A Study On The Clinical Phenotypes Of Acute Respiratory Tract Infection Caused By RSV And The Diagnostic Value Of CLBP

Objective:To analyze the clinical phenotypes of acute respiratory tract infection caused by respiratory syncytial virus（RSV）and explore its diagnostic indicators for RSV infection.Methods:In this study,156 children with acute respitatory tract infection,1 month to 5 years of age,were admitted to the 3^rdAffiliated Hospital of Zunyi Medical University during November 2020–March 2021 and assigned in the research group based on all study inclusion criteria and any exclusion criteria.RSV subtypes were detected in nasal swabs by RPA（Recombinase polymerase amplification）.The patients were divided into RSV positive group（90 cases）and negative group（66cases）coding information from clinical manifestation,diagnosis and treatment,and follow-up.The clinical features of RSV infection group and control group were analyzed by SPSS 18.0 software,in which the combination of diagnostic indicators for RSV infection was implemented by means of logistic regression and ROC curve statistically.Results:1.The rate of contracting RSV is 57.7%with 90 positive cases（90/156）in nucleic acid testing,in which A Subtype accounts for 53%（83 in 156 cases）,B Subtype for 2%（3 in 156 cases）,A/B Subtype for 3%（4 in 156 cases）respectively.2.The following indexes in RSV positive group were significantly higher or lower than those in negative group:complications（90.0%,77.3%,P=0.030）（OR=2.647,95%CI 1.079-6.495,P=0.034）、bilateral pneumonia（93.2%,80.4%,P=0.032）（OR=3.317,95%CI 1.059-10.385,P=0.039）、platelets（51.8%,31.9%,P=0.037）（OR=3.197,95%CI 1.449-7.052,P=0.004）、Co-infection（77.8%,62.1%,P=0.033）（OR=2.134,95%CI 1.057-4.311,P=0.035）、the rate of monocytes>8%（56.4%,39.3%,P=0.046）,the rate of lymphocyte>4×10⁹/L（60.0%,83.9%,P=0.003）（OR=3.481,95%CI 1.511-8.022,P=0.003）、wheezing（37.9%,17.3%,P=0.014）,diarrhea（48.5%,26.9%,P=0.017）and re-admission due to respiratory tract infection（45.5%,25.0%,P=0.022）for 6 months after discharge.3.Logistic Regression analysis showed statistically significant differences in complications,lymphocyte,blateral pneumonia,platelets.Combine them into a joint diagnostic index called CLBP.Making ROC curve,the area under the curve was0.774,the sensitivity was 76.7%,the specificity was 70.4%.Conclusion:RSVA was the major infectious subtype in the study,CLBP combination has good specificity and sensitivity in the diagnosis and evaluation of respiratory tract infection related to RSV,and may provide valuable information for clinical prevention and treatment of RSV infection.