Respiratory Syncytial Virus Infection May be More Dangerous in Neonate

This single center cross-sectional study was conducted in University of Health Sciences Dr
Behçet Uz Children's Hospital with a 400-bed tertiary care hospital in İzmir, Turkey, during
the period of March 11 - April 30, 2020. This hospital is a pediatric referral center in the
Aegean Region of Turkey with annual approximately 600,000 outpatients and 24,000
hospitalizations. All children with fever and cough who were tested by taken nasopharyngeal
swabs for SARS-CoV2 and common human respiratory tract pathogens were included in the study.

The clinician responsible for taking the respiratory samples were trained by the infection
control committee on sampling and using personal protective equipment. Firstly, an
oropharyngeal sampling was taken, and then a nasopharyngeal sampling was taken using the same
swab from patient with fever and cough/shortness of breath for SARS-CoV-2 PCR. The same swab
was used and placed in the same transport medium. The samples were sent to the laboratory
determined by the Ministry of Health, following the cold chain rules. The protocol of Real
Time-PCR was consistent with the recommendation of the WHO. Real time-PCR was performed at
the local governmental centers for disease control and prevention. The kit wasapplied to
nucleic acid isolates from nasopharyngeal aspirate/lavage, bronchoalveolar lavage,
nasopharyngeal swab, oropharyngeal swab and sputum samples. Rapid diagnosis with the kit is
achieved via one-step reverse transcription (RT) and real-time PCR (qPCR) (RT-qPCR) targeting
SARS-CoV-2 (2019-nCoV)-specific RNA-dependent RNA polymerase (RdRp) gene fragment. The RdRp
gene-targeted Wuhan-RdRp oligonucleotide set gives positive results only with SARS-CoV-2
(2019-nCoV)( Bio-Speedy®, Turkey SARS-CoV-2 (2019-nCoV) qPCR Detection Kit)

Respiratory samples taken by nasopharyngeal swabs were tested for common human respiratory
tract pathogens. For the testing of samples, real-time polymerase chain reaction (PCR) assay
was performed. In the assay a commercial multiplex real-time PCR kit (Bosphore Respiratory
Pathogens Panel Kit V4, Anatolia Geneworks, Turkey) was used to investigate the presence of
Influenza viruses ( Influenza A, Pandemic H1N1 Influenza A, Seasonal H1N1 Influenza A and
Influenza B), Parainfluenza (PIV) viruses (PIV-1, PIV-2, PIV-3 and PIV-4), Human
Coronaviruses (HCoV) (CoV OC43, CoV NL63, CoV HKU1 and CoV 229E), Respiratory Syncytial Virus
(RSV) A/B, Rhinovirus, Metapneumovirus, Enterovirus, Bocavirus, Adenovirus, Parechovirus and
bacterial pathogens such as Mycoplasma pneumonia, Moraxella catarrhalis, Bordetella pertussis
and Haemophilus influenzae type B in the clinical samples.

Demographic, epidemiological and clinical data were obtained from hospital electronic
information system medical records. For the statistical evaluation of the data, SPSS 20.0
Microsoft for Windows (IBM Corporation, Armonk, NY, USA). was used and P <0.05 value was
considered statistically significant.