Patient characteristics and severity of human rhinovirus infections in children

Abstract

Background: It is increasingly recognized that human rhinoviruses (HRV) can be associated with severe infections. However, conflicting results have been reported on the relative prevalence and severity of the three HRV species.

Objectives: The relative prevalence and clinical characteristics of HRV-A, B and C, in children attending a South London teaching hospital were investigated retrospectively.

Study design: Children aged<16 years with episodes of respiratory tract infections and detectable entero/rhinovirus RNA in respiratory samples between November 2009 and December 2010 were investigated. Retrospective case review was performed and patients' characteristics recorded.

Results: Entero/rhinoviruses were the commonest viral pathogens (498/2316; 21.5%). Amongst 204 infection episodes associated with entero/rhinovirus, 167 were typed HRV, HRV-C was the most prevalent (99/167, 59.3%) followed by HRV-A (60/167; 35.9%) and HRV-B (8/167, 4.8%). The severity spectrum of HRV-A and HRV-C infections were similar and affected all parts of the respiratory tract. Co-pathogens were observed in 54 (26.5%) episodes. Severity was increased in patients with non-viral co-pathogens and those with an underlying respiratory condition. Univariate and multiple regression analyses of potential prognostic variables including age, co-pathogens and underlying respiratory illnesses showed that mono-infection with HRV-C, as compared with other HRV species, was associated with more severe disease in young children<3 years.

Conclusions: HRV-C was the most prevalent species and on its own was associated with severe disease in children<3 years. The association between infection with HRV species and clinical presentation is complex and affected by many confounding factors.

Keywords: 5′NCR; 5′noncoding region; Co-pathogens; HDU; HMPV; HRV; High Dependency Unit; Human rhinoviruses; ICU; IQR; Intensive Care Unit; LRTI; PIV; RSV; RTI; Severity; URTI; Young children; human metapneumovirus; human rhinovirus; interquartile range; lower respiratory tract infection; parainfluenzaviruses; respiratory syncytial viruses; respiratory tract infection; upper respiratory tract infection.

Fig. 1

Respiratory samples received during the study period and samples positive for entero/rhinoviruses and other respiratory viruses.