Influenza and rhinovirus viral load and disease severity in upper respiratory tract infections
Influenza and rhinovirus viral load and disease severity in upper respiratory tract infections
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DOI：
10.1016/j.jcv.2016.11.008
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发表时间：
2017-01-01
影响因子：
8.8
通讯作者：
Gubbay, Jonathan B.
中科院分区：
文献类型：
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作者：
Granados, Andrea;Peci, Adriana;Gubbay, Jonathan B.
背景：病毒载量在呼吸道病毒感染中的作用尚不清楚。有人提出，病毒载量的一些，但不是所有的呼吸道病毒与疾病severity.Objectives：我们的目的是确定是否存在关联的病毒载量之间的患者在门诊设置，相比，那些需要住院/重症监护病房（ICU）入院与流感A/H3 N2，流感B，或人鼻病毒（HRV）;我们还探讨了年龄、性别和同时检测肺炎链球菌对患者环境的影响。我们假设住院/ICU患者的呼吸道病毒载量高于门诊患者，研究设计：我们通过内部实时RT-PCR定量了来自加拿大安大略不同患者环境的774个带有流感A/H3N2或B或HRV病毒的鼻咽拭子中的病毒载量。结果：甲型流感/H3N2（6.94）的平均病毒载量（log（10）拷贝/ml）高于乙型流感（4.96）和HRV（5.58）（p <0.0001）。婴儿和老年人中甲型流感/H3N2病毒载量最高;然而，与在门诊/急诊室环境中收集的拭子相比，A/H3N2病毒载量增加与住院/ICU入院无关。医院/ICU患者的流感B病毒载量高于门诊患者（OR 1.28，95%CI 1.11 - 1.47）。HRV病毒载量随年龄（p = 0.67）或环境（p = 0.54）而无差异; S.结论：当与门诊/ER患者相比时，患有流感B的住院/ICU患者的病毒载量更高，但不是流感A或HRV。(C)© 2016 Elsevier B.V.版权所有。
Background: The role of viral load in respiratory viral infection is unclear. It is proposed that the viral load of some, but not all respiratory viruses correlate with disease severity.Objectives: We aimed to determine if an association exists between viral loads among patients in ambulatory settings, compared to those requiring hospitalization/intensive care unit (ICU) admission with influenza A/H3N2, influenza B, or human rhinovirus (HRV); we also explored the impact of age, gender and co-detection of Streptococcus pneumoniae on patient setting. We hypothesized that hospitalized/ICU patients have higher respiratory virus viral loads compared to ambulatory (e.g. walk-in clinics, family practices)/ER patients.Study design: We quantified viral load by in-house real-time RT-PCR in 774 nasopharyngeal swabs with influenza A/H3N2, or B or HRV viruses from various patient settings in Ontario, Canada.Results: Mean viral load (log(10) copies/ml) of influenza A/H3N2 (6.94) was higher than influenza B (4.96) and HRV (5.58) (p < 0.0001). Influenza A/H3N2 viral loads were highest in infants and the elderly; however, increased A/H3N2 viral loads were not associated with hospitalization/ICU admission compared to swabs collected in ambulatory/ER settings. Influenza B viral loads were higher in patients in hospital/ICU settings compared to those in ambulatory settings (OR 1.28,95% CI 1.11-1.47). HRV viral loads did not differ by age (p = 0.67) or setting (p = 0.54); there was no association between S. pneumoniae colonization and setting for any virus.Conclusion: When compared to ambulatory/ER patients, viral load was higher in hospitalized/ICU patients with influenza B, but not influenza A or HRV. (C) 2016 Elsevier B.V. All rights reserved.