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인간 코로나 바이러스를 중심으로 2017-2019년 소아청소년 호흡기 바이러스 감염증의 역학 및 특성: 경기 북서부지역 단일기관의 후향적 연구

Epidemiology and Characteristics of Pediatric Respiratory Virus Infection From 2017 to 2019 Focusing on Human Coronavirus: A Retrospective Study of a Single Center in Northwestern Gyeonggi-do

  • 투고 : 2022.08.12
  • 심사 : 2023.06.19
  • 발행 : 2023.08.25

초록

목적: Coronavirus disease 2019 (COVID-19) 발생 이후 인간 코로나바이러스를 포함한 호흡기 바이러스의 패턴에 변화가 있을 것으로 생각되어, COVID-19 발생 이전 경기도 명지병원에 급성 호흡기 감염증으로 입원한 소아청소년을 대상으로 바이러스 감염의 패턴을 보고하였다. 방법: 2017년 1월부터 2019년 12월까지 급성 호흡기 감염증으로 명지병원에 입원한 18세 이하 소아청소년을 대상으로 하였고 real-time reverse transcription polymerase chain reaction (RT-PCR) 결과를 바탕으로 후향적으로 의무기록을 고찰하였다. 결과: 총 3,557명 중에서 중복감염 포함하여 3,686건의 바이러스가 검출되었고 평균 양성률은 78.6%이었으며 여름에 비해 겨울에 PCR 양성률이 높았다. 파라인플루엔자바이러스, 메타뉴모바이러스, 보카바이러스는 4-6월에 주로 검출되고, 인간엔테로바이러스는 7-9월에, 호흡기세포융합바이러스와 인플루엔자바이러스는 겨울철에 주로 검출되었다. 진단별로 인두편도염에서는 아데노바이러스가 가장 많았고 폐렴에서는 호흡기세포융합바이러스가 가장 많이 검출되었다. 인간 코로나 바이러스는 겨울철에 주로 검출되었으며, 크루프 환자 중에서 3번째 높은 빈도로 나타났다. 결론: 본 연구결과가 이전에 보고되었던 소아청소년의 호흡기 바이러스 역학과 크게 다르지 않았다. 또한 COVID-19 발생 이후 호흡기 바이러스 패턴 비교 연구에 도움이 되고자 COVID-19 발생 이전 호흡기 바이러스 역학정보를 보고하는 바이다.

Purpose: A change is expected in the pattern of respiratory viruses including human coronavirus (HCoV) after the coronavirus disease 2019 (COVID-19) outbreak. Accordingly, identifying the distribution of respiratory viruses before the COVID-19 outbreak is necessary. Methods: We retrospectively analyzed the results of samples of nasal swabs collected from children under aged ≤18 years who were hospitalized at Myongji Hospital, Gyeonggi-do due to acute respiratory infections from 2017 to 2019. Viruses were detected by real-time reverse transcription polymerase chain reaction (RT-PCR). Results: Out of 3,557 total patients, 3,686 viruses were detected with RT-PCR including coinfections. Of the 3,557 patients, 2,797 (78.6%) were confirmed as PCR-positive. Adenovirus and human rhinovirus (hRV) were detected throughout the year, and human enterovirus was most detected during summer. Respiratory syncytial virus, influenza virus, and HCoV were prevalent in winter. In patients with croup, parainfluenza virus was most frequently detected, followed by hRV and HCoV. The PCR positive rate in summer and winter differed significantly. Conclusions: Respiratory virus patterns in northwestern Gyeonggi-do were not much different from previously reported data. The data reported herein regarding respiratory virus epidemiological information before the COVID-19 outbreak can be used for use in comparative studies of respiratory virus patterns after the COVID-19 outbreak.

키워드

참고문헌

  1. Kim KH, Kim JH, Kim KH, Kang C, Kim KS, Chung HM, et al. Identification of viral pathogens for lower respiratory tract infection in children at Seoul during autumn and winter seasons of the year of 2008-2009. Korean J Pediatr Infect Dis 2010;17:49-55. https://doi.org/10.14776/kjpid.2010.17.1.49
  2. Jeong JW, Hwang YH, Cho KS, Jung MJ, Min SK, Kim SJ, et al. Viral etiology and epidemiology of outpatients with acute respiratory illnesses in Busan: 2007-2008. Korean J Pediatr Infect Dis 2010;17:130-6. https://doi.org/10.14776/kjpid.2010.17.2.130
  3. Kwon YR, Cho WJ, Kim HM, Lee JM. Single or dual infection with respiratory syncytial virus and human rhinovirus: epidemiology and clinical characteristics in hospitalized children in a rural area of South Korea. Pediatr Infect Vaccine 2019;26:99-111. https://doi.org/10.14776/piv.2019.26.e11
  4. Lee C, Ki M. Strengthening epidemiologic investigation of infectious diseases in Korea: lessons from the Middle East Respiratory Syndrome outbreak. Epidemiol Health 2015;37:e2015040.
  5. Park S, Michelow IC, Choe YJ. Shifting patterns of respiratory virus activity following social distancing measures for Coronavirus Disease 2019 in South Korea. J Infect Dis 2021;224:1900-6. https://doi.org/10.1093/infdis/jiab231
  6. Park JY, Kim HI, Kim JH, Park S, Hwang YI, Jang SH, et al. Changes in respiratory virus infection trends during the COVID-19 pandemic in South Korea: the effectiveness of public health measures. Korean J Intern Med 2021;36:1157-68. https://doi.org/10.3904/kjim.2021.026
  7. Kim JH, Roh YH, Ahn JG, Kim MY, Huh K, Jung J, et al. Respiratory syncytial virus and influenza epidemics disappearance in Korea during the 2020-2021 season of COVID-19. Int J Infect Dis 2021;110:29-35. https://doi.org/10.1016/j.ijid.2021.07.005
  8. Huh K, Jung J, Hong J, Kim M, Ahn JG, Kim JH, et al. Impact of nonpharmaceutical interventions on the incidence of respiratory infections during the coronavirus disease 2019 (COVID-19) outbreak in Korea: a nationwide surveillance study. Clin Infect Dis 2021;72:e184-91. https://doi.org/10.1093/cid/ciaa1682
  9. V'kovski P, Kratzel A, Steiner S, Stalder H, Thiel V. Coronavirus biology and replication: implications for SARS-CoV-2. Nat Rev Microbiol 2021;19:155-70. https://doi.org/10.1038/s41579-020-00468-6
  10. Roh EJ, Chang YP, Kim JK, Rheem IS, Park KS, Chung EH. Clinical significance of codetection of the causative agents for acute respiratory tract infection in hospitalized children. Korean J Pediatr 2009;52:661-6. https://doi.org/10.3345/kjp.2009.52.6.661
  11. Lambert SB, Whiley DM, O'Neill NT, Andrews EC, Canavan FM, Bletchly C, et al. Comparing nose-throat swabs and nasopharyngeal aspirates collected from children with symptoms for respiratory virus identification using real-time polymerase chain reaction. Pediatrics 2008;122:e615-20. https://doi.org/10.1542/peds.2008-0691
  12. Park JS, Choi YJ, Nam HS, Kim YB, Park K. Comparison of nasopharyngeal aspirates and nasal swabs for the detection of respiratory viruses by multiplex RT-PCR. Allergy Asthma Respir Dis 2009;19:365-73.
  13. Choi EH, Lee HJ, Kim SJ, Eun BW, Kim NH, Lee JA, et al. The association of newly identified respiratory viruses with lower respiratory tract infections in Korean children, 2000-2005. Clin Infect Dis 2006;43:585-92. https://doi.org/10.1086/506350
  14. Kim KH, Lee JH, Sun DS, Kim YB, Choi YJ, Park JS, et al. Detection and clinical manifestations of twelve respiratory viruses in hospitalized children with acute lower respiratory tract infections: focus on human metapneumovirus, human rhinovirus and human coronavirus. Korean J Pediatr 2008;51:834-41. https://doi.org/10.3345/kjp.2008.51.8.834
  15. Chung JY, Han TH, Kim SW, Hwang ES. Respiratory picornavirus infections in Korean children with lower respiratory tract infections. Scand J Infect Dis 2007;39:250-4. https://doi.org/10.1080/00365540600999126
  16. Woo YR, Kim HJ, Kim MS, Koh HJ, Lee SG, Ahn YH. Clinical difference between single infection and coinfection with respiratory virus: the 2014 single-center study. Allergy Asthma Respir Dis 2016;4:360-8. https://doi.org/10.4168/aard.2016.4.5.360
  17. Lee SJ, Lee SH, Ha EK, Sheen YH, Sung MS, Jung YH, et al. Prevalence of respiratory virus infection with regard to age, sex, and seasonality factors: a single center experience against children hospitalized during the 10 years. Allergy Asthma Respir Dis 2017;5:320-5. https://doi.org/10.4168/aard.2017.5.6.320
  18. Monto AS. Epidemiology of viral respiratory infections. Am J Med 2002;112 Suppl 6A:4S-12S. https://doi.org/10.1016/S0002-9343(01)01058-0
  19. Kwon JW, Kim KW, Kim WK, Kim JK, Kim JH, Kim JT, et al. Hong Chang Eui Pediatrics. 12th ed. Seoul: Mirae-N Co., 2020:696-8.
  20. Kang YH, Lee DJ, Cho KS, Chung WS. Epidemiology of acute viral respiratory tract infections in Busan (2004-2006). Korean J Pediatr Infect Dis 2007;14:179-87. https://doi.org/10.14776/kjpid.2007.14.2.179
  21. Esposito S, Bosis S, Niesters HG, Tremolati E, Begliatti E, Rognoni A, et al. Impact of human coronavirus infections in otherwise healthy children who attended an emergency department. J Med Virol 2006;78:1609-15. https://doi.org/10.1002/jmv.20745
  22. Lim JS, Woo SI, Kwon HI, Baek YH, Choi YK, Hahn YS. Clinical characteristics of acute lower respiratory tract infections due to 13 respiratory viruses detected by multiplex PCR in children. Korean J Pediatr 2010;53:373-9. https://doi.org/10.3345/kjp.2010.53.3.373
  23. Park JS. Acute viral lower respiratory tract infections in children. Korean J Pediatr 2009;52:269-76. https://doi.org/10.3345/kjp.2009.52.3.269
  24. Borchers AT, Chang C, Gershwin ME, Gershwin LJ. Respiratory syncytial virus--a comprehensive review. Clin Rev Allergy Immunol 2013;45:331-79. https://doi.org/10.1007/s12016-013-8368-9
  25. Han TH, Chung JY, Kim SW, Hwang ES. Human coronavirus-NL63 infections in Korean children, 2004-2006. J Clin Virol 2007;38:27-31. https://doi.org/10.1016/j.jcv.2006.10.009
  26. Papadopoulos NG, Bates PJ, Bardin PG, Papi A, Leir SH, Fraenkel DJ, et al. Rhinoviruses infect the lower airways. J Infect Dis 2000;181:1875-84. https://doi.org/10.1086/315513
  27. Drysdale SB, Mejias A, Ramilo O. Rhinovirus - not just the common cold. J Infect 2017;74 Suppl 1:S41-6. https://doi.org/10.1016/S0163-4453(17)30190-1
  28. Jartti T, Korppi M. Rhinovirus-induced bronchiolitis and asthma development. Pediatr Allergy Immunol 2011;22:350-5. https://doi.org/10.1111/j.1399-3038.2011.01170.x