Malveste Ito Célia Regina, Moreira André Luís Elias, Silva Paulo Alex Neves da, Santos Mônica de Oliveira, Santos Adailton Pereira Dos, Rézio Geovana Sôffa, Brito Pollyanna Neta de, Rezende Alana Parreira Costa, Fonseca Jakeline Godinho, Peixoto Fernanda Aparecida de Oliveira, Wastowski Isabela Jubé, Goes Viviane Monteiro, Estrela Mariely Cordeiro, Souza Priscila Zanette de, Carneiro Lilian Carla, Avelino Melissa Ameloti Gomes
Microorganism Biotechnology Laboratory, Institute of Tropical Pathology and Public Health, Federal University of Goiás, 235 St. Leste Universitário, Goiânia 74605-050, GO, Brazil.
State Emergency Hospital of the Northwest Region of Goiânia Governador Otávio Lage de Siqueira (HUGOL), Anhanguera Avenue, 14.527-Santos Dumont, Goiânia 74463-350, GO, Brazil.
Biomedicines. 2023 May 9;11(5):1402. doi: 10.3390/biomedicines11051402.
The main pathogens of severe respiratory infection in children are respiratory viruses, and the current molecular technology allows for a rapid and simultaneous detection of a wide spectrum of these viral pathogens, facilitating the diagnosis and evaluation of viral coinfection.
This study was conducted between March 2020 and December 2021. All children admitted to the ICU with a diagnosis of SARI and who were tested by polymerase chain reaction on nasopharyngeal swabs for SARS-CoV-2 and other common respiratory viral pathogens were included in the study.
The result of the viral panel identified 446 children, with one infected with a single virus and 160 co-infected with two or more viruses. This study employed descriptive analyses, where a total of twenty-two coinfections among SARI-causing viruses were identified. Thus, the five most frequent coinfections that were selected for the study are: hRV/SARS-CoV-2 (17.91%), hRV/RSV (14.18%), RSV/SARS-CoV-2 (12.69%), hRV/BoV (10.45%), and hRV/AdV (8.21%). The most significant age group was 38.1%, representing patients aged between 24 and 59 months (61 individuals). Patients older than 59 months represented a total of 27.5%, comprising forty-four patients. The use of oxygen therapy was statistically significant in coinfections with Bocavirus, other CoVs, Metapneumovirus, and RSV. Coinfections with SARS-CoV-2 and the other different coinfections presented a similar time of use of oxygen therapy with a value of ( > 0.05). In the year 2020, hRV/BoV was more frequent in relation to other types of coinfections, representing a total of 35.1%. The year 2021 presented a divergent profile, with hRV/SARS-CoV-2 coinfection being the most frequent (30.8%), followed by hRV/RSV (28.2%). Additionally, 25.6% and 15.4% represented coinfections between RSV/SARS-CoV-2 and hRV/AdV, respectively. We saw that two of the patients coinfected with hRV/SARS-CoV-2 died, representing 9.52% of all deaths in the study. In addition, both hRV/hBoV and hRV/RSV had death records for each case, representing 8.33% and 6.67% of all deaths, respectively.
Coinfections with respiratory viruses, such as RSV and hBoV, can increase the severity of the disease in children with SARI who are admitted to the ICU, and children infected with SARS-CoV-2 have their clinical condition worsened when they have comorbidities.
儿童严重呼吸道感染的主要病原体是呼吸道病毒，当前的分子技术能够快速同时检测多种此类病毒病原体，有助于病毒合并感染的诊断和评估。
本研究于2020年3月至2021年12月进行。纳入所有因严重急性呼吸感染（SARI）入住重症监护病房（ICU）且通过鼻咽拭子聚合酶链反应检测SARS-CoV-2和其他常见呼吸道病毒病原体的儿童。
病毒检测结果确定了446名儿童，其中1名感染单一病毒，160名合并感染两种或更多病毒。本研究采用描述性分析，共确定了22种SARI致病病毒的合并感染情况。因此，本研究选取的五种最常见合并感染为：人鼻病毒（hRV）/SARS-CoV-2（17.91%）、hRV/呼吸道合胞病毒（RSV）（14.18%）、RSV/SARS-CoV-2（12.69%）、hRV/博卡病毒（BoV）（10.45%）和hRV/腺病毒（AdV）（8.21%）。最主要的年龄组占38.1%，为年龄在24至59个月之间的患者（61人）。59个月以上的患者共占27.5%，包括44名患者。在与博卡病毒、其他冠状病毒、偏肺病毒和呼吸道合胞病毒的合并感染中，使用氧疗具有统计学意义。与SARS-CoV-2的合并感染以及其他不同的合并感染在氧疗使用时间上呈现相似值（>0.05）。2020年，hRV/BoV相对于其他类型的合并感染更为常见，共占35.1%。2021年呈现出不同的情况，hRV/SARS-CoV-2合并感染最为常见（30.8%），其次是hRV/RSV（28.2%）。此外，RSV/SARS-CoV-2和hRV/AdV合并感染分别占25.6%和15.4%。我们发现，两名hRV/SARS-CoV-2合并感染的患者死亡，占本研究所有死亡病例的9.52%。此外，hRV/hBoV和hRV/RSV每种情况都有死亡记录，分别占所有死亡病例的8.33%和6.67%。
呼吸道病毒如RSV和hBoV的合并感染可增加入住ICU的SARI儿童疾病的严重程度，感染SARS-CoV-2的儿童在合并其他疾病时临床状况会恶化。
