Differences in clinical severity of respiratory viral infections in hospitalized children

Abstract

It is uncertain whether clinical severity of an infection varies by pathogen or by multiple infections. Using hospital-based surveillance in children, we investigate the range of clinical severity for patients singly, multiply, and not infected with a group of commonly circulating viruses in Nha Trang, Vietnam. RT-PCR was performed to detect 13 respiratory viruses in nasopharyngeal samples from enrolled patients. We apply a novel clinical severity score and examine associations with the odds of being severe and differences in raw severity scores. We find no difference in severity between 0-, 1-, and 2-concurrent infections and little differences in severity between specific viruses. We find RSV and HMPV infections to be associated with 2- and 1.5-fold increase in odds of being severe, respectively, and that infection with ADV is consistently associated with lower risk of severity. Clinically, based on the results here, if RSV or HMPV virus is suspected, PCR testing for confirmatory diagnosis and for detection of multiple coinfecting viruses would be fruitful to assess whether a patient’s disease course is going to be severe.

Clinical characteristics and illness course based on pathogen among children with respiratory illness presenting to an emergency department

“…To further understand which pathogens were associated with increased illness severity in this population, we evaluated hospitalization risk by pathogen. In our analyses, hospitalization risk was highest for children with RSV, hMPV, and HRV/EV compared with influenza, which have been corroborated in other studies 11,12 . In comparison with influenza, retrospective studies demonstrate that RSV results in up to 16 times more hospitalizations and ED visits in children <5 years of age 3,13 .…”

“…In our analyses, hospitalization risk was highest for children with RSV, hMPV, and HRV/EV compared with influenza, which have been corroborated in other studies. 11,12 In comparison with influenza, retrospective studies demonstrate that RSV results in up to 16 times more hospitalizations and ED visits in children <5 years of age. 3,13 Similarly, there is a growing body of literature recognizing hMPV as a significant respiratory pathogen associated with higher illness severity.…”

Disappearance of Seasonal Respiratory Viruses in Children Under Two Years Old During COVID-19 Pandemic: A Monocentric Retrospective Study in Milan, Italy

“…There is a general consensus on NPI effectiveness in containing SARS-CoV-2, even if before the COVID-19 pandemic evidence supporting isolate NPIs was low (11). Apart from those related to SARS-CoV-2, many studies report a reduction of hospitalization due to lower respiratory tract infections (LRTIs) caused by seasonal respiratory viruses since the first lockdown in March 2020 (12)(13)(14)(15)(16)(17)(18)(19)(20)(21). This trend is confirmed by weekly reports of epidemic Influenza virus infection, which show a striking reduction of cases of influenza when compared to previous years (22).…”

Potential Neurocognitive Symptoms Due to Respiratory Syncytial Virus Infection

“…As it is known, the highest risk age group susceptible to viral infection are infants, the elderly, and immunocompromised people [25][26][27][28]. However, during pregnancy, the women increase their probability of having complications from a respiratory viral infection, such as preeclampsia, acute cardiopulmonary diseases, respiratory distress, and pneumonia, among others [29,30].…”