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Master's Dissertation
DOI
https://doi.org/10.11606/D.17.2020.tde-12022020-173815
Document
Author
Full name
Fabrícia Louzada Depizzol Vito Sobrinho
E-mail
Institute/School/College
Knowledge Area
Date of Defense
Published
Ribeirão Preto, 2019
Supervisor
Committee
Carlotti, Ana Paula de Carvalho Panzeri (President)
Arruda Neto, Eurico de
Martin, Joelma Gonçalves
Title in Portuguese
Epidemiologia e fatores associados à gravidade da infecção viral aguda de vias aéreas inferiores em crianças hospitalizadas em Manaus
Keywords in Portuguese
Coinfecção viral
Gravidade
Infecção viral de trato respiratório inferior
Vírus sincicial respiratório
Abstract in Portuguese
As infecções virais agudas do trato respiratório inferior representam importante problema de saúde pública no mundo e são responsáveis por grande número de óbitos em lactentes jovens, em países em desenvolvimento. Realizamos estudo observacional retrospectivo de coorte, que teve como objetivo, investigar a epidemiologia e os fatores associados à gravidade dos quadros de infecções virais agudas de vias aéreas inferiores em crianças de < 6 anos de idade, hospitalizadas no Hospital e Pronto Socorro Delphina Rinaldi Abdel Aziz em Manaus. Incluímos 146 crianças < 6 anos de idade, hospitalizadas por infecções virais agudas de vias aéreas inferiores no HPS Delphina Rinaldi Abdel Aziz, em Manaus, no Setor de Pediatria, no período de 1 de abril de 2017 a 31 de agosto de 2018, com diagnóstico clínico e com isolamento viral positivo em aspirado de nasofaringe. Coletamos todos os dados em prontuário eletrônico através de fichas de avaliação específicas. As crianças foram divididas em 2 grupos, de acordo com a gravidade da doença classificada conforme o escore de Gagliardi (doença moderada, com escore de Gagliardi 0-4; n= 66 (45,2%) e doença grave, com escore 5-7; n= 80 (54,8%)). Observamos maior número de casos de infecções virais agudas de vias aéreas inferiores nos meses com maior precipitação pluviométrica. O vírus sincicial respiratório foi o mais prevalente (n=103; 70,3%). O único fator de risco de gravidade da doença encontrado foi a presença de coinfecção viral (RR 1,59; IC95% 1,18- 2,15). Não houve associação da gravidade da doença com o tipo de vírus nem com a presença de comorbidades. Os pacientes com doença grave tiveram maior tempo de ventilação mecânica em comparação àqueles com doença moderada (mediana de 2 dias vs. 0; p=0,01). Doze pacientes (8,2%) morreram, todos com doença grave. Os fatores de risco para óbito foram evolução para choque (RR 10,53; IC 95% 2,40-46,17) e necessidade de uso de drogas vasoativas (RR 10,86; IC95% 2,48-47,63).
Title in English
Epidemiology and factors associated with severity of acute lower respiratory viral infection in children hospitalized in Manaus
Keywords in English
Lower respiratory tract viral infection
Respiratory syncytial virus
Severity
Viral coinfection
Abstract in English
Acute viral lower respiratory tract infections represent an important public health problem on a global scale, and are responsible for a large amount of deaths in infants and young children, in developing countries. This was an observational retrospective cohort study which aimed to investigate the epidemiology and factors associated with the severity of acute viral lower respiratory tract infections in children under six years of age, hospitalized in HPS Delphina Rinaldi Abdel Aziz em Manaus. We included 146 children <6 years of age, hospitalized for acute lower airway viral infections at the Delphina Rinaldi Abdel Aziz HPS, Manaus, Pediatrics Sector, from April 1, 2017 to August 31, 2018, with clinical diagnosis and positive viral isolation in nasopharyngeal aspirate. We collected all data in electronic medical records using specific evaluation forms. The children were divided into 2 groups according to the severity of the disease classified according to the Gagliardi score (moderate disease with Gagliardi score 0-4; n = 66 (45.2%) and severe disease with score 5 to 7; n = 80 (54.8%)). We observed a higher number of cases of acute lower airway viral infections in the months with higher rainfall. Respiratory syncytial virus was the most prevalent (n = 103; 70.3%). The only risk factor for disease severity was the presence of viral coinfection (RR 1.59; 95% CI 1.18- 2.15). There was no association of disease severity with virus type or comorbidities. Patients with severe disease had longer duration of mechanical ventilation compared to those with moderate disease (median 2 days vs. 0; p = 0.01). Twelve patients (8.2%) died, all with severe disease. Risk factors for death were evolution to shock (RR 10.53; 95% CI 2.40-46.17) and need for vasoactive drugs (RR 10.86; 95% CI 2.48-47.63).
 
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Publishing Date
2020-05-05
 
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