Comparative Study On The Clinical Characteristics Of Wheezing Pneumonia And Non-wheezing Pneumonia In HCMV Infection Of Lower Respiratory Tract In Children Under 6 Years Old

Objectives: Respiratory tract infection is a common disease in pediatrics,mostly caused by viral or bacterial infection,and respiratory wheezing symptoms are mostly related to viral infection.Severe wheezing can lead to dyspnea aggravation,which seriously endangers children’s life and health.Although there is no confirmed relationship between wheezing and Human cytomegalovirus infection in children,it has been found that HCMV plays a role in prolonging the duration of wheezing and aggravating the degree of wheezing in children.The aim of this study is to investigate the clinical features of asthmatic and non-asthmatic pneumonia with HCMV infection in children under6 years old and the relationship between HCMV viral load in bronchoalveolar lavage fluid and clinical features.Methods: From July 2020 to July 2022,58 children who were hospitalized for lower respiratory tract infection(LRTI)in the Department of Pediatrics of Guilin People’s Hospital and underwent bronchoscopy during the hospitalization period were selected to obtain alveolar lavage fluid for HCMV nucleic acid testing,and 58 children with positive HCMV nucleic acid quantification by BALF were selected for the study.The study group consisted of 29 children with positive quantification of HCMV nucleic acid detected by BALF with wheezing,and the control group consisted of 29 children with positive quantification of HCMV nucleic acid detected by BALF without wheezing.General information,clinical characteristics,laboratory examination,imaging results,cytomegalovirus load,lung function,exhaled nitric oxide,and the number of days of wheezing were collected from the children,and statistical analysis was performed.Results:1.Pneumonia associated with HCMV lower respiratory tract infection was distributed all year round,and was more common in winter and spring,with 39/58(67.24%)in winter and spring.The group of <2 years old was more than that of ≥2 years old and <4 years old group,≥4 years old and <6 years old group(P<0.05).2.The incidence of mixed pathogen infection in the study group was higher than that in the control group(P<0.05).The viral load of bronchoalveolar lavage fluid in the study group was higher than that in the control group(P<0.05).The high viral load group had a significantly higher incidence rate of wheezing than the low viral load group(P<0.05).3.The mean values of TPTEF/TE and VPEF/VE in the study group were lower than those in the control group(P<0.05).4.The duration of wheezing in the study group was shorter than that in the control group(P=0.000).Conclusions: 1.Pneumonia associated with HCMV lower respiratory tract infection was distributed all year round,and was more common in winter and spring.Wheezing pneumonia mainly occurred in children under 2 years old.2.The high risk factors of wheezing after lower respiratory tract HCMV infection are mixed infection of more than two pathogens and the increase of cytomegalovirus load in bronchoalveolar lavage fluid.3.The decrease of obstructive tidal function in asthmatic pneumonia with HCMV infection of lower respiratory tract was more obvious than that in non-asthmatic pneumonia.4.Application of ganciclovir in the treatment of lower respiratory tract HCMV infected asthmatic pneumonia can shorten the duration of wheezing.