Different Clinical Presentations of Human Rhinovirus Species Infection in Children and Adults in Mexico
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Background: Human rhinoviruses (HRVs) are a common cause of influenza-like illness, with the ability to infect the upper and lower respiratory tracts. In this study we aim to describe the clinical and molecular features of HRV infection in Mexican children and adults. Methods: We performed a hospital-based, 4-year multicenter prospective observational cohort study of patients with influenza-like illness. Participants who tested positive for HRV were included. We described demographic, clinical, and laboratory characteristics and the association between HRV types, illness severity, and clinical outcomes. Results: Of the 5662 subjects recruited, 1473 (26%25) had HRV; of those, 988 (67.1%25) were adults (≥18 years) and 485 (32.9%25) were children. One hundred sixty-seven (11.33%25) samples were sequenced; 101 (60.5%25) were rhinovirus species A (HRV-A), 22 (13.2%25) were rhinovirus species B (HRV-B), and 44 (26.3%25) were rhinovirus species C (HRV-C). Among children and adults, 30.5%25 and 23.5%25, respectively, were hospitalized (non-intensive care unit [ICU]). The odds of HRV-C are higher than HRV-A for participants in the ICU (compared to outpatient) and when platelets, lymphocytes, white blood cells, and lactate dehydrogenase are increased. The odds of HRV-C are higher than HRV-A and HRV-B with shortness of breath. The odds of HRV-A are higher than HRV-B, and the odds of HRV-B are higher than HRV-C, when mild symptoms like muscle ache and headache occur. Conclusions: Rhinoviruses are a common cause of influenza-like illness. It is necessary to improve the surveillance, testing, and species identification for these viruses to understand different clinical presentations and risk factors associated with worse outcomes. © 2022 The Author(s).
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National Institutes of Health, NIH: HHSN27200002, HHSN2722009000031; National Cancer Institute, NCI: 75N91019D00024; National Institute of Allergy and Infectious Diseases, NIAID; Ministry of Health Mexico; Consejo Nacional de Ciencia y Tecnología, CONACYT; Instituto Mexicano del Seguro Social, IMSS; Instituto de Seguriidad y Servicios Sociales de los Trabadores del Estado, ISSSTE: 127088, 71260; Secretaría de Salud, SS; Statistical Society of Australia, SSA Grant
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clinical presentation; HRV species; influenza-like illness; rhinovirus; severity lactate dehydrogenase; adolescent; adult; Article; bioinformatics; blood cell count; blood sampling; Bordetella pertussis; child; Chlamydia pneumoniae; chronic lung disease; clinical trial; cohort analysis; coughing; disease severity; dyspnea; emergency ward; fever; flu like syndrome; headache; human; Human immunodeficiency virus infection; Human parainfluenza virus 1; Human parainfluenza virus 4; influenza A; Influenza A virus (H5N1); lactate dehydrogenase blood level; Legionella pneumophila; lower respiratory tract infection; major clinical study; malaise; multicenter study; myalgia; Mycoplasma pneumoniae; nasopharyngeal swab; observational study; oxygen saturation; phylogeny; Picornaviridae; questionnaire; real time polymerase chain reaction; Rhinovirus infection; risk factor; RNA extraction; upper respiratory tract infection; virus load
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