Single, dual and multiple respiratory virus infections and risk of hospitalization and mortality

Abstract

Respiratory virus infections cause a significant number of hospitalization and deaths globally. This study investigated the association between single and multiple respiratory virus infections and risk of admission to a general ward, intensive care unit or death in patients aged 0-105 years (mean ± s.d. = 24·4 ± 24·1 years), from North West England, that were tested for respiratory virus infections between January 2007 and June 2012. The majority of infections were in children aged ⩽5 years. Dual or multiple infections occurred in 10·4% (1214/11 715) of patients, whereas single infection occurred in 89·6% (10 501/11 715). Rhinovirus was the most common co-infecting virus (occurring in 69·5%; 844/1214 of co-infections). In a multivariate logistic regression model, multiple infections were associated with an increased risk of admission to a general ward [odds ratio (OR) 1·43, 95% confidence interval (CI) 1·2-1·7, P < 0·0001]. On the other hand, patients with respiratory syncytial virus (RSV) and human parainfluenza virus types 1-3 (hPIV1-3), as a single infection, had a higher risk of being admitted to a general ward (OR 1·49, 95% CI 1·28-1·73, P < 0·0001 and OR 1·34, 95% CI 1·003-1·8, P = 0·05, respectively); admitted to an intensive-care unit or dying (OR 1·5, 95% CI 1·20-2·0, P = 0·001 and OR 1·60, 95% CI 1·02-2·40, P = 0·04, respectively). This result emphasizes the importance of RSV, hPIV and mixed infections and calls for research on vaccines, drugs and diagnostic tests targeting these respiratory viruses.

Outcomes of Nosocomial Viral Respiratory Infections in High-Risk Neonates

“…Other studies 13,14,19 have not found this to be the dominant pathogen although many of these were prior to the widespread use of PCR and their methodologies may not reliably identify Rhinovirus. After respiratory syncytial virus (RSV), rhinovirus is a common pathogen and responsible for many community respiratory infections [24][25][26] and can cause severe respiratory disease in older children requiring hospitalisation 11,27 . As the dominant pathogen in our cases, rhinovirus was associated with a need for increased respiratory support in half of the infants with many of the premature infants requiring additional pressure support ventilation, similar to other smaller studies 12,14,17 .…”

Infection Control Implications of Protracted Lengths of Stay With Noninfluenza Viral Influenza-Like Illnesses in Hospitalized Adults During the 2015 Influenza A (H3N2) Epidemic

“…One patient had a dual-positive rapid influenza diagnostic test for influenza A and influenza B, but PCR testing was positive for influenza A (H 3 N 2 ). [2][3][4][5][6] Of the 37 adults with viral ILIs, 16 (43%) had respiratory syncytial virus (RSV), 10 (27%) had rhinovirus/enterovirus (R/E), 5 (14%) had human parainfluenza virus type 3 (HPIV-3), 4 (11%) had human metapneumovirus (hMPV), and 2 (5%) had coronavirus (Table 1). Elderly patients, more commonly admitted for viral ILIs, had longer LOS for viral ILIs than for influenza.…”

“…Two patients had co-colonization with influenza A (H 3 N 2 ) and another respiratory virus, but not a worse prognosis. [4][5][6] None of the 37 adults with viral ILIs had bacterial coinfection at admission or during hospitalization.…”

“…[3][4][5] In our view, because of potential nosocomial transmission, patients with hMPV, RSV, or HPIV-3 should be placed on the same IC precautions as those with influenza.…”

Acute and Recurrent Respiratory Tract Infections: Possible Reduction of the Patient’s Pill Burden

“…Инфекции верхних дыхательных путей представля-ют собой наиболее распространенные острые заболе-вания, характеризующиеся высоким риском развития осложнений у детей [1,2]. Ежегодно только в США с осложненным течением острых респираторных вирус-ных инфекций (ОРВИ) и гриппа госпитализируют около 20 тыс.…”