Incidence and Outcome of Coinfections with SARS-CoV-2 and Rhinovirus

Abstract

Background: We aimed to compare the clinical severity in patients who were coinfected with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and rhinovirus or monoinfected with a single one of these viruses. Methods: The study period ranged from 1 March 2020 to 28 February 2021 (one year). SARS-CoV-2 and other respiratory viruses were identified by real-time reverse-transcription-PCR as part of the routine work at Marseille University hospitals. Bacterial and fungal infections were detected by standard methods. Clinical data were retrospectively collected from medical files. This study was approved by the ethical committee of our institute. Results: A total of 6034/15,157 (40%) tested patients were positive for at least one respiratory virus. Ninety-three (4.3%) SARS-CoV-2-infected patients were coinfected with another respiratory virus, with rhinovirus being the most frequent (62/93, 67%). Patients coinfected with SARS-CoV-2 and rhinovirus were significantly more likely to report a cough than those with SARS-CoV-2 monoinfection (62% vs. 31%; p = 0.0008). In addition, they were also significantly more likely to report dyspnea than patients with rhinovirus monoinfection (45% vs. 36%; p = 0.02). They were also more likely to be transferred to an intensive care unit and to die than patients with rhinovirus monoinfection (16% vs. 5% and 7% vs. 2%, respectively) but these differences were not statistically significant. Conclusions: A close surveillance and investigation of the co-incidence and interactions of SARS-CoV-2 and other respiratory viruses is needed. The possible higher risk of increased clinical severity in SARS-CoV-2-positive patients coinfected with rhinovirus warrants further large scale studies.

Coinfection between SARS‐CoV‐2 and other respiratory tract viruses

“…4 , 5 , 6 Also, in a retrospective study, the most common coinfected microorganism was found to be Mycoplasma pneumoniae (25%), followed by virus (7%) and bacteria (5%). 7 Similar to previous literature, 2 , 3 , 4 , 5 , 6 the authors demonstrated four times human rhinovirus (A and B), thrice both human coronavirus (229E and OC43) and mastadenovirus A, and once Influenza A virus. 1 …”

“…We have read the article titled to ‘Coinfection with severe acute respiratory syndrome coronavirus‐2 and other respiratory viruses at a tertiary hospital in Korea’ by Lee et al 1 In this manuscript, we agree with the authors that SARS‐CoV‐2 coinfections with other respiratory tract infection (RTI) viruses recently have begun to draw attention. 2 , 3 In this study, the authors explored specific RTI viruses and their possible relations with SARS‐CoV‐2.…”

Sequential appearance and isolation of a SARS-CoV-2 recombinant between two major SARS-CoV-2 variants in a chronically infected immunocompromised patient

“…Recently, 7 coronaviruses have been reported to be able to integrate se-quences putatively from insects [36]. Such natural mosaicisms in these viruses make it possible to understand the emergence of RNA viruses and should lead to a strengthening of genomic surveillance in patients presenting with coinfections by several RNA viruses, as is observed in patients infected with several respiratory viruses including SARS-CoV-2, endemic human coronaviruses, influenza viruses, or rhinoviruses [37]. Such infectious episodes could perhaps lead to the creation of new emerging viruses, as has been for instance reported for enteroviruses of humans and great apes [38].…”

Priming With Rhinovirus Protects Mice Against a Lethal Pulmonary Coronavirus Infection

“…In the case of RSV, this occurred out of its normal seasonal pattern ( 2 , 3 ). As SARS-CoV-2 continues to circulate in human populations worldwide, there are overlapping incidences of COVID-19 and other respiratory viral infections ( 4 ). Circulation of rhinovirus (RV) was less affected than influenza viruses and RSV by public health measures intended to slow SARS-CoV-2 transmission, and RV has been frequently detected as a co-pathogen in COVID-19 patients ( 4 , 5 ).…”

“…As SARS-CoV-2 continues to circulate in human populations worldwide, there are overlapping incidences of COVID-19 and other respiratory viral infections ( 4 ). Circulation of rhinovirus (RV) was less affected than influenza viruses and RSV by public health measures intended to slow SARS-CoV-2 transmission, and RV has been frequently detected as a co-pathogen in COVID-19 patients ( 4 , 5 ). Multiple studies have proposed that RV infections mediate viral interference with heterologous respiratory viruses, including influenza viruses and SARS-CoV-2 ( 6 – 8 ).…”