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The interdependence between rhinovirus cycle threshold values, viral co-detections, and clinical disease severity in

María Isabel Sánchez Códez1, Isabel Benavente Fernández2,3,4, Katherine Moyer5

  • 1Division of Pediatric Infectious Diseases, Puerta del Mar, Cadiz, Spain.

Journal of Medical Virology
|September 5, 2024
PubMed

Insights

Rhinovirus (RV) infections in children are common. Higher RV viral loads and single RV infections, not co-detections, were linked to older age and increased hospitalization risk.

Area of Science:

  • Pediatric Infectious Diseases
  • Virology
  • Clinical Research

Background:

  • Rhinoviruses (RVs) are a primary cause of acute respiratory infections (ARI) in children.
  • The impact of RV viral load (VL) and viral co-detections on disease severity remains unclear.

Purpose of the Study:

  • To investigate the association between RV viral loads, viral co-detections, and clinical outcomes in pediatric RV-ARI.
  • To determine factors predicting disease severity in children with RV-ARI.

Main Methods:

  • Retrospective study of 1,899 children and adolescents (≤21 years) with RV-ARI from 2011-2013.
  • RV viral loads (VL) stratified by PCR cycle threshold (CT) values (high ≤25, intermediate 26-32, low >32).
  • Adjusted analyses assessed the impact of RV VL and co-detections on hospitalization, oxygen needs, PICU care, and length of stay.

Main Results:

  • 78% of children had chronic comorbidities; 24% had viral co-detections.
  • Single RV infections showed higher VL and were associated with older age compared to co-infections.
  • Viral co-detections decreased as RV VL increased.
  • Underlying conditions independently predicted worse outcomes; high RV VL predicted PICU care; single RV-ARI predicted hospitalization.

Conclusions:

  • Single RV infections are associated with higher viral loads and older age in children.
  • Underlying medical conditions are the strongest predictors of severe clinical outcomes in pediatric RV-ARI, outweighing viral load or co-detections.

Keywords:
Ct valueschildrencomorbiditiesdisease severityrhinoviruses loadsviral coinfections

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