Evidence map›Paper›PMID 29498483›Full record

ArticleInfluenza and other respiratory viruses2018

Enterovirus D-68 in children presenting for acute care in the hospital setting.

Timothy J Savage, Jane Kuypers, Helen Y Chu, Miranda C Bradford, Anne Marie Buccat, Xuan Qin, Eileen J Klein, Keith R Jerome, Janet A Englund, Alpana Waghmare

Open access · goldAbstract read
In one paragraph

Article in Influenza and other respiratory viruses, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
0.3field-weighted citation impact, top 39% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

3 citing papers in PubMed, 5 citations in OpenAlex.

  1. Article
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

10 authors at 2 institutions in 1 country.

Timothy J SavageSeattle Children's Hospital, Seattle, WA, USA.ORCID 0000-0002-9528-7379
Jane KuypersUniversity of Washington, Seattle, WA, USA.
Helen Y ChuUniversity of Washington, Seattle, WA, USA.ORCID 0000-0001-8502-9600
Miranda C BradfordSeattle Children's Research Institute, Seattle, WA, USA.
Anne Marie BuccatSeattle Children's Hospital, Seattle, WA, USA.
Xuan QinSeattle Children's Hospital, Seattle, WA, USA.
Eileen J KleinSeattle Children's Hospital, Seattle, WA, USA.
Keith R JeromeUniversity of Washington, Seattle, WA, USA.
Janet A EnglundSeattle Children's Hospital, Seattle, WA, USA.
Alpana WaghmareSeattle Children's Hospital, Seattle, WA, USA.ORCID 0000-0003-2268-9470
Seattle Children's Hospital · USUniversity of Washington · US

Funding

Transform Dissemination and Implementation Science in CTSA ProgramsUL1TR002319 · NCATS · UNIVERSITY OF WASHINGTON · PI John K. Amory · 2017 to 2026
$100.0M
Institute of Translational Health SciencesUL1TR000423 · NCATS · UNIVERSITY OF WASHINGTON · PI DISIS, MARY L. · 2012 to 2016
$49.4M
Viral and Host Biomarkers of Human Rhinovirus Disease Severity in TransplantationK23AI114844 · NIAID · SEATTLE CHILDREN'S HOSPITAL · PI WAGHMARE, ALPANA AMALKANT · 2015 to 2019
$897k
Prospective Community-Based Study of RSV Risk Factors in Nepalese ChildrenK23AI103105 · NIAID · UNIVERSITY OF WASHINGTON · PI CHU, HELEN YING-HUI · 2013 to 2017
$897k
NCATS NIH HHS UL1 TR000423NCATS NIH HHS UL1 TR002319NIAID NIH HHS K23 AI103105NIAID NIH HHS K23 AI114844
6 · The paper itself

Abstract

backgroundSevere respiratory disease associated with enterovirus D68 (EV-D68) has been reported in hospitalized pediatric patients. Virologic and clinical characteristics of EV-D68 infections exclusively in patients presenting to a hospital Emergency Department (ED) or urgent care have not been well defined.

methodsMid-nasal swabs from pediatric patients with respiratory symptoms presenting to the ED or urgent care were evaluated using a commercial multiplex PCR platform. Specimens positive for rhinovirus/enterovirus (HRV/EV) were subsequently tested using real-time reverse-transcriptase PCR for EV-D68. The PCR cycle threshold (CT) was used as a viral load proxy. Clinical outcomes were compared between patients with EV-D68 and patients without EV-D68 who tested positive for HRV/EV.

resultsFrom August to December 2014, 511 swabs from patients with HRV/EV were available. EV-D68 was detected in 170 (33%) HRV/EV-positive samples. In multivariable models adjusted for age and underlying asthma, patients with EV-D68 were more likely to require hospitalization for respiratory reasons (odds ratio (OR): 3.11, CI: 1.85-5.25), require respiratory support (OR: 1.69, CI: 1.09-2.62), have confirmed/probable lower respiratory tract infection (LRTI; OR: 3.78, CI: 2.03-7.04), and require continuous albuterol or steroids (OR: 3.91, CI: 2.22-6.88 and OR: 4.73, CI: 2.65-8.46, respectively). Higher EV-D68 viral load was associated with need for respiratory support and LRTI in multivariate models.

conclusionsAmong pediatric patients presenting to the ED or urgent care, EV-D68 causes more severe disease than non-EV-D68 HRV/EV independent of underlying asthma. High viral load was associated with worse clinical outcomes. Rapid and quantitative viral testing may help identify and risk stratify patients.

Indexed as

AdolescentAmbulatory CareChildChild, PreschoolEnterovirus D, HumanEnterovirus InfectionsFemaleHospitalsHumansInfantMaleOdds RatioRespiratory Tract InfectionsWashingtonYoung Adultenterovirusenterovirus-D68respiratory infectionrhinovirus

Identifiers

PMID29498483
PMCPMC6005627
OpenAlexW2793706590

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.