Is virus coinfection a predictor of severity in children with viral respiratory infections?
Is virus coinfection a predictor of severity in children with viral respiratory infections?
复制标题
DOI：
10.1016/j.cmi.2014.08.024
复制
发表时间：
2015-03
期刊：
影响因子：
--
通讯作者：
Tran DJ
中科院分区：
文献类型：
--
作者：
Asner SA;Rose W;Petrich A;Richardson S;Tran DJ
分子检测增加了对患有急性呼吸道感染的儿童的病毒性呼吸道感染（包括病毒合并感染）的检测。然而，与单一病毒感染相比，病毒合并感染的临床严重程度仍不确定。我们对患有急性呼吸道感染的儿童进行了一项回顾性研究，比较了单一呼吸道病毒感染与病毒合并感染的临床严重程度，并通过分子测定对中鼻甲拭子进行了检测。从健康记录中提取患者特征和临床严重程度的衡量标准。共纳入病毒感染儿童472例，其中单一病毒感染391例，病毒合并感染81例。调整年龄和潜在合并症后，病毒状态并不影响住院患者的入院（比值比 (OR) = 0.8；95% 置信区间 (CI) 0.5–1.4；p = 0.491）或住院患者的临床疾病严重程度（OR = 0.8；95% CI 0.5–1.5；p = 0.515）。然而，与同时感染 HRV/ENT 和至少另一种病毒的儿童相比，单独感染鼻病毒/肠道病毒 (HRV/ENT) 的儿童更有可能入院，尽管这在多变量分析中并不显着（OR 0.47；95% CI 0.22–1.0；p < 0.051）。在多变量分析中，与单纯 RSV 感染的儿童相比，同时感染呼吸道合胞病毒 (RSV) 和其他病毒的儿童更容易出现经放射学确诊的肺炎（OR 3.16，95% CI 1.07–9.34，p < 0.037）。尽管同时感染 RSV 和其他病毒的儿童比单一 RSV 感染的儿童更容易出现肺炎，但在单一病毒感染和病毒合并感染的儿童之间观察到相同的临床严重程度。在单一 HRV/ENT 感染的儿童中观察到的疾病严重程度增加需要进一步调查。
Molecular assays have resulted in increased detection of viral respiratory infections, including virus coinfection, from children with acute respiratory infections. Yet the clinical severity of virus coinfection compared to single virus infection remains uncertain. We performed a retrospective study of children presenting with acute respiratory infections comparing clinical severity of single respiratory virus infection to virus coinfection, detected on midturbinate swabs by molecular assays. Patient characteristics and measures of clinical severity were abstracted from health records. A total of 472 virus-infected children were included, 391 with a single virus infection and 81 with virus coinfection. Virus status did not affect admission to hospital (odds ratio (OR) = 0.8; 95 % confidence interval (CI) 0.5–1.4; p 0.491) or clinical disease severity among inpatients (OR = 0.8; 95% CI 0.5–1.5; p 0.515) after adjusting for age and underlying comorbidities. However, children infected with rhinovirus/enterovirus (HRV/ENT) alone were more likely to be admitted to the hospital compared to those coinfected with HRV/ENT and at least another virus, although this was not significant in multivariable analyses (OR 0.47; 95% CI 0.22–1.0; p 0.051). In multivariable analyses, children coinfected with respiratory syncytial virus (RSV) and other viruses were significantly more likely to present with radiologically confirmed pneumonia compared to those with an isolated RSV infection (OR 3.16, 95% CI 1.07–9.34, p 0.037). Equivalent clinical severity was observed between children with single virus infection and virus coinfection, although children coinfected with RSV and other viruses presented more frequently with pneumonia than those with single RSV infection. Increased disease severity observed among children with single HRV/ENT infection requires further investigation.
登录
查看更多内容
DOI：
10.1016/s0140-6736(10)61459-6
发表时间：
2011-04-09
期刊：
Lancet (London, England)
影响因子：
--
作者：
Ruuskanen O;Lahti E;Jennings LC;Murdoch DR
通讯作者：
Murdoch DR
多重与单个病毒呼吸道感染：住院儿童的病毒负荷和临床疾病严重程度。
影响因子：
4.4
作者：
Martin ET;Kuypers J;Wald A;Englund JA
通讯作者：
Englund JA
影响因子：
5.2
作者：
Midulla, F.;Scagnolari, C.;Moretti, C.
通讯作者：
Moretti, C.
影响因子：
11.8
作者：
Mermond, Sylvain;Zurawski, Virginie;Levine, Orin S.
通讯作者：
Levine, Orin S.
DOI：
10.1517/17530059.2011.537653
发表时间：
2011-01-01
期刊：
Expert opinion on medical diagnostics
影响因子：
--
作者：
Slupsky, Carolyn M
通讯作者：
Slupsky, Carolyn M