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Year : 2023  |  Volume : 7  |  Issue : 1  |  Page : 1

Viral respiratory infections and intensive care admissions during the pandemic

Department of Paediatrics, Chinese University of Hong Kong, Shatin, Hong Kong

Date of Submission24-Mar-2023
Date of Acceptance24-Mar-2023
Date of Web Publication07-Apr-2023

Correspondence Address:
Prof. Gary W K Wong
Department of Paediatrics, Prince of Wales Hospital, Chinese University of Hong Kong, Shatin, NT
Hong Kong
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/prcm.prcm_10_23

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How to cite this article:
Wong GW. Viral respiratory infections and intensive care admissions during the pandemic. Pediatr Respirol Crit Care Med 2023;7:1

How to cite this URL:
Wong GW. Viral respiratory infections and intensive care admissions during the pandemic. Pediatr Respirol Crit Care Med [serial online] 2023 [cited 2023 Jun 1];7:1. Available from: https://www.prccm.org/text.asp?2023/7/1/1/373838

As the world is slowly coming out from the coronavirus disease 2019 (COVID-19) pandemic, pediatricians and pediatric intensivists are facing new challenges. Young children who have been well protected from various common viral infections are now facing great danger of severe viral respiratory tract infections. Early data from New Zealand and Australia clearly showed a significant rebound of severe respiratory synctial virus infection in young children.[1],[2] In addition to respiratory synctial virus, other viral infections are coming back into the community. Asthmatics are at high risk of developing exacerbations precipitated by viral infections. In this issue, Nguyen et al.[3] reported a cross-sectional study in Vietnam demonstrating a high percentage of children with asthma exacerbations were found to have concomitant viral infections. The results are in line with results in other parts of the world. Strategies to reduce viral respiratory infections will potentially reduce asthma exacerbations in the population setting. The epidemiology of intensive care admission has experienced dramatic changes during the pandemic. Severe viral respiratory infections other than COVID-19 have decreased dramatically, whereas high rates of diabetic ketoacidosis (DKA) resulting in admission to intensive care units (ICUs) have been observed.[4],[5] Whang et al.[6] reported, in this issue, a large series of pediatric patients with ICU admission due to DKA within the period of pandemic. Interestingly, nonemergency room admission and younger age were identified as risk factors for longer ICU stay. It was likely that a delay in diagnosis was an important reason for the longer ICU stay for those transferred from other hospital wards instead of admitting directly from the emergency department where the diagnosis of DKA was made promptly. High index of suspicion is needed in order to facilitate early diagnosis of this potentially lethal condition. Pulmonary hemorrhage is an uncommon but potentially lethal condition affecting children especially for those with severe hemorrhage. Nathan et al[7] described five interesting cases of children who presented with possible pulmonary hemorrhage and discussed the diagnostic approach including the important differentiation of hemoptysis, hematemesis, or simple bleeding from the nose. I am sure readers will find these cases educational and the approach described will help them to manage future cases of possible pulmonary hemorrhage.

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  References Top

Eathorne A, Hills T, Bruce P, Beasley R. Respiratory syncytial virus: Paying the immunity debt with interest. Lancet Child Adolesc Health 2021;5:e44-5.  Back to cited text no. 1
Eden JS, Sikazwe C, Xie R, Deng YM, Sullivan SG, Michie A, et al; Australian RSV Study Group. Off-season RSV epidemics in Australia after easing of COVID-19 restrictions. Nat Commun 2022;13:2884.  Back to cited text no. 2
Nguyen TVT, Tran TA, Le VT, To KG. Virus infection and severe asthma exacerbations: A cross-sectional study in Children’s Hospital 1, Ho Chi Minh City, Vietnam. Pediatr Respirol Crit Care Med 2023;7:20-5.  Back to cited text no. 3
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Groves HE, Papenburg J, Mehta K, Bettinger JA, Sadarangani M, Halperin SA, et al; for members of the Canadian Immunization Monitoring Program Active (IMPACT). The effect of the COVID-19 pandemic on influenza-related hospitalization, intensive care admission and mortality in children in Canada: A population-based study . Lancet Reg Health Am 2022;7:100132.  Back to cited text no. 4
Al-Abdulrazzaq D, Alkandari A, Alhusaini F, Alenazi N, Gujral UP, Narayan KMV, et al; CODeR Group. Higher rates of diabetic ketoacidosis and admission to the paediatric intensive care unit among newly diagnosed children with type 1 diabetes in Kuwait during the COVID-19 pandemic. Diabetes Metab Res Rev 2022;38:e3506.  Back to cited text no. 5
Whang JE, Wu Y-L, Chen J-Y, Kor C-T, Lee M-S. Factors associated with prolonged intensive care unit treatment and organ failure in pediatric patients with diabetic ketoacidosis. Pediatr Respirol Crit Care Med 2023;7:13-9.  Back to cited text no. 6
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Nathan AM, Ying HS, Peng EK, Gowdh NFM, de Bruyne J. Approach to pulmonary haemorrhage in children: What could it be? Pediatr Respirol Crit Care Med 2023;7:2-12.  Back to cited text no. 7
  [Full text]  


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