BACKGROUND

The impact of the COVID-19 pandemic on respiratory virus activity in children has been studied globally, but no published study in the Philippines has provided viral profiling and epidemiological data on children during and after the pandemic’s peak.

OBJECTIVES

To identify respiratory pathogens detected using a multiplex RT-PCR assay (BioFire® Respiratory 2.1 Panel) among pediatric patients with respiratory symptoms admitted to St. Luke’s Medical Center–Global City during (March 2020–February 2022) and after (March 2022–March 2023) the peak of the COVID-19 pandemic; to compare the prevalence of these pathogens between the two periods; and to assess the clinico-demographic characteristics, diagnostic test results, and clinical outcomes of patients with single-pathogen infections versus co-infections.

METHODS

A single-center, cross-sectional study was conducted through a retrospective chart review of pediatric patients with respiratory symptoms tested using a multiplex RT-PCR assay (BioFire® Respiratory 2.1 Panel) at St. Luke’s Medical Center–Global City from March 2020 to March 2023.

RESULTS

Of 739 children, 92.02% were positive for at least one respiratory pathogen, mostly viruses. Rhinovirus/enterovirus (50.59%), RSV (19.71%), and COVID-19 (12.50%) were the most common. COVID-19 and Influenza A were more prevalent during the peak, while rhinovirus/enterovirus and adenovirus were higher post-peak. Most patients were male, aged 1–5 years, and cough (89.99%) was the most common symptom. Normal leukocyte, CRP, and procalcitonin levels were observed in 70.09%, 47.31%, and 68.25%, respectively. No significant differences were noted in diagnostic test results based on pathogen detection. Antibiotics were given to 53.31% of patients, and 99.86% were discharged. The average length of stay was 3.69 days

CONCLUSION

The prevalence of respiratory pathogens among children admitted to our institution during and after the peak of the COVID-19 pandemic predominantly consisted of viruses, showing statistically significant differences. Rhinovirus/enterovirus and RSV were the leading respiratory pathogens in both periods. The peak group showed a higher prevalence of COVID-19 and Influenza A whereas the post-peak group exhibited a higher prevalence of rhinovirus/enterovirus and adenovirus. Single viral infections were more prevalent compared to co-infections

Human ; Pandemics ; Prevalence ; Philippines

Background: Acute respiratory infection (ARI) is a major cause of morbidity and mortality among children worldwide however, local data on the etiologic diagnosis of ARI are limited. Objectives: To determine the prevalence and the most commonly detected respiratory pathogens using a multiplex PCR assay, known as the Respiratory Panel, among hospitalized children with ARI and compare their clinical and laboratory differences. Methods: This is a cross sectional study of children with ARI who were tested with a multiplex PCR assay. Retrospective chart review was done on these patients admitted from January 2018 to February 2020. Results: There were 47 charts reviewed, mean age was 4.2 years old. Out of 47 patients, 36 (76.6%) tested positive for a pathogen. Respiratory syncytial virus (RSV) being the most common followed by Influenza A/H1-2009 and Human metapneumovirus (hMPV). Two patients had viral co-infections and no bacteria were detected on all subjects. 61.7% patients were started on antibiotics on admission. Fever and cough were the most common sign and symptom, respectively. Normal WBC (68% with neutrophilic predominance) and platelet were detected in 72.3% and 70.2% of patients, respectively; 50% of patients had normal CRP and 60.5% had abnormal findings on chest x-ray. Only the presence of chest x-ray findings was found to have a higher probability of yielding a positive Respiratory Panel p=0.27. Conclusion Among admitted patients with ARI, 76.6% tested positive for a respiratory pathogen. All were caused by viruses presenting as nonspecific manifestations – fever and cough. Clinical manifestations, CBC and CRP showed no association with the Respiratory Panel result while abnormal chest x-ray had a higher probability of yielding a positive Respiratory Panel result.
Multiplex Polymerase Chain Reaction

Background: Influenza is one of the most common illnesses pediatricians face. Children are especially at risk for contracting influenza. Aside from fever, cough and colds, the disease may present differently in children. Complications due to influenza are varied and anti-virals may be useful if given early in the course of illness. Objectives: To determine the clinical profile of admitted pediatric patients with influenza based on rapid testing and determine its prevalence, outcome and complications. Methods: Cross sectional study of pediatric patients who had nasopharyngeal swab for influenza by antigen rapid detection test were included. Retrospective chart review was done on patients with influenza-like illness admitted from 2013-2019. Results: There were 244 patient charts reviewed, the mean age of patients was 5 – 9 years old and majority had no influenza vaccine during the year of admission. Patients presented with fever, cough, colds and non-specific symptoms. Ear pain, difficulty of breathing and myalgia were found to be associated with a positive influenza infection. Of the 244 suspected patients, 133 (54%) were positive for influenza rapid testing, 33% were influenza B positive and 21.3 % were influenza A positive. The most common clinical complication for influenza positive patients was pneumonia. 1 patient had respiratory failure, 5 had febrile convulsions and 7 developed viral myositis. 19% of the subjects had asthma as co-morbidity. Only 11% of the population had their annual influenza vaccine. Conclusion 54% of pediatric patients tested for influenza had positive tests for either Influenza A or B. Although generally a mild illness, it contributes to morbidity and mortality in children. Complications are not uncommon in the pediatric population as seen in this study. Vaccination remains an important preventive measure to curb influenza cases.
Influenza, Human