Viral etiologies of acute respiratory tract infections among hospitalized children-a comparison between single and multiple viral infections

Abstract Background Acute respiratory tract infections are commonly caused by viruses in children. The differences in clinical data and outcome between single and multiple viral infections in hospitalized children were analyzed. Methods We retrospectively reviewed the medical records of hospitalized children who had fever and a xTAG Respiratory Virus Panel (RVP) test over a 2-year period. The clinical data were analyzed and compared between single and multiple viral infections. Viral etiologies in upper and lower respiratory infections were analyzed and compared. Results A total of 442 patients were enrolled. Patients with positive viral detection (N=311) had a significantly lower rate of leukocytosis (p=0.03), less evidence of bacterial infection (p=0.004), and shorter duration of hospitalization (p=0.019) than those with negative viral detection. The age of patients with multiple viral infections was younger than those with single viral infection; however, there were no significant differences in duration of fever, antibiotics treatment and hospitalization between these two groups. The most commonly identified virus was human rhinovirus. About 27% (n=83) of patients had multiple viral infections. Overall, the highest percentage of human bocavirus infection was detected in multiple viral infections (79%). Lower respiratory tract infection (LRTI) was independently associated with multiple viral infections (p=0.022), respiratory syncytial virus (RSV) infection (p=0.001) and longer hospitalization duration (p=0.011). Conclusion Multiple viral infections were associated with younger age and a higher risk of developing LRTI. However, multiple viral infections did not predict a worse disease outcome. More studies are needed to unveil the interplay between the hosts and different viruses in multiple viral infections.