Respiratory viral infections in pediatric patients with hematopoietic stem cell transplantation

Abstract 
Background: Viral respiratory infections in pediatric patients with hematopoietic stem cell transplantation (HSCT) significant-ly impact morbidity and mortality. It is necessary to determine the viral agents and their frequency of presentation to unders-tand  their  impact  on  transplantation  patients’  evolution.  Methods:  From  January  2017  to  December  2019,  we  conducted  a  cross-sectional, descriptive, and observational study of patients who underwent HSCT with a viral respiratory infection. Viral identification was performed using multiplex polymerase chain reaction for nine respiratory viruses. Descriptive statistics were performed with a report of central tendency measures and percentages. Results: Of the 54 pediatric patients who underwent HSCT,  59.2%  presented  an  airway  infection;  in  turn,  at  least  one  viral  agent  was  identified  in  59.3%  of  these  patients.  The  most  frequent  viral  agents  were  influenza  (25.9%),  human  rhinovirus  (18.5%),  and  respiratory  syncytial  virus  (18.5%).  Viral  co-infections  occurred  in  36.8%  of  the  cases.  The  reported  complications  were  supplemental  oxygen  requirement  (73.6%),  support  with  mechanical  ventilation  (21%),  admission  to  the  pediatric  intensive  care  unit  (15.7%),  and  mortality  associated  with a viral respiratory infection (10.5%). Conclusions: Viral respiratory infections are frequent in pediatric patients with HSCT; influenza A/B virus was the most frequent agent. As morbidity and mortality increase due to these infections in patients with HSCT, strategies are necessary for its prevention and timely treatment after transplantation.