Human Rhinovirus and Disease Severity in Children

Abstract

WHAT'S KNOWN ON THIS SUBJECT: Human rhinovirus has been known as the common cold agent. Recently, studies have reported that this virus is responsible for severe infections of the lower respiratory tract in children. Reports of factors that increase disease severity have been contradictory. WHAT THIS STUDY ADDS:This study identifies some of the factors involved in disease severity in HRV infections in children. We expect that children at risk for developing severe disease could be identified sooner and appropriate measures could be taken. abstract OBJECTIVE: To evaluate retrospectively human rhinovirus (HRV) infections in children up to 5 years old and factors involved in disease severity.METHODS: Nasopharyngeal aspirates from 434 children presenting a broad range of respiratory infection symptoms and severity degrees were tested for presence of HRV and 8 other respiratory viruses. Presence of host risk factors was also assessed.RESULTS: HRV was detected in 181 (41.7%) samples, in 107 of them as the only agent and in 74 as coinfections, mostly with respiratory syncytial virus (RSV; 43.2%). Moderate to severe symptoms were observed in 28.9% (31/107) single infections and in 51.3% (38/74) coinfections (P = .004). Multivariate analyses showed association of coinfections with lower respiratory tract symptoms and some parameters of disease severity, such as hospitalization. In coinfections, RSV was the most important virus associated with severe disease. Prematurity, cardiomyopathies, and noninfectious respiratory diseases were comorbidities that also were associated with disease severity (P = .007).CONCLUSIONS: Our study showed that HRV was a common pathogen of respiratory disease in children and was also involved in severe cases, causing symptoms of the lower respiratory tract. Severe disease in HRV infections were caused mainly by presence of RSV in coinfections, prematurity, congenital heart disease, and noninfectious respiratory disease. Pediatrics 2014;133:e312-e321 AUTHORS:

Outcomes of Nosocomial Viral Respiratory Infections in High-Risk Neonates

“…Other studies 13,14,19 have not found this to be the dominant pathogen although many of these were prior to the widespread use of PCR and their methodologies may not reliably identify Rhinovirus. After respiratory syncytial virus (RSV), rhinovirus is a common pathogen and responsible for many community respiratory infections [24][25][26] and can cause severe respiratory disease in older children requiring hospitalisation 11,27 . As the dominant pathogen in our cases, rhinovirus was associated with a need for increased respiratory support in half of the infants with many of the premature infants requiring additional pressure support ventilation, similar to other smaller studies 12,14,17 .…”

Hyperoxic Exposure of Immature Mice Increases the Inflammatory Response to Subsequent Rhinovirus Infection: Association with Danger Signals

“…Infants with bronchopulmonary dysplasia (BPD), the most common chronic pulmonary disease following premature birth (3), have increased respiratory morbidity and healthcare utilization, including increased medication use, wheezing and hospital readmissions (4–6). Infants with BPD are at particular risk for severe disease and hospitalization following respiratory viral infections including respiratory syncytial virus (RSV) (7) and rhinovirus (RV), the most common childhood viral pathogen (8–11). …”

Etymological Peculiarities of Modern Acute Respiratory Viral Infections in Children of Early Age Hospitalized to the Intensive Care Unit

“…В последнее время в литературе появились данные, подтверждающие значимость риновируса (hRV) в па-тогенезе тяжелых форм острых инфекций нижних дыхательных путей, пневмонии, синдрома дыхатель-ных расстройств. Авторы даже выделяют «группу риска» подобного течения заболевания: недоношен-ные, дети с выраженной белково-энергетической недостаточностью, кардиомиопатией, с сопутствую-щей респираторной неинфекционной патологией [5]. Однако обращает на себя внимание большое число пациентов с риновирусной инфекцией, гос-питализированных в отделение реанимации и ин-тенсивной терапии именно в связи с выраженными проявлениями интоксикации.…”