Introduction
Acute lower respiratory tract infections (ALRI) are common diseases in pediatric patients and one of the leading causes of hospitalizations, with an estimated 149,000 admissions annually1 . Most children present with mild-to-moderate illness, however, 2–6% of hospitalized patients require pediatric intensive care unit (PICU) admission 2. Respiratory syncytial virus (RSV) is the commonest etiology associated with ALRI, accounting for 43–74% of all cases 3. The widespread use of respiratory real-time multiplex polymerase chain reaction [PCR] has helped in identifying other viruses including rhinovirus, coronavirus, human metapneumovirus, parainfluenza virus, and adenovirus 4,5.
Viral co-infection in hospitalized children with ALRI ranges from 10% to 40% 6,7. The clinical implications of these viral co‐infections remain controversial. Some studies have suggested that viral co-infection results in a more severe disease of ALRI, while others have reported that course and severity did not differ between infections caused by one or multiple viruses8-10. Several studies about viral co-infection were limited for only providing descriptive statistics without accounting for confounders or for having a small sample size 11,12. It is essential to know if multiple respiratory viral infections lead to worse clinical outcomes, since early intensive care given to this population might decrease the complications. As we learn more about COVID 19 infestations in children it would be helpful to have contemporary data on impact of other viral coinfection is on the disease progression, so the impact of COVID 19 coinfection with other common respiratory viruses in children can be compared.
This retrospective study was designed to compare the demographics, disease distribution, resource utilization and outcomes of children with single versus multiple viral coinfections.