Disease Burden Associated with Viral Respiratory Infections in Pediatric Oncology Patients

G. Syridou, C. Vliora, C. Kottaridi, D. Doganis, V. Papadakis, N. Tourkantoni, A. Paissiou, G. Kourlaba, T. Zaoutis, V. Papaevangelou
32nd Annual Meeting of the European Society for Paediatric Infectious Diseases (ESPID 2014)
|Dublin, Ireland, May 6-10, 2014

AIM: A prospective observational study was conducted to examine whether viral infections of the upper/lower respiratory tract are associated with chemotherapy delay in pediatric oncology patients.

METHODS: Children presenting with respiratory tract symptoms at the "Elpida" Children’s Oncology Unit in Athens, Greece were offered enrolment. Inpatients as well as children visiting the outpatient clinics were included. Patient demographic data and complete medical history was obtained. A nasopharyngeal aspirate was obtained and tested with a multiplex PCR (PneumoVir kit, GENOMICA, Spain), detecting 18 respiratory human viruses.

RESULTS: Between 11/2012-10/2013, 107 patients (54 boys) with upper/lower respiratory symptoms were included. Median age was 5.5±3.7years. Underlying malignancy included: hematological malignancy (65%), lymphoma (8%), solid tumor (26%) and Langerhans ‘cell histiocytosis (1%).

Viral pathogen was detected in 62% of children, the most frequent being RSV (32%), followed by Influenza, parainfluenza-3, Bocavirus, Rhinovirus, human metapneumovirus and Adenovirus. Viral co-infections were detected in 10% of children. Median symptom duration was 7±5.5days. Most children with identifiable viral etiology (71%) were febrile. Six children (5.6%) were admitted to the PICU and 7 children (6.5%) died. Virus was detected upon enrollment in 5/6 and 6/7 respectively. Two children died due to their underlying disease, four secondary to respiratory failure and one post septic shock. Fourteen children (13%) experienced chemotherapy delay for a median of 9 days. In 9 children (64%) a viral agent was detected (p=0.54).

CONCLUSIONS: Although our preliminary results showed no association between respiratory viral infections in pediatric oncology patients and chemotherapy delay, disease burden was substantial.