Viral Coinfection of Children Hospitalized with Severe Acute Respiratory Infections during COVID-19 Pandemic
Célia Regina Malveste Ito,
André Luís Elias Moreira,
Paulo Alex Neves da Silva,
Mônica de Oliveira Santos,
Adailton Pereira dos Santos,
Geovana Sôffa Rézio,
Pollyanna Neta de Brito,
Alana Parreira Costa Rezende,
Jakeline Godinho Fonseca,
Fernanda Aparecida de Oliveira Peixoto,
Isabela Jubé Wastowski,
Viviane Monteiro Goes,
Mariely Cordeiro Estrela,
Priscila Zanette de Souza,
Lilian Carla Carneiro,
Melissa Ameloti Gomes Avelino
Affiliations
Célia Regina Malveste Ito
Microorganism Biotechnology Laboratory, Institute of Tropical Pathology and Public Health, Federal University of Goiás, 235 St. Leste Universitário, Goiânia 74605-050, GO, Brazil
André Luís Elias Moreira
Microorganism Biotechnology Laboratory, Institute of Tropical Pathology and Public Health, Federal University of Goiás, 235 St. Leste Universitário, Goiânia 74605-050, GO, Brazil
Paulo Alex Neves da Silva
Microorganism Biotechnology Laboratory, Institute of Tropical Pathology and Public Health, Federal University of Goiás, 235 St. Leste Universitário, Goiânia 74605-050, GO, Brazil
Mônica de Oliveira Santos
Microorganism Biotechnology Laboratory, Institute of Tropical Pathology and Public Health, Federal University of Goiás, 235 St. Leste Universitário, Goiânia 74605-050, GO, Brazil
Adailton Pereira dos Santos
Microorganism Biotechnology Laboratory, Institute of Tropical Pathology and Public Health, Federal University of Goiás, 235 St. Leste Universitário, Goiânia 74605-050, GO, Brazil
Geovana Sôffa Rézio
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
Pollyanna Neta de Brito
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
Alana Parreira Costa Rezende
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
Jakeline Godinho Fonseca
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
Fernanda Aparecida de Oliveira Peixoto
Neonatal ICU of Clinical Hospital of Federal University of Goiás/EBSERH, 1st Avenue Leste Universitário, Goiânia 74605-020, GO, Brazil
Isabela Jubé Wastowski
Molecular Immunology Laboratory, Goiás State University, Laranjeiras Unity Prof. Alfredo de Castro St., 9175, Parque das Laranjeiras, Goiânia 74855-130, GO, Brazil
Viviane Monteiro Goes
Institute of Molecular Biology of Paraná (IBMP), Professor Algacyr Munhoz Mader St, 3775–Industrial City of Curitiba, Curitiba 81350-010, PR, Brazil
Mariely Cordeiro Estrela
Institute of Molecular Biology of Paraná (IBMP), Professor Algacyr Munhoz Mader St, 3775–Industrial City of Curitiba, Curitiba 81350-010, PR, Brazil
Priscila Zanette de Souza
Institute of Molecular Biology of Paraná (IBMP), Professor Algacyr Munhoz Mader St, 3775–Industrial City of Curitiba, Curitiba 81350-010, PR, Brazil
Lilian Carla Carneiro
Microorganism Biotechnology Laboratory, Institute of Tropical Pathology and Public Health, Federal University of Goiás, 235 St. Leste Universitário, Goiânia 74605-050, GO, Brazil
Melissa Ameloti Gomes Avelino
Departament of Pediatrics, Federal University of Goiás, Universitaria Avenue, Leste Universitário, Goiânia 74605-050, GO, Brazil
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. Methods: 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. Results: 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 (p > 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. Conclusion: 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.
