Do children with HRV/EV fare better than those with other respiratory viruses?

Children who test positive for human rhinovirus/enterovirus (HRV/EV) require close monitoring by clinicians, given possible clinical outcomes that are either similar or worse than known highly pathogenic viruses, suggests a recent study.

“While infections caused by rhinoviruses and enteroviruses are common among children, the entirety of their clinical impact remains elusive,” according to the researchers.

This retrospective analysis was conducted on nasopharyngeal samples singly positive for HRV/EV, influenza A/B (flu), or respiratory syncytial virus (RSV) from paediatric patients aged ≤17 years submitted for clinical testing via multiplex polymerase chain reaction between 2016 and 2019.

The following outcomes were then examined: days of respiratory symptoms before testing, visits for respiratory symptoms, receipt of a breathing treatment, receipt of antibiotics, and hospital admission. The researchers conducted statistical analyses, controlled for age and comorbidities.

Of the 1,355 positive samples analysed, 743 were HRV/EV infections, 303 flu, and 309 RSV. Children with flu infection had 28-percent fewer days of respiratory symptom (β, ‒0.32, 95 percent confidence interval [CI], ‒0.46 to ‒0.18; p<0.001), fewer visits for respiratory symptoms, and significantly lower likelihood of receiving a breathing treatment or antibiotics and hospitalization than those with HRV/EV infections.

On the other hand, children with RSV had a similar number of days of respiratory symptoms, outpatient visits, and odds of hospital admission but significantly higher chances of receiving a breathing treatment and antibiotics relative to those with HRV/EV.