Virus-Specific Impact of Respiratory Viruses on Adult Emergency Department Outcomes

Few studies have examined the impact of community-acquired respiratory viruses (CRVs) on emergency department visits and outcomes in adults. This study aimed to characterize the epidemiology of CRV infections and assess associations between virus types and clinical outcomes. We retrospectively reviewed adult patients with respiratory symptoms who underwent rapid influenza testing at a community hospital emergency department in Okinawa, Japan, from February 2020 to January 2021. Residual samples were tested using multiplex polymerase chain reaction assays to identify CRVs. Among 551 cases, 228 (41%) tested positive for viruses. Compared with virus-negative patients, there were no significant differences in median age (64 years, range 20-99) or the proportions requiring oxygen supplementation (n = 60) or hospitalization (n = 125). The common cold was more frequent in virus-positive patients (n = 74, p = 0.002). Rhinovirus was the most prevalent virus (n = 111) and accounted for the highest numbers of oxygen supplementation (n = 26) and hospitalizations (n = 61). Seasonal coronavirus was significantly associated with oxygen supplementation (p = 0.029), and co-detection of multiple viruses was associated with hospitalization (p = 0.046). These findings highlight the clinical impact of CRVs on adult emergency department outcomes. Point-of-care virus diagnostics may improve risk stratification and prediction of outcomes based on virus types and co-infections.