tetano
Editor, Senior Moderator
Pediatr Infect Dis J
. 2025 Apr 1;44(4):333-341.
doi: 10.1097/INF.0000000000004623. Epub 2024 Nov 8. Respiratory Viral Co-infection in SARS-CoV-2-Infected Children During the Early and Late Pandemic Periods
Jianling Xie[SUP] 1 [/SUP], Todd A Florin[SUP] 2 [/SUP], Anna L Funk[SUP] 1 [/SUP], Daniel J Tancredi[SUP] 3 [/SUP], Nathan Kuppermann[SUP] 4 [/SUP], Stephen B Freedman[SUP] 5 [/SUP]; Pediatric Emergency Research Network (PERN)-COVID-19 and Pediatric Emergency Research Canada (PERC) Study Teams
Collaborators, Affiliations
Background: Knowledge regarding the impact of respiratory pathogen co-infection in severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2)-infected children seeking emergency department care is limited, specifically as it relates to the association between SARS-CoV-2 viral co-infection and disease severity and factors associated with co-infection.
Methods: This secondary analysis included data from 2 prospective cohort studies conducted between March 2020 and February 2022 that included children <18 years of age tested for SARS-CoV-2 infection along with additional respiratory viruses in a participating emergency department. Outcomes included the detection rate of other respiratory viruses and the occurrence of severe outcomes (ie, intensive interventions, severe organ impairment and death).
Results: We included 2520 participants, of whom 388 (15.4%) were SARS-CoV-2-positive. Detection of additional respiratory viruses occurred in 18.3% (71/388) of SARS-CoV-2-positive children, with rhinovirus/enterovirus being most frequently detected (42/388; 10.8%). In multivariable analyses (adjusted odds ratio and 95% confidence interval), among SARS-CoV-2-positive children, detection of another respiratory virus was not associated with severe outcomes [1.74 (0.80-3.79)], but detection of rhinovirus/enterovirus [vs. isolated SARS-CoV-2 detection 3.56 (1.49-8.51)] and having any preexisting chronic medical condition [2.15 (1.06-4.36)] were associated with severe outcomes. Among SARS-CoV-2-positive children, characteristics independently associated with an increased odds of any other viral co-infection included: age and delta variant infection.
Conclusions: Approximately 1 in 5 children infected with SARS-CoV-2 had co-infection with another respiratory virus, and co-infection with rhinovirus/enterovirus was associated with severe outcomes. When public health restrictions were relaxed, co-infections increased.
. 2025 Apr 1;44(4):333-341.
doi: 10.1097/INF.0000000000004623. Epub 2024 Nov 8. Respiratory Viral Co-infection in SARS-CoV-2-Infected Children During the Early and Late Pandemic Periods
Jianling Xie[SUP] 1 [/SUP], Todd A Florin[SUP] 2 [/SUP], Anna L Funk[SUP] 1 [/SUP], Daniel J Tancredi[SUP] 3 [/SUP], Nathan Kuppermann[SUP] 4 [/SUP], Stephen B Freedman[SUP] 5 [/SUP]; Pediatric Emergency Research Network (PERN)-COVID-19 and Pediatric Emergency Research Canada (PERC) Study Teams
Collaborators, Affiliations
- PMID: 40063967
- DOI: 10.1097/INF.0000000000004623
Background: Knowledge regarding the impact of respiratory pathogen co-infection in severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2)-infected children seeking emergency department care is limited, specifically as it relates to the association between SARS-CoV-2 viral co-infection and disease severity and factors associated with co-infection.
Methods: This secondary analysis included data from 2 prospective cohort studies conducted between March 2020 and February 2022 that included children <18 years of age tested for SARS-CoV-2 infection along with additional respiratory viruses in a participating emergency department. Outcomes included the detection rate of other respiratory viruses and the occurrence of severe outcomes (ie, intensive interventions, severe organ impairment and death).
Results: We included 2520 participants, of whom 388 (15.4%) were SARS-CoV-2-positive. Detection of additional respiratory viruses occurred in 18.3% (71/388) of SARS-CoV-2-positive children, with rhinovirus/enterovirus being most frequently detected (42/388; 10.8%). In multivariable analyses (adjusted odds ratio and 95% confidence interval), among SARS-CoV-2-positive children, detection of another respiratory virus was not associated with severe outcomes [1.74 (0.80-3.79)], but detection of rhinovirus/enterovirus [vs. isolated SARS-CoV-2 detection 3.56 (1.49-8.51)] and having any preexisting chronic medical condition [2.15 (1.06-4.36)] were associated with severe outcomes. Among SARS-CoV-2-positive children, characteristics independently associated with an increased odds of any other viral co-infection included: age and delta variant infection.
Conclusions: Approximately 1 in 5 children infected with SARS-CoV-2 had co-infection with another respiratory virus, and co-infection with rhinovirus/enterovirus was associated with severe outcomes. When public health restrictions were relaxed, co-infections increased.