Table 3.
Adjusted odds ratios for comparison of clinical manifestations between severe and non‐severe RSV‐LRTI and agreement between clinical manifestation and SpO2 < 93%
| Clinical manifestation | Total | Non‐severe case | Severe case | aORa | 95% CI | P‐value | Sensitivity | Specificity | Agreement with SpO2 < 93% | |
|---|---|---|---|---|---|---|---|---|---|---|
| RSV‐RTI and RSV‐LRTI | Severe and very severe RSV‐RTI | |||||||||
| n = 395 | n = 294 (%) | n = 101 (%) | % | κ | ||||||
| Illness history | ||||||||||
| Convulsion | ||||||||||
| No | 391 | 290 (74.2) | 101 (25.8) | — | ||||||
| Yes | 4 | 4 (100) | 0 (0.0) | — | — | — | — | — | ||
| Pallor | ||||||||||
| No | 394 | 293 (74.4) | 101 (25.6) | — | ||||||
| Yes | 1 | 1 (100) | 0 (0.0) | — | — | — | — | — | ||
| Physical examination | ||||||||||
| Grunting | ||||||||||
| No | 380 | 287 (75.5) | 93 (24.5) | Ref | ||||||
| Yes | 15 | 7 (46.7) | 8 (53.3) | 2.9 | 1.0‐8.8 | 0.052 | 7.9% | 97.6% | 84.20% | 0.1 |
| Decreasing breath sound | ||||||||||
| No | 386 | 292 (75.6) | 94 (24.4) | Ref | ||||||
| Yes | 9 | 2 (22.2) | 7 (77.8) | 8.6 | 1.9‐60.4 | 0.01 | 6.9% | 99.3% | 85.30% | 0.1 |
| Wheezing sounds | ||||||||||
| No | 281 | 227 (80.8) | 54 (19.2) | Ref | ||||||
| Yes | 114 | 67 (58.8) | 47 (41.2) | 3.1 | 1.9‐5.2 | <0.001 | 46.5% | 77.1% | 71.90% | 0.2 |
| Rales | ||||||||||
| No | 174 | 159 (91.4) | 15 (8.6) | Ref | ||||||
| Yes | 221 | 135 (61.1) | 86 (38.9) | 6.2 | 3.5‐11.9 | <0.001 | 85.1% | 53.9% | 54.60% | 0.1 |
| Alar flaring | ||||||||||
| No | 353 | 288 (81.6) | 65 (18.4) | Ref | ||||||
| Yes | 42 | 6 (14.3) | 36 (85.7) | 26.7 | 11.1‐75.3 | <0.001 | 35.6% | 98.0% | 83.90% | 0.2 |
| Chest indrawing | ||||||||||
| No | 325 | 293 (90.2) | 32 (9.8) | |||||||
| Yes | 70 | 1 (1.4) | 69 (98.6) | 790.6 | 156.6‐14 558.7 | <0.001 | 68.30% | 99.70% | 82.80% | 0.3 |
| Central cyanosis | ||||||||||
| No | 395 | 288 (81.6) | 65 (25.6) | — | ||||||
| Yes | 0 | 6 (14.3) | 36 | — | — | — | — | — | ||
| Apnoea | ||||||||||
| No | 395 | 294 (74.4) | 101 (25.6) | — | ||||||
| Yes | 0 | — | — | — | — | — | — | |||
| Poor skin turgor | ||||||||||
| No | 395 | 294 (74.4) | 101 (25.6) | — | ||||||
| Yes | 0 | — | — | — | — | — | — | |||
| Vital signs | ||||||||||
| Axillary temperature | ||||||||||
| <38°C | 300 | 232 (77.3) | 68 (22.7) | Ref | ||||||
| ≥38°C | 95 | 62 (65.3) | 33 (34.7) | 2 | 1.2‐3.4 | 0.008 | 32.7% | 78.9% | 71.00% | 0.1 |
| Tachycardia | ||||||||||
| No | 302 | 233 (77.2) | 69 (22.8) | Ref | ||||||
| Yes | 93 | 61 (65.6) | 32 (34.4) | 2 | 1.2‐3.3 | 0.01 | 31.7% | 79.3% | 72.10% | 0.1 |
| Co‐detected virus | ||||||||||
| Rhinovirus | ||||||||||
| No | 365 | 275 (75.3) | 90 (24.7) | Ref | ||||||
| Yes | 30 | 19 (63.3) | 11 (36.7) | 1.4 | 0.6‐3.1 | 0.39 | 10.9% | 93.5% | 80.3 | 0 |
LRTI, lower respiratory tract illness; OR, odds ratio; RSV, respiratory syncytial virus; RTI, respiratory tract illness.
Non‐severe RSV‐RTI consists of RSV‐LRTI and RSV‐RTI. Tachycardia is defined by age: >160 pulse/min for younger than 12 mo, >150 pulses/min for 12‐35 mo and >140 pulse/min for 36‐59 mo.
a
Adjusted for age group, sex and municipality