title: Clinical Course of Enterovirus D68 in Hospitalized Children.
abstract: Enterovirus D68 (EV-D68) has been sporadically reported as a cause of respiratory tract infections. In 2014, an international outbreak of EV-D68 occurred and caused severe respiratory disease in the pediatric population.
  
  
  
  A retrospective chart review was performed of children admitted to Children's Mercy Hospital from August 1, 2014, to September 15, 2014, with positive multiplex polymerase chain reaction testing for EV/rhinovirus (RV). Specimens were subsequently tested for EV-D68, and clinical data were obtained from the medical records. Patients with EV-D68 were compared with children presenting simultaneously with other EV/RV.
  
  
  
  Of 542 eligible specimens, children with EV-D68 were significantly older than children with other EV/RV (4.6 vs. 2.2 years, P < 0.001). Children with EV-D68 were more likely to have a history of asthma (38.6% vs. 30.0%, P = 0.04) or recurrent wheezing (22.1% vs. 14.8%, P = 0.04). EV-D68-positive children more commonly received supplemental oxygen (86.7% vs. 65.0%, P < 0.001), albuterol (91.2% vs. 65.5%, P < 0.001) and corticosteroids (82.9% vs. 58.6%, P < 0.001). Age ≥5 years was an independent risk factor for intensive care unit management in EV-D68-infected children. Children with a history of asthma or recurrent wheezing and EV-D68 received supplemental oxygen (92.7% vs. 82.4%, P = 0.007) and magnesium (42.7% vs. 29.7%, P = 0.03) at higher rates and more continuous albuterol (3 vs. 2 hours, P = 0.03) than those with other EV/RV.
  
  
  
  EV-D68 causes severe disease in the pediatric population, particularly in children with a history of asthma or recurrent wheezing. EV-D68-positive children are more likely to require therapy for refractory bronchospasm and may need intensive care unit- level care.
authors.affiliation: From the *Department of Pediatrics, Children's Mercy Hospital, †Department of Pathology and Laboratory Medicine, Children's Mercy Hospital, and ‡University of Missouri-Kansas City, School of Medicine, Kansas City, Missouri.
authors.forename: Jennifer E
authors.initials: JE
authors.lastname: Schuster
authors.forename: Rangaraj
authors.initials: R
authors.lastname: Selvarangan
authors.forename: Ferdaus
authors.initials: F
authors.lastname: Hassan
authors.forename: Kayla B
authors.initials: KB
authors.lastname: Briggs
authors.forename: Lindsay
authors.initials: L
authors.lastname: Hays
authors.forename: Jenna O
authors.initials: JO
authors.lastname: Miller
authors.forename: Barbara
authors.initials: B
authors.lastname: Pahud
authors.forename: Henry T
authors.initials: HT
authors.lastname: Puls
authors.forename: Mary Ann
authors.initials: MA
authors.lastname: Queen
authors.forename: Marita T
authors.initials: MT
authors.lastname: Thompson
authors.forename: Gina
authors.initials: G
authors.lastname: Weddle
authors.forename: Mary Anne
authors.initials: MA
authors.lastname: Jackson
mesh_terms: D002648:Child; D002675:Child, Preschool; D004196:Disease Outbreaks / Q000706:statistics & numerical data; D030016:Enterovirus D, Human; D004769:Enterovirus Infections / Q000175:diagnosis* / Q000453:epidemiology* / Q000628:therapy / Q000821:virology; D005260:Female; D006760:Hospitalization; D006801:Humans; D008297:Male; D012189:Retrospective Studies