Age- and Virus-Composition-Aware Interpretation of Respiratory Viral Co-Detection Using Same-Day C-Reactive Protein...

Area of Science:

• Clinical Medicine
• Infectious Diseases
• Biochemistry

Background:

• C-reactive protein (CRP) is a key inflammatory marker.
• Interpreting CRP levels during respiratory viral co-infections can be challenging.
• The impact of viral composition and patient demographics on CRP is not fully understood.

Purpose of the Study:

• To evaluate if patient age and viral composition offer better context for same-day CRP profiles than the number of detected targets alone.
• To investigate the association between respiratory virus detection (single vs. co-detection) and CRP levels.
• To identify specific viruses influencing CRP during co-infections.

Main Methods:

• Retrospective analysis of 19,002 same-day respiratory multiplex PCR and serum CRP episodes.
• Classification of episodes into PCR-not-detected, single-virus, or viral co-detection.
• Statistical analysis using adjusted regression, leave-one-virus-out, and mixed-effects models.

Main Results:

• Co-detection was initially associated with higher CRP (11.8%) after age/sex adjustment.
• Excluding adenovirus attenuated this association.
• Adenovirus was independently associated with a 75.1% increase in CRP; age also showed graded CRP associations.

Conclusions:

• Same-day CRP profiles during viral co-infections are best interpreted considering patient age and specific viral composition.
• The number of detected viruses alone is insufficient for accurate CRP interpretation.
• Adenovirus and patient age are significant factors influencing CRP levels in respiratory viral infections.