Authors
Keerthana M R, Shukla Das, Charu Jain, Pooja Dewan, Rumpa Saha, Praveen Kumar Singh, Sajad Ahmad Dar
Published in
Journal of medical virology. Volume 98. Issue 10. Pages e71180.
Abstract
Children with lymphoreticular malignancies are highly vulnerable to respiratory viral infections (RVIs) because of disease- and chemotherapy-related immunosuppression, yet data on their epidemiology, clinical spectrum, and outcomes from resource-limited settings remain scarce. This study aimed to characterize the seasonal distribution, clinical presentation, and outcomes of RVIs other than SARS-CoV-2 in febrile children with lymphoreticular malignancies at a tertiary care centre in India. In this prospective, descriptive, cross-sectional study (May 2023-November 2024), 33 children under 12 years of age with lymphoreticular malignancies were enrolled at a tertiary care centre in Delhi, India, contributing 70 febrile episodes with respiratory symptoms. All episodes were screened for SARS-CoV-2 by rapid antigen test at admission, independent of the viral PCR panel, and none tested positive. Nasopharyngeal swabs were analyzed by multiplex real-time PCR (TRUPCR® Respiratory Viral Pathogen Panel Kit, 3B BlackBio, Bhopal, India; CFX96™, Bio-Rad, Hercules, CA, USA) targeting 18 other respiratory viral pathogens. Respiratory viruses were detected in 34% of episodes (24/70). The most prevalent viruses identified were human coronavirus (HCoV α/β, 21%), human rhinovirus (HRV, 17%), human parainfluenza virus type 3 (HPIV-3, 13%), influenza A (IAV,13%), and human adenovirus (HAdV, 13%). Co-infections occurred in 13% of virus-positive episodes, with HAdV being the predominant co-pathogen. Upper respiratory tract infections (URTI) predominated (87%). Among virus-positive episodes, breathlessness (p = 0.005), URTI/LRTI classification (p < 0.001), erythrocyte sedimentation rate (ESR; p < 0.001), and abnormal chest radiography (p < 0.001) were significantly associated with viral status. Two patients (6%) died, both attributed to lower respiratory tract infection (LRTI) caused by human parainfluenza virus type 4 (HPIV-4). The remaining 66% of episodes were PCR-negative. No SARS-CoV-2 was detected in this cohort at any point during the study period. In approximately one-third of febrile episodes of children with hematologic malignancies, a viral pathogen could be detected. Both fatalities in this cohort were associated with HPIV-4-related LRTI; although the numbers are small, this finding warrants clinical attention and continued epidemiological surveillance in this population. Multiplex PCR supports targeted management; prospective, multicentre stewardship studies are needed.
PMID:
42891561
Bibliographic data and abstract were imported from PubMed on 18 Oct 2026.
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