Download PDF
J Pediatr Infect Dis 2024; 19(01): 011-016
DOI: 10.1055/s-0043-1776391
Original Article

Respiratory Syncytial Virus and Parainfluenza Virus: Characterizing Distinct Clinical Profiles and How They Shift with Bacterial Coinfection

Bo Nie
1   Department of Clinical Laboratory, Maternal and Child Health Hospital of Hubei Province, Wuhan, China
,
Ying Cheng
2   Department of Pediatrics, Maternal and Child Health Hospital of Hubei Province, Wuhan, China
,
Hong-bo Hu 
1   Department of Clinical Laboratory, Maternal and Child Health Hospital of Hubei Province, Wuhan, China
› Author Affiliations
› Further Information
    Permissions and Reprints

Abstract

Objective The objectives are to characterize the distinct clinical profiles of respiratory syncytial virus (RSV) and parainfluenza virus (PIV) infections and how these profiles shift with the addition of bacterial coinfections.

Methods This retrospective study analyzed data from more than 1,000 hospitalized children to compare RSV monoinfection with PIV monoinfection, as well as RSV/PIV coinfection with bacteria with monoinfection.

Results Significant differences in age distribution (p < 0.001), clinical presentation (p < 0.001), the proportion of pneumonia (p < 0.001), mechanical ventilation (p = 0.004), pediatric intensive care unit (PICU) admission (p = 0.001), and duration of hospitalization (p = 0.003) were observed between RSV and PIV monoinfections. Children with bacterial coinfections had a higher proportion of cough (p = 0.004), wheezing (p = 0.003), rales (p = 0.002), pneumonia (p = 0.002), and PICU admission (p = 0.021) than PIV monoinfection. Notably, the duration of hospitalization for children with bacterial coinfections was longer than that of those infected with a single PIV infection, with a statistically significant difference (p = 0.028).

Conclusion Compared with PIV, RSV was more likely to cause severe respiratory tract infections. Coinfection of PIV with bacteria may have exacerbated the severity of acute respiratory tract infections and worsened the symptoms.

Keywords

acute respiratory tract infections - respiratory syncytial virus - parainfluenza virus - coinfections


Publication History

Received: 06 July 2023

Accepted: 25 September 2023

Article published online:
22 November 2023

© 2023. Thieme. All rights reserved.

Georg Thieme Verlag KG
Rüdigerstraße 14, 70469 Stuttgart, Germany

 

  • References

  • 1 Li ZJ, Zhang HY, Ren LL. et al; Chinese Centers for Disease Control and Prevention (CDC) Etiology of Respiratory Infection Surveillance Study Team. Etiological and epidemiological features of acute respiratory infections in China. Nat Commun 2021; 12 (01) 5026
    CrossrefPubMedGoogle Scholar
  • 2 Goktas S, Sirin MC. Prevalence and seasonal distribution of respiratory viruses during the 2014 - 2015 season in Istanbul. Jundishapur J Microbiol 2016; 9 (09) e39132
    CrossrefPubMedGoogle Scholar
  • 3 Zhao Y, Lu R, Shen J, Xie Z, Liu G, Tan W. Comparison of viral and epidemiological profiles of hospitalized children with severe acute respiratory infection in Beijing and Shanghai, China. BMC Infect Dis 2019; 19 (01) 729
    CrossrefPubMedGoogle Scholar
  • 4 Shang XP, Wu JG, Cheng Y, Hu HB. Epidemiology and clinical characteristics of Henoch-Schönlein purpura associated with Mycoplasma pneumoniae infection in 131 children in Hubei Province, China. Mediterr J Hematol Infect Dis 2021; 13 (01) e2021037
    PubMedGoogle Scholar
  • 5 Shi T, McAllister DA, O'Brien KL. et al; RSV Global Epidemiology Network. Global, regional, and national disease burden estimates of acute lower respiratory infections due to respiratory syncytial virus in young children in 2015: a systematic review and modelling study. Lancet 2017; 390 (10098): 946-958
    CrossrefPubMedGoogle Scholar
  • 6 Branche AR, Falsey AR. Parainfluenza virus infection. Semin Respir Crit Care Med 2016; 37 (04) 538-554
    Article in Thieme ConnectPubMedGoogle Scholar
  • 7 Zhang Y, Qiao L, Yao J. et al. Epidemiological and clinical characteristics of respiratory viruses in 4403 pediatric patients from multiple hospitals in Guangdong, China. BMC Pediatr 2021; 21 (01) 284
    CrossrefPubMedGoogle Scholar
  • 8 Zhang HY, Li ZM, Zhang GL, Diao TT, Cao CX, Sun HQ. Respiratory viruses in hospitalized children with acute lower respiratory tract infections in Harbin, China. Jpn J Infect Dis 2009; 62 (06) 458-460
    CrossrefPubMedGoogle Scholar
  • 9 Mao N, Ji Y, Xie Z. et al. Human parainfluenza virus-associated respiratory tract infection among children and genetic analysis of HPIV-3 strains in Beijing, China. PLoS One 2012; 7 (08) e43893
    CrossrefPubMedGoogle Scholar
  • 10 Huang XB, Yuan L, Ye CX. et al. Epidemiological characteristics of respiratory viruses in patients with acute respiratory infections during 2009-2018 in southern China. Int J Infect Dis 2020; 98: 21-32
    CrossrefPubMedGoogle Scholar
  • 11 Cawcutt K, Kalil AC. Pneumonia with bacterial and viral coinfection. Curr Opin Crit Care 2017; 23 (05) 385-390
    CrossrefPubMedGoogle Scholar
  • 12 Vaughn VM, Gandhi TN, Petty LA. et al. Empiric antibacterial therapy and community-onset bacterial coinfection in patients hospitalized with coronavirus disease 2019 (COVID-19): a multi-hospital cohort study. Clin Infect Dis 2021; 72 (10) e533-e541
    CrossrefPubMedGoogle Scholar
  • 13 Smithgall M, Maykowski P, Zachariah P. et al. Epidemiology, clinical features, and resource utilization associated with respiratory syncytial virus in the community and hospital. Influenza Other Respir Viruses 2020; 14 (03) 247-256
    CrossrefPubMedGoogle Scholar
  • 14 Lu D, Cheng Y, Hu H. Parainfluenza virus type 3 co-infection with other respiratory pathogens among hospitalized children with acute respiratory infections in Wuhan, China. Jundishapur J Microbiol 2023; 16 (01) e135823
    PubMedGoogle Scholar
  • 15 Li Y, Peterson ME, Campbell H, Nair H. Association of seasonal viral acute respiratory infection with pneumococcal disease: a systematic review of population-based studies. BMJ Open 2018; 8 (04) e019743
    CrossrefPubMedGoogle Scholar
  • 16 Choo S, Lee YY, Lee E. Clinical significance of respiratory virus coinfection in children with Mycoplasma pneumoniae pneumonia. BMC Pulm Med 2022; 22 (01) 212
    CrossrefPubMedGoogle Scholar
  • 17 Liu Y, Ling L, Wong SH. et al. Outcomes of respiratory viral-bacterial co-infection in adult hospitalized patients. EClinicalMedicine 2021; 37: 100955
    CrossrefPubMedGoogle Scholar
  • 18 Brealey JC, Sly PD, Young PR, Chappell KJ. Viral bacterial co-infection of the respiratory tract during early childhood. FEMS Microbiol Lett 2015; 362 (10) fnv062
    CrossrefPubMedGoogle Scholar
  • 19 Lee N, Lui GC, Wong KT. et al. High morbidity and mortality in adults hospitalized for respiratory syncytial virus infections. Clin Infect Dis 2013; 57 (08) 1069-1077
    CrossrefPubMedGoogle Scholar
  • 20 Wen S, Yu M, Zheng G. et al. Changes in the etiology of viral lower respiratory tract infections in hospitalized children in Wenzhou, China: 2008-2017. J Med Virol 2020; 92 (08) 982-987
    CrossrefPubMedGoogle Scholar
  • 21 Liu T, Li Z, Zhang S. et al. Viral etiology of acute respiratory tract infections in hospitalized children and adults in Shandong Province, China. Virol J 2015; 12: 168
    CrossrefPubMedGoogle Scholar
  • 22 Tan J, Wu J, Jiang W. et al. Etiology, clinical characteristics and coinfection status of bronchiolitis in Suzhou. BMC Infect Dis 2021; 21 (01) 135
    CrossrefPubMedGoogle Scholar
  • 23 Okahashi N, Sumitomo T, Nakata M, Kawabata S. Secondary streptococcal infection following influenza. Microbiol Immunol 2022; 66 (06) 253-263
    CrossrefPubMedGoogle Scholar
  • 24 Zhu X, Ge Y, Wu T. et al. Co-infection with respiratory pathogens among COVID-2019 cases. Virus Res 2020; 285: 198005
    CrossrefPubMedGoogle Scholar
  • 25 Bakaletz LO. Viral-bacterial co-infections in the respiratory tract. Curr Opin Microbiol 2017; 35: 30-35
    CrossrefPubMedGoogle Scholar
  • 26 Hanada S, Pirzadeh M, Carver KY, Deng JC. Respiratory viral infection-induced microbiome alterations and secondary bacterial pneumonia. Front Immunol 2018; 9: 2640
    CrossrefPubMedGoogle Scholar
  • 27 Meskill SD, O'Bryant SC. Respiratory virus co-infection in acute respiratory infections in children. Curr Infect Dis Rep 2020; 22 (01) 3
    CrossrefPubMedGoogle Scholar
  • 28 Morein B, Höglund S, Bergman R. Studies on parainfluenza-3 virus neuraminidase. Dev Biol Stand 1975; 28: 489-492
    PubMedGoogle Scholar
  • 29 Chatterjee M, van Putten JPM, Strijbis K. Defensive properties of mucin glycoproteins during respiratory infections-relevance for SARS-CoV-2. MBio 2020; 11 (06) e02374
    CrossrefPubMedGoogle Scholar
  • 30 Bystrom J, Al-Adhoubi N, Al-Bogami M, Jawad AS, Mageed RA. Th17 lymphocytes in respiratory syncytial virus infection. Viruses 2013; 5 (03) 777-791
    CrossrefPubMedGoogle Scholar
  • 31 Cheon IS, Kim JY, Choi Y. et al. Sublingual immunization with an RSV G glycoprotein fragment primes IL-17-mediated immunopathology upon respiratory syncytial virus infection. Front Immunol 2019; 10: 567
    CrossrefPubMedGoogle Scholar
  • 32 Li W, Du X, Yang Y. et al. miRNA-34b/c regulates mucus secretion in RSV-infected airway epithelial cells by targeting FGFR1. J Cell Mol Med 2021; 25 (22) 10565-10574
    CrossrefPubMedGoogle Scholar
  • 33 Marr N, Turvey SE. Role of human TLR4 in respiratory syncytial virus-induced NF-κB activation, viral entry and replication. Innate Immun 2012; 18 (06) 856-865
    CrossrefPubMedGoogle Scholar
  • 34 Li W, Liu LF, Xu JL, Shang SQ. Epidemiological and immunological features of influenza viruses in hospitalized children with influenza illness in Hangzhou. Fetal Pediatr Pathol 2020; 39 (01) 21-28
    CrossrefPubMedGoogle Scholar
  • 35 Herzog S, Fragkou PC, Arneth BM, Mkhlof S, Skevaki C. Myeloid CD169/Siglec1: an immunoregulatory biomarker in viral disease. Front Med (Lausanne) 2022; 9: 979373
    CrossrefPubMedGoogle Scholar
  • 36 Rayavara K, Kurosky A, Stafford SJ. et al. Proinflammatory effects of respiratory syncytial virus-induced epithelial HMGB1 on human innate immune cell activation. J Immunol 2018; 201 (09) 2753-2766
    CrossrefPubMedGoogle Scholar