Unraveling the complexities: Clinical patterns and outcomes of Acute Lower Respiratory Tract Infection in post-covid19 pandemic

Abstract

Background: Acute lower respiratory tract infections (ARTI) with underlying aetiology mostly viral cause huge global burden in mobility and mortality, loss of work, financial burden, and antibiotic misuse. We planned to evaluate viral ARTI infections in children (September 2022 to August 2023). Methodology: This was a cross-sectional retrospective study and children admitted with ALRTI between1 month -18 years and; with virus isolation on nasopharyngeal/ bronchoalveolar lavage by Real time- Polymerase Chain Reaction (RT-PCR) were included. Results:  A total of 39 children were included of which most common etiology were Influenza (n=9), Respiratory syncitial Virus (RSV) (n=8), Rhinovirus (n=6) and Adenovirus (n=6). The presenting complaints were fever (97%; mean duration: 6.3 ± 5.7d), Cough (78%; mean duration: 7 ± 6.8d), breathing difficulty (77.14%), respiratory failure (34.3%), diarrhoea (48.57%), nasal discharge (30.7%) and wheezing (25.71%). Most children were infants (n=19) or toddlers (1-5 years: n=15).  Enrolled children had mean Haemoglobin (9.2±1.7 gm %), mean Total Leukocyte Count (11,875±6.314 cells/cmm, chest X-ray abnormalities (n=34), Contrast Enhanced CT chest (n=8) abnormalities (bronchiectasis/and bronchiolitis obliterans). The average hospital stay was 20.4 ± 40.1 days with high use of antibiotics (n=37) and steroids (n=9). Around 17.9 %( n=7)   children required intensive care admission. The outcome showed low mortality (n=1) and high recovery with 5.1% (n=2) of discharged requiring home oxygen. Conclusion: An understanding of aetiology of ALRTI may help to improve clinical care, guide, and reduce unnecessary antibiotic prescriptions in a hospital setting in India.