1142Critically Ill Children Hospitalized with an Acute Respiratory Viral Infection: Characterizing ICU severity

Background. Acute respiratory viral infections (ARVI) are a common public health problem with a significant global health care burden. There is no comprehensive data on which viral pathogen or pathogens are associated with the highest severity in children with ARVI requiring intensive care. We characterized the severity of critical illness secondary to ARVI in a Pediatric Intensive Care Unit (PICU). We hypothesized that no single virus would consistently correlate with a greater severity of illness. Methods. We performed a retrospective chart review of children ≤18 years of age with a respiratory viral infection and a positive PCR test (Respiratory Viral Panel, Biofire) requiring PICU admission in a 23-bed New York City PICU between 2010-2013. We described and analyzed the clinical characteristics of infected children. The institutional review board of Weill Cornell Medical College approved conduct of this study with a waiver of informed consent. Results. Our PICU admitted 2957 patients during the study period, of which 245 (8%) tested positive for a viral pathogen. The average age was 3.08 years (0.04-19.45), compared to an average age of 3.48 years for the general PICU population. Most patients with a positive viral assay also had an underlying medical condition (78%). 103 patients (42%) with a respiratory virus were intubated and 27 patients (18.6%) had a tracheostomy, compared to 221 (7.5%) and 81 patients (2.7%) respectively in the general PICU population during the same period. Rhinovirus was the most common pathogen, comprising 55% of our cohort. RSV comprised 13%. Regarding severity, adenovirus (p = 0.06) and parainfluenza (p = 0.01) were associated with a longer length of stay in both the PICU and hospital. Additionally, 67% of children with adenovirus required mechanical ventilation vs only 29% of children with RSV, though these results did not achieve statistical significance. Conclusion. Our data suggests that while no single virus was responsible for an overall greater severity of illness, parainfluenza and adenovirus trended towards this; further study is needed. Overall, respiratory viruses have a considerable pediatric healthcare and critical care burden. Disclosures. All authors: No reported disclosures.