Multiple versus single virus respiratory infections: viral load and clinical disease severity in hospitalized children

Martin, Emily T.; Kuypers, Jane; Wald, Anna; Englund, Janet A.

doi:10.1111/j.1750-2659.2011.00265.x

Cited by 206 publications

(259 citation statements)

References 28 publications

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“…In the present study, the differences between infections by single or multiple pathogens were not significant in terms of clinical presentation and severity, with the exception of the higher rate of dyspnea observed in the cases of co-infection. Although some studies found that multiple viral infections were associated with more severe fever, a higher rate of hospitalization and more severe disease (20,32), our findings are in agreement with other studies which have shown that the presence of multiple pathogens was not associated with the severity of the clinical presentation (33,34).…”

Section: Discussionsupporting

confidence: 93%

Detection of Respiratory Co-Infections in Children Less Than Five Years With Adenovirus Infection

Malekshahi

Shafiei-Jandaghi

Yavarian

et al. 2016

Arch Pediatr Infect Dis

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Background: Acute respiratory tract infection is associated with significant morbidity, mortality, and economic loss worldwide. Viral infections seem to be responsible for 80% of the cases. There are several reports on the influence of dual or multiple respiratory viral infections on the severity of disease in childhood. Objectives: A limited number of studies have been conducted on co-infection of Adenovirus (AdV) with coxsackievirus, human bocavirus (HBoV) and Mycoplasma pneumoniae (MP) in Iran. To address this, the present article focuses on both the etiology and epidemiology of multiple microbial respiratory infections (coxsackievirus, HBoV, MP and influenza virus) and their clinical significance in young Iranian children with confirmed AdV infection. Patients and Methods: Molecular detection of HBoV, coxsackievirus, MP and influenza virus was performed by conventional PCR in 71 respiratory adenovirus-positive samples obtained from children younger than 5 years of age. Results: Among the 71 adenovirus-positive samples, 6 (8.4%) were co-infected, three were co-infected with MP and three of which were co-infected with influenza A/H3N2. Of the six patients with co-infection, four were male and two were female; three patients were less than 1 year of age and the remaining were 2, 3 and 4 years of age. Moreover, there were two inpatients and four outpatients. Conclusions: Although several studies have investigated viral respiratory co-infection, no study has evaluated the rate of respiratory co-infections in adenovirus-positive samples from children younger than 5 years. However, this study has filled this gap, the the number of co-infections were too small to draw any definite conclusions. Therefore, large-scale studies using bigger samples are required to understand the clinical significance of polymicrobial acute respiratory infections.

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Section: Discussionsupporting

confidence: 93%

Detection of Respiratory Co-Infections in Children Less Than Five Years With Adenovirus Infection

Malekshahi

Shafiei-Jandaghi

Yavarian

et al. 2016

Arch Pediatr Infect Dis

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“…Two patients who had association of human bocavirus and RSV were hospitalized. Although some studies reported that patients with multiple viral infections had a more severe course, some other studies reported that the disease course was not affected or a milder course was observed (16,20). It is thought that the disease severity may vary depending on the agent viruses.…”

Section: Discussionmentioning

confidence: 99%

Evaluation of epidemiological and clinical features of influenza and other respiratory viruses

Aktürk¹,

Sütçü²,

Badur³

et al. 2015

Turk Pediatri Ars

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Aim: In our study, we aimed to clinically and epidemiologically evaluate respiratory tract infections the viral agents of which were detected by molecular methods and to compare influenza and other respiratory tract viruses in this context. Material and Methods:The records of 178 patients aged above 2 years who presented to pediatric emergency outpatient clinic with fever and respiratory tract infection findings between December 2013 and April 2014 were examined retrospectively. Results: At least one respiratory tract pathogen was detected by polymerase chain reaction in 78.6% (n=140) of the patients: influenza A 33.5%, influenza B 16.4%, respiratory syncytial virus 9.2%, adenovirus 7.8%, rhinovirus 7.1%, coronavirus 7.1%, human metapneumovirus 5.7%, human bocavirus 5.7%, parainfluenza virus 3.5%, coinfection 2.8%. The mean age of the patients was 6.3±3.6 years. Sixty-nine patients (49.2%) were aged between 2 and 5 years. Seventy-one patients (50.7%) were aged 5 years and above. Upper respiratory tract infection was found with a rate of 65.7% and lower respiratory tract infection was found with a rate of 34.2%. It was observed that the distribution of respiratory tract viruses showed variance by age groups. Influenza A infection was observed with the highest rate in both age groups. Influenza B was the second leading agent (p=0.008) above the age of 5 years and respiratory syncytial virus was the second leading agent in the 2-5 year age group (p=0.003). Influenza viruses were detected in 55.9% of 118 patients who were found to be compatible with the definition of "influenza-like illness" specified in the Center for Disease Control and Prevention guidelines and other viral agenst were detected in 44%. No difference could be found between the clinical pictures and radiological findings caused by influenza and other respiratory tract viruses. Conclusions: In this study, it was concluded that influenza and other respiratory viruses can not be differentiated definitely by clinical and radiological findings, though there are some differences. (Turk Pediatri Ars 2015; 50: 217-25)

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“…In contrast, Esposito, et al (2013) reported that the difference in LOS between single (6.9 days) and multiple infections (7.1 days) was not significant. Other studies have reported no difference in clinical symptoms, prognosis, or intensive care unit admission rates between single and multiple infections [21][22][23], with some reporting less severe disease in patients with multiple respiratory virus infections [24,25]. These results might be The present study has some limitations.…”

Section: Discussionmentioning

confidence: 57%

Correlation between Infection with Multiple Respiratory Viruses and Length of Hospital Stay in Patients from Cheonan, Korea

Jeon

Park

Kim

2017

Korean J Clin Lab Sci.

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The length of hospital stay (LOS) for patients with respiratory virus infections has been reported to depend the virus type and infection severity. However, the impact of co-infections remains unclear. Patients with suspected respiratory virus infections, who visited Dankook University Hospital between December 2006 and February 2014, were included to examine the relationship between co-infections and LOS. Multiplex reverse transcriptase-polymerase chain reactions were used to identify the causative viruses. LOS was analyzed with respect to sex, age, virus, and co-infection. During this period, 5,310 out of the 8,860 patients (59.9%; median age, 1.5 years) were respiratory virus-positive. In respiratory virus-positive patients with single, double, and three-or-more infections, the average LOS was 7.3, 6.7, and 6.6 days, respectively. Longer LOS was observed for older patients and those with human coronavirus OC43 infections compared with adenovirus or respiratory syncytial virus A infections. LOS differed significantly according to age, virus type, and co-infection, but not between double and three or more infections.

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Multiple versus single virus respiratory infections: viral load and clinical disease severity in hospitalized children

Cited by 206 publications

References 28 publications

Detection of Respiratory Co-Infections in Children Less Than Five Years With Adenovirus Infection

Detection of Respiratory Co-Infections in Children Less Than Five Years With Adenovirus Infection

Evaluation of epidemiological and clinical features of influenza and other respiratory viruses

Correlation between Infection with Multiple Respiratory Viruses and Length of Hospital Stay in Patients from Cheonan, Korea

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