title: Viral aetiology of bronchiolitis in hospitalised children in Qatar.
abstract: Bronchiolitis is considered one of the earliest and most common causes of hospitalisation in young children. Development of molecular technologies allowed a better understanding of bronchiolitis aetiology. Results from cohort studies evaluating the association between single, multiple viral infections and clinical outcomes are conflicting. Data on viral bronchiolitis in children were found to be limited in Qatar. This study aimed to determine frequency and seasonal trends of viral pathogens causing acute bronchiolitis, and to explore association between viral pathogens, disease severity and length of stay (LOS).
  
  
  
  This is a retrospective descriptive study, including children admitted in 2010 and 2011 with acute bronchiolitis. Presenting history, physical examination and respiratory viral co-infections as detected by molecular assays were analysed.
  
  
  
  At least one virus was detected in 315/369 (85.4%) of included children with single and multiple viruses in 67 and 33% of cases respectively. Respiratory syncytial virus (RSV) was the most detected virus, accounting for 51.2% followed by rhinovirus (RV) in 25.5% of cases. Fall and summer admissions were associated with longer LOS. On multivariate logistic regression analysis, retraction (OR 3.96; 95% CI 1.64,9.59) and age group 1-3 months (OR 3.09; 95% CI 1.06,9.05) were associated with longer LOS. Crepitation (OR 9.15; 95% CI 1.58,53.13), retraction (OR 4.10; 95% CI 1.05,16.12) and respiratory rate (OR 1.46; 95% CI 1.28,1.66) were associated with moderate to severe bronchiolitis. Identifying the viral agent did not influence disease severity or LOS.
  
  
  
  Clinical presentation is of more relevance to LOS and disease severity than the detected viruses. Future studies should investigate the interplay between climate characteristics, population's factors and the most detectable circulating viruses.
authors.affiliation: Paediatric Pulmonology Unit, Hamad Medical Corporation, P. O. Box 3050, Doha, Qatar. ijanahi@hamad.qa.
authors.forename: Ibrahim
authors.initials: I
authors.lastname: Janahi
authors.affiliation: Icahn School of Medicine at Mount Sinai, New York, USA.
authors.forename: Anas
authors.initials: A
authors.lastname: Abdulkayoum
authors.affiliation: Paediatric Pulmonology Unit, Hamad Medical Corporation, P. O. Box 3050, Doha, Qatar.
authors.forename: Fawziya
authors.initials: F
authors.lastname: Almeshwesh
authors.affiliation: Paediatric Pulmonology Unit, Hamad Medical Corporation, P. O. Box 3050, Doha, Qatar.
authors.forename: Mohamed
authors.initials: M
authors.lastname: Alkuwari
authors.affiliation: Paediatric Pulmonology Unit, Hamad Medical Corporation, P. O. Box 3050, Doha, Qatar.
authors.forename: Ahmed
authors.initials: A
authors.lastname: Al Hammadi
authors.affiliation: Paediatric Pulmonology Unit, Hamad Medical Corporation, P. O. Box 3050, Doha, Qatar.
authors.forename: Marwah
authors.initials: M
authors.lastname: Alameri
mesh_terms: D001990:Bronchiolitis, Viral / Q000453:epidemiology / Q000209:etiology*; D002673:Child, Hospitalized / Q000706:statistics & numerical data; D060085:Coinfection / Q000150:complications* / Q000453:epidemiology / Q000821:virology; D005260:Female; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D007902:Length of Stay / Q000706:statistics & numerical data*; D008297:Male; D029121:Metapneumovirus / Q000302:isolation & purification; D018184:Paramyxoviridae Infections / Q000150:complications* / Q000453:epidemiology; D010850:Picornaviridae Infections / Q000150:complications* / Q000453:epidemiology; D016133:Polymerase Chain Reaction; D011780:Qatar / Q000453:epidemiology; D018357:Respiratory Syncytial Virus Infections / Q000150:complications* / Q000453:epidemiology; D018113:Respiratory Syncytial Virus, Human / Q000302:isolation & purification; D012189:Retrospective Studies; D012229:Rhinovirus / Q000302:isolation & purification; D012621:Seasons
keywords: Bronchiolitis severity; Length of stay; Multivariate predictors