Objective: To determine whether viral coinfection is a risk for severe
lower respiratory tract infection (LRTI). Working Hypothesis: Children
with viral coinfection had a higher risk for admission to the intensive
care unit (ICU) than those with a single virus infection. Study Design:
Retrospective, observational study for ten years. Patient-Subject
Selection: Children between 1-60 months of age hospitalized with LRTI.
Methodology: We defined severe LRTI as admission to the ICU for
high-flow nasal cannula oxygen/bilevel positive airway pressure/invasive
ventilation and assessed demographic and laboratory data with potential
risk factors from the patients’ medical records. Results: Of 2115
children hospitalized with LRTI, 562 had severe, and 1553 had mild
disease. Viral coinfection was present in 28.3% of all patients, and
those with viral coinfection were at a higher risk of severe LRTI than
those with a single virus infection (43.8% vs. 22.7%; aOR, 3.44; 95%
CI, 2.74-4.53). Respiratory syncytial virus (RSV) and rhinovirus (except
for between 25-60 months) coinfections were associated with severe LRTI
in all ages, whereas parainfluenza virus-3 (PIV3; 7-24 months) and
bocavirus (7-12 months) coinfections led to severe LRTI in early
childhood. Moreover, influenza-A coinfection caused severe LRTI in
children between 7-12 and 25-60 months. Other risk factors included
young age, prematurity, history of atopy, exposure to tobacco smoke,
underlying condition, neutrophilia, lymphopenia, and high CRP value.
Conclusion: Children with viral coinfection, particularly with
rhinovirus, RSV, influenza-A, PIV3, and bocavirus, may be followed
closely regarding the clinical changes.
Is Viral Coinfection A Risk Factor For Severe Lower Respiratory Tract Infection? A Retrospective Observational Study
