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An In vitro Model to Study Immune Responses of Human Peripheral Blood Mononuclear Cells to Human Respiratory Syncytial Virus Infection
Published on: December 10, 2013
Associations between virus single infection or coinfection and respiratory symptoms in young children: A
Emma Hauser-van Westrhenen1, Laia Junquera Guinovart1, Rob Schuurman2
1Julius Centre for Health Sciences and Primary Care, Department of Epidemiology, University Medical Centre Utrecht, Utrecht, The Netherlands.
Insights
Virus coinfections in young children commonly lead to acute respiratory illness (ARI). Coinfections significantly increase ARI risk, highlighting virus interactions that mediate illness severity.
Area of Science:
- Pediatrics
- Virology
- Epidemiology
Background:
- Virus coinfections are frequent in young children.
- Understanding coinfection impact on acute respiratory illness (ARI) is crucial.
Purpose of the Study:
- Quantify single and coinfections in children.
- Assess the association between viral infections and ARI.
- Investigate virus virulence and coinfection effects on ARI severity.
Main Methods:
- Prospective community-based cohort study of children under 4 years.
- Weekly nasal samples and daily symptom diaries collected over 16 weeks.
- PCR testing for 17 respiratory viruses and mixed-effects logistic regression analysis.
Main Results:
- 19.9% of 1,241 virus infections were coinfections; 49.4% were associated with ARI.
- Single virus infections increased ARI odds (OR: 2.15).
- Coinfection further elevated ARI odds by 1.87, independent of individual virus virulence.
Conclusions:
- Approximately half of pediatric respiratory viral infections are linked to ARI.
- Virus-specific virulence influences ARI likelihood.
- Coinfection exacerbates ARI risk, suggesting synergistic virus interactions.
Objectives:
Virus coinfections are common in young children. We quantified single and coinfections and their association with acute respiratory illness (ARI) in a prospective community-based cohort.
Methods:
Healthy children (aged <4 years) were randomly invited for participation. Between October and May of 2021-2024, weekly nasal samples and daily symptom diaries were collected over 16 week, regardless of symptoms. Samples were tested via polymerase chain reaction for 17 respiratory viruses. Associations between ARI and infection status (coinfection, single virus, none) were analyzed using mixed-effects logistic regression.
Results:
A total of 228 children (median age: 19.9 months) contributed 24,432 diaries and 3332 nasal samples. Of 1241 virus infection episodes, 247 (19.9%) were coinfections and 613 (49.4%) were associated with ARI. Single virus vs no infection increased the odds of ARI (odds ratio [OR]: 2.15; 95% confidence interval [CI]: 1.69-2.73). Three virulence categories emerged: mild (not associated with ARI; enterovirus, adenovirus, bocavirus), moderate (ORs: 1.36-1.81; rhinovirus, seasonal coronaviruses, SARS-CoV-2), and severe (ORs: 3.44-5.01; influenza, human metapneumovirus, parainfluenza, respiratory syncytial virus). Coinfection further increased the odds of ARI by 1.87 (95% CI: 1.22-2.89), even when accounting for virulence category.
Conclusions:
About half of respiratory viral infections in young children are associated with ARI. This likelihood varies by virus, reflecting virulence differences. Coinfection increases the odds of ARI beyond individual virus effects, suggesting virus interactions mediate severity.
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