Pathogenic Role of Human Rhinovirus Mono-Infection in Pediatric Lower Respiratory Tract Infection

Area of Science:

• Pediatric Infectious Diseases
• Virology
• Respiratory Medicine

Background:

• Human rhinovirus (HRV) is a major cause of pediatric respiratory tract infections (RTIs), affecting 30-50% of children under five.
• HRV infections can range from mild to life-threatening, impacting children as mono-infections or co-infections.
• Significant economic losses are associated with pediatric RTIs caused by HRV.

Purpose of the Study:

• To emphasize the role of HRV mono-infection in pediatric acute respiratory tract infections (ARTIs).
• To correlate clinical and molecular laboratory findings in children with HRV mono-infection.
• To identify factors associated with severe disease manifestation in pediatric HRV infections.

Main Methods:

• A four-year retrospective study (March 2019-October 2023) in a tertiary care hospital.
• Inclusion of children up to 14 years with ARTIs, analyzing clinical and laboratory data.
• Multiplex real-time polymerase chain reaction (RT-PCR) on nasopharyngeal or throat swabs to detect HRV.

Main Results:

• Out of 245 samples, 52 tested positive for HRV, with 27 cases of HRV mono-infection.
• The majority of HRV mono-infection cases (88.8%) were under five years old.
• Fever and shortness of breath were consistent symptoms; 62.9% had comorbidities requiring respiratory support, developing conditions like bronchiolitis, LRTI, or pneumonia. HRV mono-infections showed Ct values < 25, while HRV in co-infections had Ct > 30.

Conclusions:

• HRV mono-infection in children under five with comorbidities and low Ct values (<25) indicates severe disease.
• These cases require cautious clinical management due to the higher risk of severe outcomes.
• Molecular findings (Ct values) can help differentiate severity in HRV infections.