Comparación de la gravedad de la infección por adenovirus y virus sincitial respiratorio en niños con insuficiencia respiratoria aguda en cuidados intensivos: un estudio multicéntrico de LARed en América Latina entre 2017 y 2022.

Introducción y objetivos: Las infecciones virales son la causa más frecuente de fallo respiratorio agudo (FRA) y la primera causa de ingreso a cuidados intensivos pediátricos (UCIp) en niños. El tipo de agente viral identificado influye en el curso de la enfermedad. La infección por adenovirus es un...

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2023
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Universidad del Rosario
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Repositorio EdocUR - U. Rosario
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https://doi.org/10.48713/10336_40178
https://repository.urosario.edu.co/handle/10336/40178
Palabra clave:
Niño
Falla respiratoria aguda
Adenovirus
Virus sincitial respiratorio
Child
Acute respiratory failure
Adenovirus
Respiratory syncytial virus
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id EDOCUR2_7ae9819d6e11dced4a9caacbb85f39b6
oai_identifier_str oai:repository.urosario.edu.co:10336/40178
network_acronym_str EDOCUR2
network_name_str Repositorio EdocUR - U. Rosario
repository_id_str
dc.title.none.fl_str_mv Comparación de la gravedad de la infección por adenovirus y virus sincitial respiratorio en niños con insuficiencia respiratoria aguda en cuidados intensivos: un estudio multicéntrico de LARed en América Latina entre 2017 y 2022.
dc.title.TranslatedTitle.none.fl_str_mv Comparison of the severity of adenovirus and respiratory syncytial virus infections in children with acute respiratory failure in intensive care: a multicenter study by LARed in Latin America between 2017 and 2022.
title Comparación de la gravedad de la infección por adenovirus y virus sincitial respiratorio en niños con insuficiencia respiratoria aguda en cuidados intensivos: un estudio multicéntrico de LARed en América Latina entre 2017 y 2022.
spellingShingle Comparación de la gravedad de la infección por adenovirus y virus sincitial respiratorio en niños con insuficiencia respiratoria aguda en cuidados intensivos: un estudio multicéntrico de LARed en América Latina entre 2017 y 2022.
Niño
Falla respiratoria aguda
Adenovirus
Virus sincitial respiratorio
Child
Acute respiratory failure
Adenovirus
Respiratory syncytial virus
title_short Comparación de la gravedad de la infección por adenovirus y virus sincitial respiratorio en niños con insuficiencia respiratoria aguda en cuidados intensivos: un estudio multicéntrico de LARed en América Latina entre 2017 y 2022.
title_full Comparación de la gravedad de la infección por adenovirus y virus sincitial respiratorio en niños con insuficiencia respiratoria aguda en cuidados intensivos: un estudio multicéntrico de LARed en América Latina entre 2017 y 2022.
title_fullStr Comparación de la gravedad de la infección por adenovirus y virus sincitial respiratorio en niños con insuficiencia respiratoria aguda en cuidados intensivos: un estudio multicéntrico de LARed en América Latina entre 2017 y 2022.
title_full_unstemmed Comparación de la gravedad de la infección por adenovirus y virus sincitial respiratorio en niños con insuficiencia respiratoria aguda en cuidados intensivos: un estudio multicéntrico de LARed en América Latina entre 2017 y 2022.
title_sort Comparación de la gravedad de la infección por adenovirus y virus sincitial respiratorio en niños con insuficiencia respiratoria aguda en cuidados intensivos: un estudio multicéntrico de LARed en América Latina entre 2017 y 2022.
dc.contributor.advisor.none.fl_str_mv Vasquez Hoyos, Pablo
dc.subject.none.fl_str_mv Niño
Falla respiratoria aguda
Adenovirus
Virus sincitial respiratorio
topic Niño
Falla respiratoria aguda
Adenovirus
Virus sincitial respiratorio
Child
Acute respiratory failure
Adenovirus
Respiratory syncytial virus
dc.subject.keyword.none.fl_str_mv Child
Acute respiratory failure
Adenovirus
Respiratory syncytial virus
description Introducción y objetivos: Las infecciones virales son la causa más frecuente de fallo respiratorio agudo (FRA) y la primera causa de ingreso a cuidados intensivos pediátricos (UCIp) en niños. El tipo de agente viral identificado influye en el curso de la enfermedad. La infección por adenovirus es una de las infecciones más agresivas, aunque no es la más prevalente. Este estudio tiene como objetivo comparar el curso clínico de la infección por adenovirus en relación con la infección por virus sincitial respiratorio (VSR), que es el agente más frecuente implicado en el fallo respiratorio en niños. Métodos: Se llevó a cabo un análisis secundario del registro concurrente de fallo respiratorio agudo de LARed en pacientes pediátricos ingresados en UCIP por FRA secundario a infección respiratoria por adenovirus o VSR entre abril de 2017 y diciembre de 2022. El desenlace primario de gravedad se definió como la estancia hospitalaria, mientras que los desenlaces secundarios incluyeron mortalidad y nueva morbilidad. Se compararon los grupos virales y la estancia mediante análisis de supervivencia ajustada por mortalidad y factores de confusión mediante un modelo de riesgos competitivos. Para los desenlaces secundarios de mortalidad y nueva morbilidad se evaluó como un desenlace compuesto mediante regresión logística multivariada. Resultados: En total, se incluyeron 3,014 pacientes en el estudio, de los cuales 182 presentaban infección por AdV y 2,832 por VSR. La mediana de edad fue de 3.9 meses [RIC 1.8-86], el 62% eran hombres y el 38% mujeres. Previa al ingreso hospitalario, el 32% de los pacientes presentaba comorbilidades, siendo la prematuridad la más frecuente. En comparación con el grupo de pacientes con VSR, los pacientes con infección por AdV presentaron con mayor frecuencia ingreso por neumonía (29% Vs 17%, p<0.01), mayor mediana de edad (8,2 meses Vs 3,7 meses, p<0,01) y mayor frecuencia de comorbilidades (42,7% Vs 32,2, p<0,01). La infección por AdV se asoció con un aumento en la estancia hospitalaria (HR 0,74, IC 95% 0,61-0,89), y mortalidad y morbilidad (ORa 6,15, IC 95% 2,78-13,57). Otros factores que se asociaron con mayor gravedad de la infección fueron: edad, antecedente displasia broncopulmonar, antecedente de daño pulmonar crónico y diagnóstico de neumonía.
publishDate 2023
dc.date.accessioned.none.fl_str_mv 2023-07-17T16:09:13Z
dc.date.available.none.fl_str_mv 2023-07-17T16:09:13Z
dc.date.created.none.fl_str_mv 2023-07-07
dc.date.embargoEnd.none.fl_str_mv info:eu-repo/date/embargoEnd/2025-07-19
dc.type.none.fl_str_mv bachelorThesis
dc.type.coar.fl_str_mv http://purl.org/coar/resource_type/c_7a1f
dc.type.document.none.fl_str_mv Trabajo de grado
dc.type.spa.none.fl_str_mv Trabajo de grado
dc.identifier.doi.none.fl_str_mv https://doi.org/10.48713/10336_40178
dc.identifier.uri.none.fl_str_mv https://repository.urosario.edu.co/handle/10336/40178
url https://doi.org/10.48713/10336_40178
https://repository.urosario.edu.co/handle/10336/40178
dc.language.iso.none.fl_str_mv spa
language spa
dc.rights.*.fl_str_mv Attribution-ShareAlike 4.0 International
dc.rights.coar.fl_str_mv http://purl.org/coar/access_right/c_f1cf
dc.rights.acceso.none.fl_str_mv Restringido (Temporalmente bloqueado)
dc.rights.uri.*.fl_str_mv http://creativecommons.org/licenses/by-sa/4.0/
rights_invalid_str_mv Attribution-ShareAlike 4.0 International
Restringido (Temporalmente bloqueado)
http://creativecommons.org/licenses/by-sa/4.0/
http://purl.org/coar/access_right/c_f1cf
dc.format.extent.none.fl_str_mv 59
dc.format.mimetype.none.fl_str_mv application/pdf
dc.publisher.spa.fl_str_mv Universidad del Rosario
dc.publisher.department.spa.fl_str_mv Escuela de Medicina y Ciencias de la Salud
dc.publisher.program.spa.fl_str_mv Maestría en Epidemiología
institution Universidad del Rosario
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spelling Vasquez Hoyos, Pablo782cf527-e2c5-4841-92b7-f2403109da1a-1Barajas Romero, Juan SebastianMagíster en EpidemiologíaMaestríaFull time36dd6dff-a667-44f3-8b04-07694c26f140-12023-07-17T16:09:13Z2023-07-17T16:09:13Z2023-07-07info:eu-repo/date/embargoEnd/2025-07-19Introducción y objetivos: Las infecciones virales son la causa más frecuente de fallo respiratorio agudo (FRA) y la primera causa de ingreso a cuidados intensivos pediátricos (UCIp) en niños. El tipo de agente viral identificado influye en el curso de la enfermedad. La infección por adenovirus es una de las infecciones más agresivas, aunque no es la más prevalente. Este estudio tiene como objetivo comparar el curso clínico de la infección por adenovirus en relación con la infección por virus sincitial respiratorio (VSR), que es el agente más frecuente implicado en el fallo respiratorio en niños. Métodos: Se llevó a cabo un análisis secundario del registro concurrente de fallo respiratorio agudo de LARed en pacientes pediátricos ingresados en UCIP por FRA secundario a infección respiratoria por adenovirus o VSR entre abril de 2017 y diciembre de 2022. El desenlace primario de gravedad se definió como la estancia hospitalaria, mientras que los desenlaces secundarios incluyeron mortalidad y nueva morbilidad. Se compararon los grupos virales y la estancia mediante análisis de supervivencia ajustada por mortalidad y factores de confusión mediante un modelo de riesgos competitivos. Para los desenlaces secundarios de mortalidad y nueva morbilidad se evaluó como un desenlace compuesto mediante regresión logística multivariada. Resultados: En total, se incluyeron 3,014 pacientes en el estudio, de los cuales 182 presentaban infección por AdV y 2,832 por VSR. La mediana de edad fue de 3.9 meses [RIC 1.8-86], el 62% eran hombres y el 38% mujeres. Previa al ingreso hospitalario, el 32% de los pacientes presentaba comorbilidades, siendo la prematuridad la más frecuente. En comparación con el grupo de pacientes con VSR, los pacientes con infección por AdV presentaron con mayor frecuencia ingreso por neumonía (29% Vs 17%, p<0.01), mayor mediana de edad (8,2 meses Vs 3,7 meses, p<0,01) y mayor frecuencia de comorbilidades (42,7% Vs 32,2, p<0,01). La infección por AdV se asoció con un aumento en la estancia hospitalaria (HR 0,74, IC 95% 0,61-0,89), y mortalidad y morbilidad (ORa 6,15, IC 95% 2,78-13,57). Otros factores que se asociaron con mayor gravedad de la infección fueron: edad, antecedente displasia broncopulmonar, antecedente de daño pulmonar crónico y diagnóstico de neumonía.Introduction and Objectives: Viral infections are the most common cause of acute respiratory failure (ARF) and the leading cause of admission to pediatric intensive care units (PICUs) in children. The type of viral agent identified influences the course of the disease. Adenovirus infection is one of the most aggressive infections, although it is not the most prevalent. This study aims to compare the clinical course of adenovirus infection in relation to respiratory syncytial virus (RSV) infection, which is the most frequent agent involved in respiratory failure in children. Methods: A secondary analysis of the concurrent registry of acute respiratory failure by LARed was conducted in pediatric patients admitted to the PICU due to ARF secondary to adenovirus or RSV respiratory infection between April 2017 and December 2022. The primary outcome of severity was defined as hospital stay, while secondary outcomes included mortality and new morbidity. Viral groups and hospital stay were compared using survival analysis adjusted for mortality and confounding factors through a competing risks model. For the secondary outcomes of mortality and new morbidity, a multivariate logistic regression was used to evaluate them as a composite outcome. Results: A total of 3,014 patients were included in the study, of whom 182 had AdV infection and 2,832 had RSV infection. The median age was 3.9 months [IQR 1.8-86], 62% were male, and 38% were female. Prior to hospital admission, 32% of patients had comorbidities, with prematurity being the most frequent. Compared to the VSR group, patients with AdV infection more frequently presented with pneumonia upon admission (29% vs. 17%, p < 0.01), had a higher median age (8.2 months vs. 3.7 months, p < 0.01), and had a higher frequency of comorbidities (42.7% vs. 32.2%, p < 0.01). AdV infection was associated with an increase in hospital stay (HR 0.74, 95% CI 0.61-0.89), as well as mortality and morbidity (aOR 6.15, 95% CI 2.78-13.57). Other factors associated with increased severity of infection were age, history of bronchopulmonary dysplasia, history of chronic lung injury, and pneumonia diagnosis. Conclusion: Adenovirus infection in pediatric patients with ARF was associated with longer hospital stays and increased risk of mortality and morbidity compared to those infected with RSV.59application/pdfhttps://doi.org/10.48713/10336_40178 https://repository.urosario.edu.co/handle/10336/40178spaUniversidad del RosarioEscuela de Medicina y Ciencias de la SaludMaestría en EpidemiologíaAttribution-ShareAlike 4.0 InternationalRestringido (Temporalmente bloqueado)EL AUTOR, manifiesta que la obra objeto de la presente autorización es original y la realizó sin violar o usurpar derechos de autor de terceros, por lo tanto la obra es de exclusiva autoría y tiene la titularidad sobre la misma. PARGRAFO: En caso de presentarse cualquier reclamación o acción por parte de un tercero en cuanto a los derechos de autor sobre la obra en cuestión, EL AUTOR, asumirá toda la responsabilidad, y saldrá en defensa de los derechos aquí autorizados; para todos los efectos la universidad actúa como un tercero de buena fe. EL AUTOR, autoriza a LA UNIVERSIDAD DEL ROSARIO, para que en los términos establecidos en la Ley 23 de 1982, Ley 44 de 1993, Decisión andina 351 de 1993, Decreto 460 de 1995 y demás normas generales sobre la materia, utilice y use la obra objeto de la presente autorización. -------------------------------------- POLITICA DE TRATAMIENTO DE DATOS PERSONALES. Declaro que autorizo previa y de forma informada el tratamiento de mis datos personales por parte de LA UNIVERSIDAD DEL ROSARIO para fines académicos y en aplicación de convenios con terceros o servicios conexos con actividades propias de la academia, con estricto cumplimiento de los principios de ley. 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Disponible en: 10.3389/FPED.2016.00128.Newth, Christopher J.L.; Venkataraman, Shekhar; Willson, Douglas F.; Meert, Kathleen L.; Harrison, Rick; Dean, J. Michael; Pollack, Murray; Zimmerman, Jerry; Anand, Kanwaljeet J.S.; Carcillo, Joseph A.; Nicholson, Carol E. (2009) Weaning and extubation readiness in pediatric patients. En: Pediatric Critical Care Medicine. Vol. 10; No. 1; pp. 1 - 11; Disponible en: https://journals.lww.com/pccmjournal/Abstract/2009/01000/Weaning_and_extubation_readiness_in_pediatric.1.aspx. Disponible en: 10.1097/PCC.0b013e318193724d.Nations, United; Affairs, Social; Division, Population (2019) World Population Prospects. Disponible en: https://population.un.org/wpp/publications/files/wpp2019_highlights.pdf.United Nations (2019) World Population Prospects 2019. 9789211483161; Disponible en: https://population.un.org/wpp/publications/files/wpp2019_highlights.pdf.instname:Universidad del Rosarioreponame:Repositorio Institucional EdocURNiñoFalla respiratoria agudaAdenovirusVirus sincitial respiratorioChildAcute respiratory failureAdenovirusRespiratory syncytial virusComparación de la gravedad de la infección por adenovirus y virus sincitial respiratorio en niños con insuficiencia respiratoria aguda en cuidados intensivos: un estudio multicéntrico de LARed en América Latina entre 2017 y 2022.Comparison of the severity of adenovirus and respiratory syncytial virus infections in children with acute respiratory failure in intensive care: a multicenter study by LARed in Latin America between 2017 and 2022.bachelorThesisTrabajo de gradoTrabajo de gradohttp://purl.org/coar/resource_type/c_7a1fEscuela de Medicina y Ciencias de la SaludORIGINALexport (1).risexport (1).risapplication/x-research-info-systems167022https://repository.urosario.edu.co/bitstreams/5c21de3b-93e2-4144-b774-8a2e63282632/downloadbbbf79eded4269115080cc9c485184a8MD54Comparacion-de -la-gravedad-de-la-infeccion-por-AdV-y-VSR-en-ninos.pdfComparacion-de -la-gravedad-de-la-infeccion-por-AdV-y-VSR-en-ninos.pdfapplication/pdf2418900https://repository.urosario.edu.co/bitstreams/9ec2cbb5-8817-4957-a08f-e343c5a70c98/downloadce82cb0b3634e9b9b21b92d20894aeb4MD56LICENSElicense.txtlicense.txttext/plain1483https://repository.urosario.edu.co/bitstreams/3679ce4a-68bf-4492-9dc2-23c7209bd37a/downloadb2825df9f458e9d5d96ee8b7cd74fde6MD53CC-LICENSElicense_rdflicense_rdfapplication/rdf+xml; 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