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Published on: November 10, 2023
Non-SARS-CoV-2 respiratory tract infections in pediatric populations during the pandemic
Yi-Ting Chen1, Ya-Chih Cheng1, Kuo-Chen Weng1
1Department of Laboratory Medicine, National Taiwan University Hospital, Taipei, Taiwan.
Insights
In pediatric patients with non-SARS-CoV-2 respiratory infections, human rhinovirus/enterovirus and human bocavirus were frequently detected. These viral co-detections were associated with asthma, male gender, and fever, highlighting their clinical significance.
Area of Science:
- Pediatrics
- Virology
- Infectious Diseases
Background:
- Respiratory tract infections (RTIs) pose significant risks to children, necessitating identification of pathogens beyond SARS-CoV-2.
- Understanding the etiology of RTIs in pediatric patients is crucial for effective clinical management, especially during viral outbreaks.
Purpose of the Study:
- To investigate the prevalence and clinical associations of viral pathogens in SARS-CoV-2-negative pediatric patients with RTIs.
- To identify common co-detections and their potential impact on disease presentation and outcomes in children.
Main Methods:
- Analysis of 156 SARS-CoV-2-negative pediatric RTI cases using multiplex PCR (BIOFIRE® FilmArray® RP 2.1).
- Specific detection of human rhinovirus/enterovirus (HRV/EV) and human bocavirus (HBoV) using targeted assays.
Main Results:
- Viral pathogens were detected in 61.5% of cases, with HRV/EV being the most common (92.7% of positive samples).
- Human bocavirus (HBoV) was detected in 27.8% of samples and associated with age; 45.5% of pneumonia cases were HBoV-positive.
- Viral co-detections, frequently involving HBoV and HRV/EV, were linked to male gender and fever.
Conclusions:
- Viral co-infections are common in pediatric non-SARS-CoV-2 RTIs.
- Rhinovirus and human bocavirus are significant findings requiring further research into their clinical implications in Taiwanese children.
- The study underscores the importance of comprehensive viral pathogen testing in pediatric respiratory infections.
Background:
Respiratory tract infections (RTIs) remain a major concern in pediatric care, as they can pose life-threatening risks to children. While SARS-CoV-2 receives substantial public concern, identifying other respiratory pathogens in SARS-CoV-2-negative patients is crucial for guiding clinical management.
Methods:
In this study, the etiology of RTIs among 156 SARS-CoV-2-negative children in 2022 was analyzed using BIOFIRE® FilmArray® Respiratory Panel 2.1 assay, VIASURE rhinovirus + enterovirus detection kit, and an in-house realtime-PCR for human bocavirus.
Results:
Of the 156 samples tested with the FilmArray®, 96 (61.5%) were positive for viral pathogens, with human rhinovirus/enterovirus (HRV/EV) being the most prevalent (92.7%). Targeted PCR assay confirmed that 97.8% of HRV/EV detections were rhinoviruses, which were significantly associated with asthma (OR = 9.0, 95% CI = 2.0-14.2, P = 0.005). Human bocavirus (HBoV) was detected in 40 out of 144 samples (27.8%) using real-time PCR. Multivariable analysis identified age as the only factor associated with HBoV detection (OR = 0.8, 95% CI: 0.7-1.0, P = 0.014), although it was noted 45.5% of pneumonia cases were HBoV-positive. Overall, 75.7% of co-detections involved HBoV, most frequently with HRV/EV. Co-detections were significantly associated with male gender (OR = 2.9, 95% CI = 1.2-7.3, P = 0.024) and fever (OR = 6.3, 95% CI = 2.0-19.8, P = 0.002).
Conclusion:
Our study demonstrates the occurrence of viral co-detections in pediatric patients with non-SARS-CoV-2 RTIs during the pandemic. The frequent detection of rhinovirus and HBoV warrants further investigation into their clinical significance in Taiwanese children with RTIs.
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