Evolution of acute respiratory viral coinfections in children

S.V. Nikolaeva¹, Yu.N. Khlypovka^1,2, A.D. Muzyka¹, D.V. Usenko¹, S.V. Shabalina¹, A.Yu. Medkova², A.V. Gorelov^1,3, Zh.B. Ponezheva¹

¹Central Research Institute of Epidemiology of the Russian Federal Service for Supervision 

 of Consumer Rights Protection and Human Well-Being, Moscow

²Central Clinical Hospital and Polyclinic, Moscow

³I.M. Sechenov First Moscow State Medical University (Sechenov University), Moscow

Aim: to analyze the changes in the etiology and clinical presentations of coexisted acute respiratory viral infections (ARVIs) in children over a 17-year period.

Patients and Methods: the comparative retrospective analysis of the etiology, population, and clinical presentations of ARVIs in children admitted to Moscow hospitals in 2002–2003 (group 1, n=130) and 2018–2019 (group 2, n=133) was performed. At admission, ARVI etiology was identified by polymerase chain reaction (oral or nasal smears and/or discharge, sputum) and enzyme immunoassay (antibodies to herpesvirus type 1, 2, and 6, cytomegalovirus, Epstein–Barr virus, Chlamydia, and Mycoplasma).

Results: children younger than 6 years predominated in both groups (84.7% and 88%, respectively, p>0.05). No gender differences were reported. In 2018–2019, the children were infected more evenly across the year, without clear seasonality. The increase in the percentage of the identified etiology of ARVIs (from 61.3% in 2002–2003 to 76.3% in 2018–2019) and the portion of ARVI coinfections (from 12.1% in 2002–2003 to 17.3% in 2018–2019) in children admitted to hospitals was revealed. Meanwhile, the percentage of children younger than 1 year reduced but the percentage of children aged 3–6 years visiting preschool facilities increased. Over the last years, the etiology of ARVI coinfections has changed from respiratory syncytial virus (53% of ARVI coinfections in 2002–2003) to rhinovirus (34.8% of ARVI coinfections in 2018–2019). The clinical presentations of ARVIs were characterized by acute onset, high temperature, and catarrhal syndrome. Temperature reaction tended to be more severe but of less duration in 2018–2019. The percentage of pneumonias reduced in 2018–2019 compared to 2002–2003. The result was less often prescription of antibacterial therapy in all groups of children. Additionally, reduced severity and duration of abnormal breath sounds revealed by auscultation was seen in 2018–2019.

Conclusions: our findings allow for a rational planning of preventive and/or therapeutic measures considering age-related characteristics of children, season, and the clinical features of ARVI coinfections.

Keywords: children, viral infections, ARVI, coinfections, prevention.

For citation: Nikolaeva S.V., Khlypovka Yu.N., Muzyka A.D. et al. Evolution of acute respiratory viral coinfections in children. RMJ. 2020;12:66–70.