Respiratory Virus Surveillance in Infants across Different Clinical Settings.

OBJECTIVES: We aimed to evaluate the distribution, clinical presentations and severity of common acute respiratory infections (ARI) viruses in infants across 3 clinical settings. STUDY DESIGN: In a prospective virus surveillance study, infants under 1 year with fever and/or respiratory symptoms were enrolled from outpatient, emergency department, and inpatient settings from December 16, 2019 through April 30, 2020. Demographic and clinical characteristics were collected through parent/guardian interviews, medical chart abstractions, and follow-up surveys. Nasal swabs were collected and tested for viruses using quantitative reverse-transcription polymerase chain reaction. RESULTS: We enrolled 366 infants and tested nasal swabs on 360 (98%); median age was 6.3 months, 50% male. In total, 295 (82%) had at least 1 virus detected; rhinovirus/enterovirus (RV/EV; 42%), respiratory syncytial virus (RSV; 34%), and influenza (15%) were the most common. RSV was the most frequently detected virus in the inpatient (63%) and emergency department (37%) settings, and RV/EV was most frequently detected virus in the outpatient setting (54%). RSV-positive infants had a lower median age (4.9 months) and were more likely to have respiratory distress, and RV/EV-positive infants were less likely to have respiratory distress. Influenza-positive infants had a higher median age (8 months) and were more likely to have systemic symptoms. RSV infection and younger age were associated with higher odds of hospitalization in multivariable logistic regression. CONCLUSIONS: Across 3 clinical settings, and combining virologic, patient, and health-system information, our results highlight the burden of viral ARI among infants. Overall, RSV, RV/EV, and influenza were most commonly detected, with RSV having the highest disease severity.

Association between blood pressure and carotid intima-media thickness.

OBJECTIVE: To investigate the association between blood pressure and carotid intima-media thickness (IMT) in healthy adolescents. STUDY DESIGN: Study participants included 285 first-year high school students (mean age, 15.2 years) at a rural high school in Korea. Systolic and diastolic blood pressure (SBP and DBP) were measured with an oscillometric automated sphygmomanometer. The carotid arteries were evaluated with high-resolution B-mode ultrasound scanning. IMT value was determined with the average of the maximal IMT at each common carotid artery. Increased IMT was defined as sex-specific top quartile. The odds ratio (OR) for increased IMT per 1 SD increase of SBP and DBP was estimated after adjusting for age, sex, body mass index, waist circumference, fasting glucose level, and total/high-density lipoprotein cholesterol ratio. RESULTS: Adjusted OR for increased IMT was 1.70 (P = .003) per 12.4 mm Hg SBP and 1.25 (P = .125) per 7.0 mm Hg DBP. When the analyses were performed by sex, increased IMT was associated with both SBP (OR, 2.67; P = .003) and DBP (OR, 1.68; P = .019) in girls, but it was not associated with either SBP (OR, 1.46; P = .093) or DBP (OR, 0.99; P = .972) in boys. CONCLUSION: These results suggest that higher blood pressure level may be associated with increased carotid IMT in apparently healthy adolescents.