Evaluation of viral co-infection in hospitalized and non-hospitalized children with respiratory infection

Viral co-infection is involved in a significant proportion of children with an acute respiratory infection (RI) and may increase the severity of clinical presentation and the risk for hospitalization. Those are the conclusions of researchers at the University of Athens, Aghia Sophia Children’s Hospital, and the University Hospital, Attikon, Athens, Greece.

They took rhinopharyngeal washes from 611 children aged one month to 14 years who presented in the emergency department with RI from June 2010 to June 2011 and were treated as outpatients (299, 48.9%) or hospitalized (312, 51.1%). Lower respiratory tract infection was diagnosed more often in hospitalized children (68% vs 36%, P=0.001). Out of 397 children in which microarrays detected viral infection (70.1%), a single virus was found in 228 (57.4%) and two or more viruses in 169 (42.5%). 

According to the researchers, the most prevalent viruses among children with positive samples (n=397) were respiratory syncytial virus (RSV) in 225 (56.6%), parainfluenza virus (PIV) in 118(29.7%), and rhinoviruses (HRV) in 73 (18.4%), followed by influenza (INFL) in 56 (14.1%), adenoviruses (ADV) in 31 (7.8%), bocavirus (HBoV) in 25 (6.3%), HMPV in 15 (3.7%), enteroviruses (EV) in 12 (3%), and coronavirus type 229 (HCoV) in two (0.5%). 

Among children with viral co-infections (n=169), most common were RSVA-RSVB in 46 children (27.2%), RSV- INFL in 20 (11.8%), RSV-HRV in 18 (10.6%), and PIV-INFL-RSV in nine (5.3%).