What is the clinical evidence from this study?

Study design: Cross-Sectional. Population: Acute respiratory infection (ARI) (n=630). Intervention: Rhinovirus-C (RV-C) infection vs. Rhinovirus-A (RV-A) infection. Primary outcome: Presentation with asthma or episodic viral wheeze (EVW) (p=0.04).

June 22, 2015Open Access

Rhinovirus‐C detection in children presenting with acute respiratory infection to hospital in Brazil

Key Result

In children presenting to the hospital with acute respiratory infection, Rhinovirus-C was detected significantly more frequently in those with asthma or episodic viral wheeze compared to Rhinovirus-A (23% vs. 5%, P=0.04).

Study Design

Type

Cross-Sectional (n=630)

Multicenter

Structured PICO

Are there differences in clinical and demographic features between children infected with RV-A and RV-C?

Population

630 children <5 years with acute respiratory infection (ARI) attending hospital, from low-income families in North-east Brazil.

Intervention

Multiplex PCR and partial sequencing for rhinovirus species detection

Comparator

Comparison between RV-A and RV-C species

Outcome

Clinical and demographic features associated with different RV species

Rhinovirus-C is more frequently associated with asthma and episodic viral wheeze in young children compared to Rhinovirus-A.

Main Result

Absolute Event Rate: 23% vs 5%

p-value: p=0.04

Limitations

The number of children with RV-C was small (n=30) and no children had RV-B.
The cohort was from a single center and may not be representative of other hospitals.
Precise prevalence of RV infection could not be estimated as total ARI presentation data over the time period were unavailable.

Abstract

Human rhinovirus (RV) is a common cause of acute respiratory infection (ARI) in children. We aimed to characterize the clinical and demographic features associated with different RV species detected in children attending hospital with ARI, from low-income families in North-east Brazil. Nasopharyngeal aspirates were collected from 630 children <5 years with ARI. Clinical diagnosis and disease severity were also recorded. Samples were analyzed by multiplex PCR for 18 viral and atypical bacterial pathogens; RV positive samples underwent partial sequencing to determine species and type. RV was the fourth commonest pathogen accounting for 18.7% of pathogens detected. RV was commonly detected in children with bronchiolitis, pneumonia, and asthma/episodic viral wheeze (EVW). Species and type were assigned in 112 cases (73% RV-A; 27% RV-C; 0% RV-B). Generally, there were no differences in clinical or demographic characteristics between those infected with RV-A and RV-C. However, in children with asthma/EVW, RV-C was detected relatively more frequently than RV-A (23% vs. 5%; P = 0.04). Our findings highlight RV as a potentially important pathogen in this setting. Generally, clinical and demographic features were similar in children in whom RV-A and C species were detected. However, RV-C was more frequently found in children with asthma/EVW than RV-A.

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