Patients were selected consecutively at the outpatient clinic of HG, from Monday through Friday, from 8:00 AM to 5:00 PM, and from the hospital admission and emergency unit of the Hospital Universitário on the other days Duvelisib cost and times. Fig. 1 shows the flowchart of patient selection, investigation, and follow-up of patients. Samples drawn from each nostril aspirate and one from nasopharyngeal swabs were obtained

from all patients enrolled in the study, in the supine position with head positioned on the midline. At the time of collection, the sample swab was submitted to the rapid test for detection of influenza A, H1N1, and B (Influenza H1N1 Pandemic test, Bioeasy, Brazil). The result was reported immediately to the physician for treatment decision. Within a maximum period of 4 hours after collection, the

samples were mixed and added to a Ringer lactate solution to a total of 4 mL. After homogenization, the samples (approximately 1 mL) were separated into aliquots in cryotubes, previously identified and stored in liquid nitrogen and stored at -80 °C. In the Pediatric Infectious Disease Research Laboratory of the FMJ, the DNA and total RNA nucleic acids were extracted from samples using the extraction Kit (RTP DNA/ RNA Virus Mini Kit, Molecular, STRATEC, Germany). The sensitivity and specificity were monitored by standard quality control for molecular diagnostics. The qualitative detection of 20 respiratory viruses (influenza [A, H1N1, and B]; coronavirus [NL63, Caspase-independent apoptosis 229E, OC43, and HKU1]; parainfluenza [PIV1, 2, 3, and 4]; rhinovirus [HRV], respiratory syncytial virus [RSV A/B]; human Histamine H2 receptor metapneumovirus [hMPV A/B]; adenovirus [ADV]; enterovirus; parechovirus; and bocavirus [hBoV]) was performed by real-time multiplex polymerase chain reaction (FTD – Fast Track Diagnostics – Belgium). All blood cultures (peripheral and central samples) were performed using the kit BACTEC/Alert (BioMérieux Inc. -United States). Urinalysis and urine culture were obtained on admission, as well as other cultures from different sites, if necessary. Analysis of peripheral blood was performed

by automated hematology analyzer (Sysmex®, Model: KX 21N, USA) within 2 hours after collection. All laboratory investigations strictly followed the manufacturers’ specifications. Measures of central tendency and dispersion were used to describe the study sample. The prevalence of viral infections with their respective 95% confidence interval was estimated. To compare proportions, the chi-squared or Fisher’s exact tests were used. The software used was SPSS, release 17 (SPSS – Chicago, IL, United States). A total of 48 patients undergoing cancer treatment agreed to participate in the study, totaling 104 episodes with fever and/or respiratory symptoms. The median age was 12 ± 5.1 years, and the youngest patient was 1 year old. The sample consisted of 82 (78.8%) male children; 82 (78.8%) were white, followed by 17 mixed-race (16.