Respiratory viral coinfection and disease severity in children: A systematic review and meta-analysis

Scottá, Marcelo Comerlato; Chakr, Valentina Coutinho Baldoto Gava; Moura, Angela de; Becker, Rafaela; Souza, Ana Paula Duarte de; Jones, Marcus Herbert; Pinto, Leonardo Araújo; Sarria, Edgar E.; Pitrez, Paulo Márcio; Stein, Renato T.; Mattiello, Rita

doi:10.1016/j.jcv.2016.04.019

Cited by 112 publications

(106 citation statements)

References 60 publications

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“…This association was likely due to the non‐mixed nature of our population, as nearly all of the participants self‐identifying as Alaskan native or American Indian were children or parents from one of the day care settings. Children were also associated with a higher risk for co‐infection than adults and teenagers, as has also been shown in earlier studies …”

Section: Discussionsupporting

confidence: 83%

Longitudinal active sampling for respiratory viral infections across age groups

Galanti

Birger

Ud‐Dean

et al. 2019

Influenza Resp Viruses

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Background Respiratory viral infections are a major cause of morbidity and mortality worldwide. However, their characterization is incomplete because prevalence estimates are based on syndromic surveillance data. Here, we address this shortcoming through the analysis of infection rates among individuals tested regularly for respiratory viral infections, irrespective of their symptoms. Methods We carried out longitudinal sampling and analysis among 214 individuals enrolled at multiple New York City locations from fall 2016 to spring 2018. We combined personal information with weekly nasal swab collection to investigate the prevalence of 18 respiratory viruses among different age groups and to assess risk factors associated with infection susceptibility. Results 17.5% of samples were positive for respiratory viruses. Some viruses circulated predominantly during winter, whereas others were found year round. Rhinovirus and coronavirus were most frequently detected. Children registered the highest positivity rates, and adults with daily contacts with children experienced significantly more infections than their counterparts without children. Conclusion Respiratory viral infections are widespread among the general population with the majority of individuals presenting multiple infections per year. The observations identify children as the principal source of respiratory infections. These findings motivate further active surveillance and analysis of differences in pathogenicity among respiratory viruses.

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Section: Discussionsupporting

confidence: 83%

Longitudinal active sampling for respiratory viral infections across age groups

Galanti

Birger

Ud‐Dean

et al. 2019

Influenza Resp Viruses

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“…Although respiratory viral coinfection increased the rate and duration of hospitalization [141727], it eventually did not cause a poorer prognosis such as oxygen supplementation and ICU admission, compared with single viral infection [1727]. In a recent meta-analysis, the overall effect of respiratory viral coinfections on the disease severity and prognosis was not significant [15]. …”

Section: Discussionmentioning

confidence: 99%

“…More cases of multiple respiratory viral infections have been diagnosed using these multiplex PCR tests than were reported before using conventional testing methods [121314]. Consequently, the clinical impact of respiratory viral coinfections, especially coinfection with respiratory syncytial virus (RSV), has been evaluated since the 2000s [15]. In a recently published meta-analysis, respiratory viral coinfections were not reported to result in a significant increase in the clinical severity of respiratory infections compared with single viral infections [15].…”

Section: Introductionmentioning

confidence: 99%

“…Consequently, the clinical impact of respiratory viral coinfections, especially coinfection with respiratory syncytial virus (RSV), has been evaluated since the 2000s [15]. In a recently published meta-analysis, respiratory viral coinfections were not reported to result in a significant increase in the clinical severity of respiratory infections compared with single viral infections [15]. However, their clinical effects vary depending on the coinfected viruses and the subjects enrolled in each study.…”

Section: Introductionmentioning

confidence: 99%

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Clinical Impact of Mixed Respiratory Viral Infection in Children with Adenoviral Infection

et al. 2016

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BackgroundAlthough adenovirus (ADV) infection occurs steadily all year round in Korea and the identification of respiratory viral coinfections has been increasing following the introduction of multiplex real-time polymerase chain reaction tests, the clinical impact of viral coinfection in children with ADV infection has rarely been reported.Materials and MethodsMedical records of children diagnosed with ADV infection were retrospectively reviewed. The enrolled children were divided into two groups based on the identified respiratory viruses: ADV group and coinfection group. Clinical and laboratory parameters were compared between the two groups.ResultsIn total, 105 children (60 males and 45 females) with a median age of 29 months (range: 0-131 months) diagnosed with an ADV infection were enrolled. Fever (99.0%) was by far the most frequent symptom, followed by respiratory (82.9%), and gastrointestinal (22.9%) symptoms. Upper and lower respiratory tract infections were diagnosed in 56 (53.3%), and 32 (30.5%) children, respectively. Five (4.8%) children received oxygen therapy, and no child died due to ADV infection. Coinfection was diagnosed in 32 (30.5%) children, with rhinovirus (46.9%), and respiratory syncytial virus (21.9%) being the most frequent. The proportions of children younger than 24 months (P <0.001), with underlying medical conditions (P = 0.020), and diagnosed with lower respiratory tract infection (P = 0.011) were significantly higher in the coinfection group than in the ADV group. In a multivariate analysis, only the younger age was significantly associated with coinfection (P <0.001). Although more children in the coinfection group received oxygen therapy (P = 0.029), the duration of fever and hospitalization was not significantly different between the two groups.ConclusionRespiratory viral coinfection with ADV occurred more frequently in children younger than 24 months of age compared with children aged 24 months or older. Respiratory viral coinfection may increase the severity of ADV infection, however, appropriate therapy prevented prolonged hospitalization and poor prognosis due to coinfection.

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“…The clinical significance and the mechanisms of disease virulence in respiratory viral coinfections remain uncertain. Recent systematic reviews and meta-analyses revealed no significant differences between children with single respiratory virus infection and those with viral-viral coinfection with respect to the length of hospital stay, admission to the intensive care unit, need for mechanical ventilation, oxygen requirements and death [56]. With increasing identification of multiple viruses as etiologic microorganisms, the clinical role of interactions between specific viruses remains to be determined.…”

mentioning

confidence: 99%