Hostname: page-component-76fb5796d-25wd4 Total loading time: 0 Render date: 2024-04-26T07:46:08.311Z Has data issue: false hasContentIssue false
  • English
  • Français

Human metapneumovirus infection in the cardiac paediatric ICU before and during COVID-19 pandemic: a retrospective cohort analysis

Published online by Cambridge University Press:  03 August 2022

Nicolas Leister Open the ORCID record for Nicolas Leister [Opens in a new window] ,
Simone Commotio ,
Christoph Menzel ,
Sirin Yücetepe ,
Christoph Ulrichs ,
Stefanie Wendt ,
Christoph Dedden ,
Uwe Trieschmann Open the ORCID record for Uwe Trieschmann [Opens in a new window]  and
Tobias Hannes
Nicolas Leister*
Affiliation:
Department of Anaesthesiology and Intensive Care Medicine, University of Cologne, Faculty of Medicine and University Hospital Cologne, Germany
Simone Commotio
Affiliation:
Department of Anaesthesiology and Intensive Care Medicine, University of Cologne, Faculty of Medicine and University Hospital Cologne, Germany
Christoph Menzel
Affiliation:
Department of Anaesthesiology and Intensive Care Medicine, University of Cologne, Faculty of Medicine and University Hospital Cologne, Germany
Sirin Yücetepe
Affiliation:
Department of Anaesthesiology and Intensive Care Medicine, University of Cologne, Faculty of Medicine and University Hospital Cologne, Germany
Christoph Ulrichs
Affiliation:
Department of Anaesthesiology and Intensive Care Medicine, University of Cologne, Faculty of Medicine and University Hospital Cologne, Germany
Stefanie Wendt
Affiliation:
Department of Cardiothoracic Surgery and Intensive Care Medicine, University of Cologne, Faculty of Medicine and University Hospital Cologne, Germany
Christoph Dedden
Affiliation:
Department of Paediatric Cardiology, University of Cologne, Faculty of Medicine and University Hospital Cologne, Germany
Uwe Trieschmann
Affiliation:
Department of Anaesthesiology and Intensive Care Medicine, University of Cologne, Faculty of Medicine and University Hospital Cologne, Germany
Tobias Hannes
Affiliation:
Department of Anaesthesiology and Intensive Care Medicine, University of Cologne, Faculty of Medicine and University Hospital Cologne, Germany Department of Paediatric Cardiology, University of Cologne, Faculty of Medicine and University Hospital Cologne, Germany Department of Neonatology and Paediatric Intensive Care Medicine, Asklepios Children’s Hospital St. Augustin, Sankt Augustin, Germany
*
Author for correspondence: Dr med. Nicolas Leister, MD, DESA, MHBA, Department of Anaesthesiology and Intensive Care Medicine, University of Cologne, Faculty of Medicine and University Hospital Cologne, Kerpener Street 62, 50937 Cologne, Germany. Tel: +49 (0) 221 478 82058. E-mail: nicolas.leister@uk-koeln.de
Get access Rights & Permissions [Opens in a new window]

Abstract

Introduction:

This study investigates the hygiene standards in the context of the COVID-19 pandemic and their impact on the perioperative incidence of human metapneumovirus as well as the typical symptom burden of human metapneumovirus-infected children with CHDs.

Materials and methods:

Between March 2018 and July 2021, all patients of a cardiac paediatric ICU of a German university hospital were included in this retrospective cohort analysis.

Results:

A total of 589 patients with CHD were included in the analysis. Three hundred and fifty-two patients (148 females and 204 males) were admitted before the introduction of social distancing and face masks between March 2018 and 15 April 2020 (cohort A). Two hundred and thirty-seven patients (118 females and 119 males) were admitted after the introduction between April 16 and July 2021 (cohort B). In cohort A, human metapneumovirus was detected in 11 out of 352 patients (3.1%) during their stay at cardiac paediatric ICU. In cohort B, one patient out of 237 (0.4%) tested positive for human metapneumovirus. Patients who tested positive for human metapneumovirus stayed in cardiac paediatric ICU for a median of 17.5 days (range, 2–45 days). Patients without a detected human metapneumovirus infection stayed in the cardiac paediatric ICU for a median of 4 days (range, 0.5–114 days). Nine out of 12 (75%) human metapneumovirus-positive patients showed atelectasis.

Conclusion:

Perioperative human metapneumovirus infections prolong cardiac paediatric ICU stay in children with CHD. In affected patients, pulmonary impairment with typical symptoms appears. Under certain circumstances, a complication-rich perioperative infection with human metapneumovirus could be prevented in paediatric cardiac high-risk patients by prophylactic hygiene intervention.

Keywords

Paediatric cardiac intensive carehuman metapneumovirusCOVID-19 pandemicCHDsAtelectasisindividual hygiene standards
Type
Original Article
Information
Cardiology in the Young , Volume 33 , Issue 9 , September 2023 , pp. 1517 - 1522
Check for updates
Copyright
© The Author(s), 2022. Published by Cambridge University Press

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Moynihan, K, Barlow, A, Alphonso, N, et al. Impact of viral respiratory pathogens on outcomes after pediatric cardiac surgery. Pediatr Crit Care Med. 2017; 18: 219–227.10.1097/PCC.0000000000001083CrossRefGoogle ScholarPubMed
Li, X, Wang, X, Li, S, Zeng, M, Li, D. Viral respiratory infection, a risk in pediatric cardiac surgery: a propensity-matched analysis. Pediatr Crit Care Med 2020; 21: e431–e40.10.1097/PCC.0000000000002308CrossRefGoogle ScholarPubMed
Spaeder, MC, Carson, KA, Vricella, LA, Alejo, DE, Holmes, KW. Impact of the viral respiratory season on postoperative outcomes in children undergoing cardiac surgery. Pediatr Cardiol. 2011; 32: 801–806.10.1007/s00246-011-9985-9CrossRefGoogle ScholarPubMed
Williams, JV, Harris, PA, Tollefson, SJ, et al. Human metapneumovirus and lower respiratory tract disease in otherwise healthy infants and children. N Engl J Med. 2004; 350: 443–450.10.1056/NEJMoa025472CrossRefGoogle ScholarPubMed
Osterhaus, A, Fouchier, R. Human metapneumovirus in the community. Lancet. 2003; 361: 890–891.10.1016/S0140-6736(03)12785-7CrossRefGoogle ScholarPubMed
Shafagati, N, Williams, J. Human metapneumovirus - what we know now. F1000Res 2018; 7: 135.10.12688/f1000research.12625.1CrossRefGoogle ScholarPubMed
Scheuerman, O, Barkai, G, Mandelboim, M, Mishali, H, Chodick, G, Levy, I. Human metapneumovirus (hMPV) infection in immunocompromised children. J Clin Virol. 2016; 83: 12–16.10.1016/j.jcv.2016.06.006CrossRefGoogle ScholarPubMed
Edwards, KM, Zhu, Y, Griffin, MR, et al. Burden of human metapneumovirus infection in young children. N Engl J Med. 2013; 368: 633–643.10.1056/NEJMoa1204630CrossRefGoogle ScholarPubMed
Rigal, E, Maakaroun-Vermesse, Z, Gaudy-Graffin, C, et al. [Epidemiological and clinical description of human metapneumovirus infectious diseases in children]. Arch Pediatr. 2010; 17: 26–33.10.1016/j.arcped.2009.10.008CrossRefGoogle ScholarPubMed
Eggleston, HA, Gunville, CF, Miller, JI, Sontag, MK, Mourani, PM. A comparison of characteristics and outcomes in severe human metapneumovirus and respiratory syncytial virus infections in children treated in an intensive care unit. Pediatr Infect Dis J. 2013; 32: 1330–1334.10.1097/INF.0b013e3182a2261bCrossRefGoogle Scholar
Martin, GR, Jonas, RA. Surgery for congenital heart disease: improvements in outcomes. Am J Perinatol. 2018; 35: 557–560.Google ScholarPubMed
Russell, CJ, Penkert, RR, Kim, S, Hurwitz, JL. Human metapneumovirus: a largely unrecognized threat to human health. Pathogens 2020; 9: 109.10.3390/pathogens9020109CrossRefGoogle ScholarPubMed
Vasquez-Hoyos, P, Diaz-Rubio, F, Monteverde-Fernandez, N, et al. Reduced PICU respiratory admissions during COVID-19. Arch Dis Child 2020 Google ScholarPubMed
Mellin-Olsen, J, Staender, S, Whitaker, DK, Smith, AF. The helsinki declaration on patient safety in anaesthesiology. Eur J Anaesthesiol. 2010; 27: 592–597.10.1097/EJA.0b013e32833b1adfCrossRefGoogle ScholarPubMed
Geier, L, Menzel, C, Germund, I, Trieschmann, U. RACHS-1 score as predictive factor for postoperative ventilation time in children with congenital heart disease. Cardiol Young. 2020; 30: 213–218.10.1017/S1047951120000025CrossRefGoogle ScholarPubMed
Jenkins, KJ, Gauvreau, K, Newburger, JW, Spray, TL, Moller, JH, Iezzoni, LI. Consensus-based method for risk adjustment for surgery for congenital heart disease. J Thorac Cardiovasc Surg. 2002; 123: 110–118.10.1067/mtc.2002.119064CrossRefGoogle ScholarPubMed
Morrow, BM, Hatherill, M, Smuts, HE, Yeats, J, Pitcher, R, Argent, AC. Clinical course of hospitalised children infected with human metapneumovirus and respiratory syncytial virus. J Paediatr Child Health. 2006; 42: 174–178.10.1111/j.1440-1754.2006.00825.xCrossRefGoogle ScholarPubMed
Hilmes, MA, Daniel Dunnavant, F, Singh, SP, et al. Chest radiographic features of human metapneumovirus infection in pediatric patients. Pediatr Radiol. 2017; 47: 1745–1750.10.1007/s00247-017-3943-5CrossRefGoogle ScholarPubMed
Kuitunen, I, Artama, M, Makela, L, Backman, K, Heiskanen-Kosma, T, Renko, M. Effect of social distancing due to the COVID-19 pandemic on the incidence of viral respiratory tract infections in children in Finland during early 2020. Pediatr Infect Dis J 2020; 39: e423–e7.10.1097/INF.0000000000002845CrossRefGoogle Scholar
Ye, J. Pediatric mental and behavioral health in the period of quarantine and social distancing with COVID-19. JMIR Pediatr Parent 2020; 3: e19867.10.2196/19867CrossRefGoogle ScholarPubMed