Relevance of codetection of respiratory viruses in the severity of acute respiratory infection in hospitalized children

Andes Pediatr. 2021 Jun;92(3):349-358. doi: 10.32641/andespediatr.v92i3.1756.
[Article in English, Spanish]

Abstract

Introduction: Multiplex polymerase chain reaction (PCR) allows simultaneous detection of respiratory viruses, raising questions about their relevance in the clinical feature.

Objective: To evaluate the contribution of clinical, epidemiological, and virological factors in the clinical course of children hospitalized due to ARI with viral co-detection.

Patients and method: Pediatric patients ≤ 15 years old, hospitalized due to ARI at the UC-CHRISTUS Health Network Clinical Hospital between June and October 2014, and who presented a positive respiratory molecular panel test, were included. Respiratory samples (nasopharyngeal swab, tracheal aspiration, or bronchoalveolar lavage) with positive panel tests by Seeplex® RV15 OneStep ACE Detection Seegene® technique, were analyzed with a second technique (xTAG-RVP-FASTv2 Luminex®, USA), which allows simultaneous and semi-quantitative detection of 17 respiratory viruses. Clinical and epidemiological records were collected.

Results: One virus was identified in 42/57 children (74%) and two or more in 15/57 (26%). Intensive care unit (ICU) hospi talization was significantly more frequent in patients with viral co-detection (OR = 5,5; IC 95%: 1,5 19,6). The most frequently detected viruses were rhinovirus/enterovirus (HRV/EV) (29%) and res piratory syncytial virus (RSV) (25%), and the most common co-detection was HRV/EV-RSV (33%). In x-rays, patients with HRV/EV infection presented interstitial images more frequently, while RSV was associated with condensations (p = 0.002). For HRV/EV, median fluorescence intensity (MFI, semi-quantification) were 1788 and 2456 in co-detection and single agent, respectively (p = 0.022). Children with HRV/EV co-detection had a longer hospital stay compared to isolated identification (5 versus 3 days, p = 0,028).

Conclusion: In children hospitalized due to ARI, viral co-detection is frequent and associated with more ICU hospitalizations. Our study highlights the presence of HRV/ EV in viral co-detection and longer length of stay. More studies are needed to define the relevance of viral co-detection in hospitalized pediatric patients.

MeSH terms

  • Acute Disease
  • Adolescent
  • Child
  • Child, Preschool
  • Coinfection / diagnosis*
  • Coinfection / therapy
  • Coinfection / virology
  • Critical Care / statistics & numerical data
  • Cross-Sectional Studies
  • Female
  • Hospitalization / statistics & numerical data
  • Humans
  • Infant
  • Infant, Newborn
  • Male
  • Multiplex Polymerase Chain Reaction*
  • Patient Acuity
  • Respiratory Tract Infections / diagnosis*
  • Respiratory Tract Infections / therapy
  • Respiratory Tract Infections / virology
  • Virus Diseases / diagnosis*
  • Virus Diseases / therapy
  • Virus Diseases / virology