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. 2024 Apr 17;10(8):e29855.
doi: 10.1016/j.heliyon.2024.e29855. eCollection 2024 Apr 30.

Viral etiology of severe lower respiratory tract infections in SARS-CoV-2 negative hospitalized patients during the COVID-19 pandemic in Kuwait

Haya Altawalah  1   2 , Wadha Alfouzan  1   3 , Talal Al-Fadalah  4 , Mariam Ali Zalzala  1 , Sayeh Ezzikouri  5
Affiliations

Viral etiology of severe lower respiratory tract infections in SARS-CoV-2 negative hospitalized patients during the COVID-19 pandemic in Kuwait

Haya Altawalah et al. Heliyon. .

Abstract

Background: The prevalence of respiratory infections is largely underexplored in Kuwait. The aim of our study is to determine the etiology of infections from patients who are SARS-CoV-2 negative hospitalized with severe lower respiratory tract infections (LRTIs) in Kuwait during the coronavirus disease 2019 (COVID-19) pandemic.

Methods: We conducted an observational cross-sectional study among severe LRTI patients between September 2021 and March 2022. Respiratory samples from 545 non-COVID-19 severe LRTIs patients were prospectively evaluated with FTD Respiratory 21 Plus® real-time PCR, targeting 20 different viruses and 1 atypical bacterial pathogen.

Results: Among all 545 hospitalized cases, 411 (75.4 %) tested positive for at least one respiratory pathogen. The most common were rhinovirus (HRV) (32.7 %), respiratory syncytial virus (RSV) (20.9 %), metapneumovirus (HMPV) (14.1 %), bocavirus (13.2 %), and influenza A (12.7 %). The proportion of pathogens detected was highest in the under-5 age group, while HKU1 (44.4 %) predominated in the elderly (>50 years).

Conclusion: Our study reveals a high prevalence of respiratory viruses in severe acute lower respiratory tract infections among non-COVID-19 hospitalized patients in Kuwait. HRV remains the main etiology affecting the country, particularly in infants. These results underscore the necessity of employing multiplex PCR for accurate diagnosis and describing the epidemiology of infections among severe lower respiratory tract infections. This will facilitate the use of specific antiviral therapy and help avoid excessive or inappropriate antibiotic therapy.

Keywords: Laboratory diagnosis; Multiplex PCR; Severe lower respiratory tract infections; Surveillance.

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Conflict of interest statement

The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.

Figures

Fig. 1
Fig. 1
Viral pathogens causing severe lower respiratory tract infections (LRTIs) morbidity, and deaths in hospitalized patients at Sabah Medical Hospital from September 2021 to March 2022. HRV, human rhinovirus; AdV, adenovirus; RSV, respiratory syncytial virus; PIV4, parainfluenza virus 4; HMPV, human metapneumovirus; PIV, parainfluenza virus; HBoV, human bocavirus; EV, enterovirus; hCoV, human coronavirus.
Fig. 2
Fig. 2
Distribution of different respiratory pathogens among hospitalized non-COVID-19 cases over the study period.
See this image and copyright information in PMC

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