The changing etiology of NICU-Admitted neonatal viral pneumonia: A multiplex RT-PCR era snapshot

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Objective: Viral pathogens are an important cause of lower respiratory tract infection (LRTI) leading to hospitalization in neonates and young infants. This study evaluated the etiologic distribution, clinical course, and management of multiplex RT-PCR–confirmed LRTI among neonatal intensive care unit (NICU) admissions. Materials and Methods: Between September 2022 and November 2023, neonates admitted to the NICU with LRTI and a positive respiratory viral panel (multiplex RT-PCR) were retrospectively analyzed (n=44). Disease severity at admission was assessed using the Downes score. Demographics, seasonality, respiratory support, treatments, and outcomes were recorded. Correlations between Downes score, oxygen requirement (FiO₂), and length of stay were examined. Results: Median age at admission was 17 days (range: 1–45). Admissions peaked in January (29.5%) and November (18.1%). The most common presenting findings were respiratory distress/tachypnea, cough, and feeding difficulties. Median Downes score was 2 (range: 1–8) and median FiO₂ requirement was 31% (range: 25–45%). Respiratory support was required in 32 infants: mechanical ventilation in 11.4% (n=5), non-invasive ventilation in 22.7% (n=10), and supplemental oxygen in 38.6% (n=17). The most common agents were SARS-CoV-2 (n=22; 50%) and respiratory syncytial virus (RSV) ( n=14; 31.8%). Downes score correlated positively with FiO₂ (r=0.39, p=0.008) and length of hospital stay (r=0.42, p=0.004). Oseltamivir was administered to three infants with influenza. Median length of stay was 6 days (range: 2–56) and no mortality occurred. Conclusion: In this multiplex RT-PCR era snapshot, SARS-CoV-2 and RSV predominated among NICU-admitted neonates and young infants with viral LRTI. Management was primarily supportive, and admission Downes score may help anticipate oxygen requirement and hospitalization duration.

Ce résumé expose les affirmations des auteurs. BNTIC ne l’interprète pas comme une validation indépendante des résultats.