Respiratory Tract Viral Infections and Coinfections Identified by Anyplex™ II RV16 Detection Kit in Pediatric Patients at a Riyadh Tertiary Care Hospital

Abstract

Respiratory infections are caused by an array of viruses, and limited information is available about viral coexistence, comparative symptoms, and the burden of illness. This retrospective cohort study aimed to determine the etiological agents responsible for respiratory tract infections by Anyplex II RV16 detection kit (RV16, Seegene), involving 2266 pediatric patients with respiratory infections admitted to the Department of Pediatrics at King Abdul-Aziz Medical City, Ministry of National Guard, Riyadh, from July 2014 to June 2015. The most frequent respiratory infections were recorded in the 1 to 5 year age group (44.7%). Rhinovirus (32.5%), Adenovirus (16.9%), and Respiratory syncytial virus (RSV) B (10.4%) were most common. In single viral infections, Rhinovirus (41.2%), Metapneumovirus (15.3%), and Bocavirus (13.7%) were most frequent. In multiple viral infections, Rhinovirus (36.7%), Adenovirus (35.2%), Bocavirus (11.2), RSV B (7.8%), and RSV A (6.7%) were most frequent. No significant difference was observed in clinical presentations; however, rhinorrhea and hypodynamia were significantly associated with viral respiratory infections. Most respiratory viral pathogens peaked during December, January, March, and April. Rhinovirus, Adenovirus, and Bocavirus circulations were detected throughout the year. Winter peaks were recorded for Rhinovirus, RSV B, Adenovirus, and RSV A, whereas the Metapneumovirus, and the Bocavirus peaked in March and April. These findings enhance understanding of viral etiology and distribution to improve respiratory infection management and treatment.

An overview of respiratory syncytial virus infections in Saudi Arabia

“…Other investigations from regions of Saudi Arabia reported detection of various respiratory viruses like influenza A and B, parainfluenza 1, 2 and 3 enteroviruses and adenovirus along with RSV in the clinical samples [32,35,38,39,45]. A recent study reported the multiple viral infection with the RSVA (6.7%) and RSVB (7.8%) [44].…”

“…A recent study conducted in Riyadh analysed 2266 paediatric patient NPAs/swabs with real-time PCR. The maximum RSV cases (29%) were reported in winter season of 2014-15 [44]. The prevalence of RSV ranged between 0.2% to 54% with an average of 22.8% (Figure 3).…”

“…RSV was highly predominant (97.4%) in 1115 viral positive samples in Riyadh [7]. Another study analyzed 2266 pediatric patient NPAs/swabs with real-time PCR in Riyadh and found 29% of RSV prevalence in winter season of 2014-15 [44]. From Jazan region, the RSV prevalence was 16% and group B RSV was predominant [35] (Table 1).…”

“…Many studies have reported the gender distribution of positive RSV cases. Most of the studies have reported that males (25-63%) were more commonly affected by RSV as compared to females [34,35,[44][45][46][47][48]. This probably is due to the fact that airways of male children are narrower than female counterparts leading to more frequent RSV infections [49][50][51].…”

“…RSV causes seasonal infection as the outbreaks are reported during winter season in areas with temperate and Mediterranean climate and during rainy season in tropical/sub-tropical regions [8,9,56]. Different investigations from Saudi Arabia have suggested that most of the RSV infections are reported during winter months from this region [7,8,39,44,45].…”