3.5% of cases and 4.4% had mixed viral-bacterial infections. Rhinovirus was the most common cause of death among children with SARI, followed by RSV (8.7% and 1.4%), whereas influenza and Adenovirus did not result in any deaths. Patients with viral-bacterial infections are more likely to be admitted to ICU and die at the hospital than bacterial or viral infections (60% and 20% vs. 31.8% and 1.9% vs. 12.5% and 12.5%, p < 0.001). Viruses particularly RSV are the leading cause of SARI causing significant health problem among children < 16 years in Egypt. Bacterial on top of viral infection can worsen disease courses and outcomes. Studies are required to estimate the SARI burden accurately among Egyptian children and a comprehensive approach tailored to Egypt is necessary to reduce its burden.
Bibliography:	ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-2 content type line 23
ISSN:	2045-2322 2045-2322
DOI:	10.1038/s41598-023-48814-x