Respiratory Syncytial Virus Coinfections With Rhinovirus and Human Bocavirus in Hospitalized Children

Abstract

It is not clearly established if coinfections are more severe than single viral respiratory infections.The aim of the study was to study and to compare simple infections and viral coinfections of respiratory syncytial virus (RSV) in hospitalized children.From September 2005 to August 2013, a prospective study was conducted on children younger than 14 years of age, admitted with respiratory infection to the Pediatric Department of the Severo Ochoa Hospital, in Spain. Specimens of nasopharyngeal aspirate were taken for virological study by using polymerase chain reaction, and clinical data were recorded. Simple RSV infections were selected and compared with double infections of RSV with rhinovirus (RV) or with human bocavirus (HBoV).In this study, 2993 episodes corresponding to 2525 children were analyzed. At least 1 virus was detected in 77% (2312) of the episodes. Single infections (599 RSV, 513 RV, and 81 HBoV) were compared with 120 RSV-RV and 60 RSV-HBoV double infections. The RSV-RV coinfections had fever (63% vs 43%; P < 0.001) and hypoxia (70% vs 43%; P < 0.001) more often than RV infections. Hypoxia was similar between single or dual infections (71%). Bronchiolitis was more frequent in the RSV simple group (P < 0.001). Pediatric intensive care unit admission was more common in RSV simple or RSV-RV groups than in the RV monoinfection (P = 0.042).Hospitalization was longer for both RSV simple group and RSV-HBoV coinfection, lasting about 1 day (4.7 vs 3.8 days; P < 0.001) longer than in simple HBoV infections. There were no differences in PICU admission. RSV single group was of a younger age than the other groups.Coinfections between RSV-RV and RSV-HBoV are frequent. Overall viral coinfections do not present greater severity, but have mixed clinical features.

Acute bronchiolitis: Influence of viral co‐infection in infants hospitalized over 12 consecutive epidemic seasons

“…When we analyzed data for emerging and less frequently studied viruses, we detected hBoV more frequently as a co‐infection than as single infection (55.9% vs 44.1%), followed by hMPV (40.0%) (Figure B), in agreement with previous studies . In the earlier study conducted in Taiwan, Chen et al reported multiple viral infection in 72.7% of children with hBoV and in 63.2% of those hMPV.…”

“…In the earlier study conducted in Taiwan, Chen et al reported multiple viral infection in 72.7% of children with hBoV and in 63.2% of those hMPV. The role of multiple viral detection remains poorly understood, given that RT‐PCR can sometimes detect a viral respiratory infection even in asymptomatic children . RSV and hMPV are all rare in asymptomatic children, in contrast, PCR frequently detects hCoV and hBoV in healthy controls, suggesting that caution is needed when inferring a causal relationship between viral detection and respiratory diseases, even in symptomatic patients, and could even reflect virus left over from a previous infection.…”

Mixed viral infections of the respiratory tract; an epidemiological study during consecutive winter seasons

“…Limited studies have evaluated the presence of mixed viral infections at the clinical setting for adult populations. Significant rates of mixed infections have been reported in several studies mainly involving pediatric populations while very little data exist regarding adult patients . The clinical significance of mixed viral infections is a matter of debate with some data supporting a role for increased illness severity and adverse outcomes including hospitalizations and some not .…”

İstanbul’da human bocavirüs enfeksiyonu

“…Co-detection with other viral pathogens is common in HBoV-positive patients as shown in previous studies 20,21 . In our study we did not investigate any other potential pathogens for this reason, it is difficult to say that all the symptoms are associated with only HBoV positivity.…”