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.