Distribution and seasonality of viral respiratory infections in pediatric oncologic patients in a tropical country

Abstract Background Comprehension of the distribution and seasonality viral respiratory infections pediatric oncologic patients in tropical localities remains poor. Due to lack mandatory report of all viruses and limitations in access to molecular biology techniques there is currently few data published on this topic. We report the distribution and seasonality of pediatric viral respiratory infections at a tertiary care oncological hospital in Guayaquil, Ecuador. Methods The laboratory database with results of real time PCR panel (Biofire® respiratory panel 2.1) from January to December 2021 was reviewed to collect the relative frequency and seasonality of identifiable viral infections in pediatric (ages < 18 years) patients. The frequency of infection according to sample characteristics including sex and age was compared using chi square test with a significance of 0.05. The frequency of detection was organized per month within the year. Percentage of coinfections was also determined. Results Out of 217 included PCR results, 143 (65.8%) tested positive for detectable viral organisms. Mean age was 7.3 years SD 4.8 years. The infection frequency for girl samples was higher than that of boy samples, X2 (1, N=217) = 4.16, p 0.041. The relation between age groups and the frequency of infection was not statistically significant X2 (2, N=217) = 5.24, p 0.073. The most prevalent viruses included Rhinovirus/Enterovirus 53 cases (relative frequency 37.0%), Parainfluenza virus 3 42 cases (relative frequency 29.3%) and Respiratory syncytial virus 19 cases (relative frequency 13.2%). Rhinovirus/Enterovirus, Paramyxovirus and Adenovirus respiratory infections occurred throughout the year while other respiratory viruses including Coronaviruses showed a higher detection rate during the rainy season (December – April). A total of 13 (5.9%) patients were coinfected with two up to four viruses. The most common combination was Parainfluenza virus 3 with Rhinovirus/Enterovirus. No bacterial targets were detected. Conclusion Larger and more complex studies are necessary to understand the burden of viral respiratory infections in pediatric oncological patients. In Ecuador, detection was higher in girls and school aged children. Rhinovirus/Enterovirus, Paramyxovirus and Adenovirus were present all year long while seasonality was common for other viruses following dry/rainy season pattern in the region. More understanding of seasonality will aim for preventive measures during more difficult months and to distribute resources accordingly. Figure 1. Seasonality of respiratory viral infections.