Respiratory Virus Co-infection in Acute Respiratory Infections in Children

Abstract

Purpose of Review This investigation aims to understand the role and burden of viral co-infections for acute respiratory illnesses in children. Co-infection can be either viral-viral or viral-bacterial and with new technology there is more information on the role they play on the health of children.Recent Findings With the proliferation of multiplex PCR for rapid diagnosis of multiple viruses as well as innovations on identification of bacterial infections, research has been attempting to discover how these co-infections affect each other and the host. Studies are aiming to discern if the epidemiology of viruses seen at a population level is related to the interaction between different viruses on a host level. Studies are also attempting to discover the burden of morbidity and mortality of these viral-viral co-infections on the pediatric population. It is also becoming important to understand the interplay of certain viruses with specific bacteria and understanding the impact of viral-bacterial co-infections. Summary RSV continues to contribute to a large burden of disease for pediatric patients with acute respiratory illnesses. However, recent literature suggests that viral-viral co-infections do not add to this burden and might, in some cases, be protective of severe disease. Viral-bacterial co-infections, on the other hand, are most likely adding to the burden of morbidity in pediatric patients because of the synergistic way they can infect the nasopharyngeal space. Future research needs to focus on confirming these conclusions as it could affect hospital cohorting, role of molecular testing, and therapeutic interventions.

Interferon-Dependent and Respiratory Virus-Specific Interference in Dual Infections of Airway Epithelia

“…We showed that RV replication is inhibited by prior infection with RSV-A and H1N1, while RV does not inhibit subsequent infection by these viruses. A number of clinical studies have described viral coinfections, particularly between RV, Flu, and RSV, but the clinical impact remains unclear 22 . Some publications have reported an enhancement in disease severity, while others have suggested the opposite 3,7,8,[23][24][25][26] .…”

Rapid Molecular Tests for Detecting Respiratory Pathogens Reduced the Use of Antibiotics in Children

“…The statistical package SPSS version 25.0 was used to analyze the data (SPSS Inc., Chicago, IL, USA). Categorical variables were compared using Pearson's chi-square test to compare patient characteristics, frequency of pathogen, and antibiotic use.…”

Identifying and quantifying robust risk factors for mortality in critically ill patients with COVID-19 using quantile regression

“…In critically ill patients with the Middle East respiratory syndrome (MERS), 18% had bacterial coinfections [ 23 ]. Viral-bacterial coinfections in the respiratory tract increase mortality and morbidity in children and adults [ [24] , [25] , [26] ]. As mentioned in a previous study, nearly 100% of COVID patients who died in the ICU had sepsis [ 4 ] The death of the non-survivors who tended to suffer from severe coinfection may be due to the need for invasive treatments such as tracheal intubation, tracheotomy or urinary tract intubation-assisted treatment.…”