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Codetections of Other Respiratory Viruses Among Children Hospitalized With COVID-19 - AAP

Mary Wilson

Well-known member
JANUARY 18 2023

https://doi.org/10.1542/peds.2022-059037

Nickolas T. Agathis, MD, MPH; Kadam Patel, MBBS, MPH; Jennifer Milucky, MSPH; Christopher A. Taylor, PhD; Michael Whitaker, MPH; Huong Pham, MPH; Onika Anglin, MPH; Shua J. Chai, MD, MPH;
Nisha B. Alden, MPH; James Meek, MPH; Evan J. Anderson, MD; Andy Weigel, MSW; Sue Kim, MPH;
Ruth Lynfield, MD; Chad Smelser, MD; Alison Muse, MPH; Kevin Popham, MPH; Laurie M. Billing, MPH; Melissa Sutton, MD, MPH; H. Keipp Talbot, MD, MPH; Andrea George, MPH; Meredith McMorrow, MD, MPH; Fiona P. Havers, MD, MHS; CDC COVID-NET Surveillance Team


OBJECTIVES:
To assess the clinical impact of respiratory virus codetections among children hospitalized with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection.

METHODS:
During March 2020 to February 2022, the US coronavirus disease 2019 (COVID-19)-Associated Hospitalization Surveillance Network (COVID-NET) identified 4372 children hospitalized with SARS-CoV-2 infection admitted primarily for fever, respiratory illness, or presumed COVID-19. We compared demographics, clinical features, and outcomes between those with and without codetections who had any non-SARS-CoV-2 virus testing. Among a subgroup of 1670 children with complete additional viral testing, we described the association between presence of codetections and severe respiratory illness using age-stratified multivariable logistic regression models.

RESULTS:
Among 4372 children hospitalized, 62% had non-SARS-CoV-2 respiratory virus testing, of which 21% had a codetection. Children with codetections were more likely to be <5 years old (yo), receive increased oxygen support, or be admitted to the ICU (P < .001). Among children <5 yo, having any viral codetection (<2 yo: adjusted odds ratio [aOR] 2.1 [95% confidence interval [CI] 1.5–3.0]; 2–4 yo: aOR 1.9 [95% CI 1.2–3.1]) or rhinovirus/enterovirus codetection (<2 yo: aOR 2.4 [95% CI 1.6–3.7]; 2-4: aOR 2.4 [95% CI 1.2–4.6]) was significantly associated with severe illness. Among children <2 yo, respiratory syncytial virus (RSV) codetections were also significantly associated with severe illness (aOR 1.9 [95% CI 1.3–2.9]). No significant associations were seen among children ≥5 yo.

CONCLUSIONS:
Respiratory virus codetections, including RSV and rhinovirus/enterovirus, may increase illness severity among children <5 yo hospitalized with SARS-CoV-2 infection.

https://publications.aap.org/pediat...atory-Viruses-Among?autologincheck=redirected
 
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