Does Respiratory Virus Coinfection Increases the Clinical Severity of Acute Respiratory Infection Among Children Infected With Respiratory Syncytial Virus?

Harada, Yoshitaka; Kinoshita, Fumiko; Yoshida, Lay‐Myint; Minh, Le Nhat; Suzuki, Motoi; Morimoto, Konosuke; Toku, Yuichirou; K, Tomimasu; Moriuchi, Hiroyuki; Ariyoshi, Koya

doi:10.1097/inf.0b013e31828ba08c

Cited by 77 publications

(63 citation statements)

References 25 publications

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“…They explained that heightened immune response during a primary infection may discourage colonization by a second viral pathogen, leading to lowered prevalence of multiple viruses in young infants [20]. Double and triple viral co-infection represented (17.1% and 7.3% respectively), which is comparable to other studies that ranged (12-20%) regarding double co-infection and (1.1-3.9%) for triple infection [19,21,22]. RV was the most frequently detected virus in single and mixed viral infection.…”

Section: Discussionsupporting

confidence: 76%

“…The discrepancy in proportion of viral agents may be due to differences in pathogen epidemiology, study populations, and/or the time the study was conducted due to seasonal variation. The leading combination in the current study was RV/AdV and RV/RSV, which was comparable to other studies [19,21,22]. Although RSV/ hMpV combination was reported by some studies [17,25,26], this combination was absent in our study and other studies [19,27].…”

Section: Respiratory Virussupporting

confidence: 38%

“…Even though some studies [5,19,21] showed significant association between severity of infection and the detection of mixed viral etiologies. Some studies went further to suggest that single infection resulted in more severe outcome [4,20].…”

Section: Urtismentioning

confidence: 99%

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Viral Infections in Egyptian Hospitalized Children with Acute Respiratory Tract Infections

Gad¹,

Refaay²,

Gad³

et al. 2017

J Clin Cell Immunol

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Acute respiratory tract infections (ARTIs) are associated with significant morbidity and mortality worldwide, especially in developing countries. Children under the age of 5 years old are mostly affected. Both viral and bacterial causes are implicated, but viral etiologies are more difficult to diagnose. Viral infections can occur either single or mixed, but the significance and association of polyviral agents with the severity of cases are poorly understood. More studies are critical for understanding this role, improving diagnosis and treatment.Objective: To identify the rule of five chosen viral pathogens in ARTIs in children below 5 years old and the association of polyviral etiology with the severity of the disease.Methods: Nasopharyngeal swabs were taken from 120 children who had symptoms and signs of ARTIs, attending the outpatient clinic and admitted in pediatric department or pediatric intensive care unit, Banha university hospital. All children were subjected to full history taking, analysis by multiplex PCR for five viruses (Rhinovirus, Respiratory syncytial virus, Human metapneumovirus, Adenovirus, and Human boca virus).Results: 54 viruses were identified by multiplex PCR from 41 children (34.2%), 75.6% of them had a single viral infection, (17% and 7.4%) were co-infected with two and three viruses respectively. Positive cases were mostly of children admitted in pediatric ward and the majority were infants. URTIs was the most common presentation followed by bronchiolitis then bronchopneumonia. HRV was the most frequently detected as a single and mixed infection (35.2%) followed by RSV (22.2%). Non-significant correlation was found between mixed infection and the severity of infection. Conclusion:HRV is the most frequently recognized viral pathogen either as single or mixed in children below 5 years old in our patient group. Mixed infection has no correlation with disease severity. And using Multiplex PCR is an ideal tool for investigating mixed infection.

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Section: Discussionsupporting

confidence: 76%

Section: Respiratory Virussupporting

confidence: 38%

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Viral Infections in Egyptian Hospitalized Children with Acute Respiratory Tract Infections

Gad¹,

Refaay²,

Gad³

et al. 2017

J Clin Cell Immunol

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“…Although some studies have reported cases with these characteristics [52–54], reports by other authors have suggested that co-infections are not synonymous with clinical differences or greater severity [55–56]. …”

Section: Discussionmentioning

confidence: 99%

Prevalence of non-influenza respiratory viruses in acute respiratory infection cases in Mexico

et al. 2017

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BackgroundAcute respiratory infections are the leading cause of morbidity and mortality worldwide. Although a viral aetiological agent is estimated to be involved in up to 80% of cases, the majority of these agents have never been specifically identified. Since 2009, diagnostic and surveillance efforts for influenza virus have been applied worldwide. However, insufficient epidemiological information is available for the many other respiratory viruses that can cause Acute respiratory infections.MethodsThis study evaluated the presence of 14 non-influenza respiratory viruses in 872 pharyngeal exudate samples using RT-qPCR. All samples met the operational definition of a probable case of an influenza-like illness or severe acute respiratory infection and had a previous negative result for influenza by RT-qPCR.ResultsThe presence of at least one non-influenza virus was observed in 312 samples (35.8%). The most frequent viruses were rhinovirus (RV; 33.0%), human respiratory syncytial virus (HRSV; 30.8%) and human metapneumovirus (HMPV; 10.6%). A total of 56 cases of co-infection (17.9%) caused by 2, 3, or 4 viruses were identified. Approximately 62.5% of all positive cases were in children under 9 years of age.ConclusionIn this study, we identified 13 non-influenza respiratory viruses that could occur in any season of the year. This study provides evidence for the prevalence and seasonality of a wide range of respiratory viruses that circulate in Mexico and constitute a risk for the population. Additionally, our data suggest that including these tests more widely in the diagnostic algorithm for influenza may reduce the use of unnecessary antibiotics, reduce the hospitalisation time, and enrich national epidemiological data with respect to the infections caused by these viruses.

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“…Conceptually, multiple pathogens should increase risk of severe illness; however, the inflammatory response generated by one virus may not be significantly increased by the presence of a second or third virus 8 . The published data regarding the outcomes associated with respiratory viral co-infection are mixed 14,15,20–22 .…”

Section: Introductionmentioning

confidence: 99%

Detection of Multiple Respiratory Viruses Associated With Mortality and Severity of Illness in Children*

Rehder

Wilson

Zimmerman

et al. 2015

Pediatric Critical Care Medicine

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Objective Respiratory viral infection is a common source of morbidity and mortality in children. Co-infection with multiple viruses occurs frequently; however, the clinical significance of concomitant viral pathogens is unclear. We hypothesized that presence of more than one respiratory virus is associated with increased morbidity and mortality when compared to children with a single respiratory virus. Design Retrospective cohort study. Setting A tertiary care hospital. Patients All children at Duke Children’s Hospital over a two year period with isolation of a virus on an extended viral respiratory panel (EVRP) result. Demographic data, co-morbidities, and details of hospital encounter were recorded. Interventions None Measurements and Main Results 235 hospital encounters demonstrated positive EVRPs. Immunocompromised status (37%) and respiratory comorbidities (23%) were common. 28 patients (12%) tested positive for multiple viruses, with adenovirus (23/28) and respiratory syncytial virus (15/28) most prevalent in patients with multiple viruses. Viral co-detection was associated with increased use of non-invasive ventilation (p=0.02), extracorporeal membrane oxygenation (p=0.02), increased likelihood of moderate or severe illness (p=0.005) and increased mortality (p=0.01). Subgroup analysis demonstrated that this mortality association persisted for children with normal immune function (p=0.003) and children with no comorbidities (p=0.007). Conclusions Children with multiple respiratory viruses may be at increased risk of moderate or severe illness and mortality, with previously healthy children potentially being at greatest risk. Further studies are indicated to determine the significance and generalizability of this finding and to better understand the pathophysiology of viral co-infection.

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Does Respiratory Virus Coinfection Increases the Clinical Severity of Acute Respiratory Infection Among Children Infected With Respiratory Syncytial Virus?

Abstract: Non-RSV respiratory virus coinfection is not uncommon in RSV-infected children and may increase the severity of RSV disease.

Cited by 77 publications

References 25 publications

Viral Infections in Egyptian Hospitalized Children with Acute Respiratory Tract Infections

Viral Infections in Egyptian Hospitalized Children with Acute Respiratory Tract Infections

Prevalence of non-influenza respiratory viruses in acute respiratory infection cases in Mexico

Detection of Multiple Respiratory Viruses Associated With Mortality and Severity of Illness in Children*

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