19 A study of 12,474 infants with AVB, of whom 1,588 were hospita

19 A study of 12,474 infants with AVB, of whom 1,588 were hospitalized, demonstrated that the risk of hospitalization was higher in male patients.20 The role of ethnicity as a risk factor remains unclear, selleck compound with controversial results in the literature. One study reported that patients of African descent have better progress when compared to Caucasians,28 while another study indicated the opposite.4 In some isolated populations, a few observations have been made: in New Zealand, patients of Maori origin had worse outcome;22 the same was observed for Native Americans and

those originating in Alaska, who had more severe disease when compared to Caucasian patients.38 There are controversial results in the literature regarding the influence of the type of virus causing the disease on a more severe evolution.14 Some studies suggest that RSV is a factor of severity for AVB when compared to other viruses.11 and 32 A recent study demonstrated that severe AVB by RSV leads to prolonged hospital stay (6 versus 5 days, p < 0.0001), higher risk of ICU admission (OR 2.7; 95% CI: 1.87 to 3.9), and increased need for oxygen therapy (OR 2.2; 95% Sunitinib in vivo CI: 1.8-2.6). 29 A Brazilian study showed that pulse

oximetry < 90% at hospital admission for lower respiratory tract infection was associated with RSV infection. 39 However, other studies have shown that RSV does not lead to greater clinical severity when compared to other viruses, as in a Brazilian study of 89 hospitalized patients,

which did not show any difference in severity between patients who had RSV and those who did not; 40 and another study showed that positive RSV had no influence on the time of hospitalization. 41 Regarding presence of viral coinfection, one study demonstrated that viral coinfection is responsible for increased severity of AVB. 21 Other studies suggest that viral coinfection does not increase the severity of AVB, 42 including a study in Brazil, which evaluated 176 patients and concluded that the clinical severity of AVB by RSV did not increase due to the presence of viral coinfection. 43 Currently, through Baricitinib the development of quantitative PCR, the importance of the viral load on AVB severity has been studied, as well as the differentiation of coinfection and viral codetection, aspects that were little known and often disregarded in the literature.44 (i) low weight at admission;19 (ii) maternal smoking during pregnancy;20 and 45 (iii) atopic dermatitis;35 (iv) mechanical ventilation in the neonatal period;21 (v) maternal history of atopy;15 (vi) history of maternal asthma during pregnancy;45 (vii) season of birth;22 (viii) low socioeconomic status;7 and 20 (ix) Down syndrome;37 and 46 (x) environmental pollution;47 (xi) living at an altitude higher than 2,500 meters above sea level;48 and (xii) C-section delivery.

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