title: Human rhinovirus and disease severity in children.
abstract: OBJECTIVE
  To evaluate retrospectively human rhinovirus (HRV) infections in children up to 5 years old and factors involved in disease severity.
  
  
  METHODS
  Nasopharyngeal aspirates from 434 children presenting a broad range of respiratory infection symptoms and severity degrees were tested for presence of HRV and 8 other respiratory viruses. Presence of host risk factors was also assessed.
  
  
  RESULTS
  HRV was detected in 181 (41.7%) samples, in 107 of them as the only agent and in 74 as coinfections, mostly with respiratory syncytial virus (RSV; 43.2%). Moderate to severe symptoms were observed in 28.9% (31/107) single infections and in 51.3% (38/74) coinfections (P = .004). Multivariate analyses showed association of coinfections with lower respiratory tract symptoms and some parameters of disease severity, such as hospitalization. In coinfections, RSV was the most important virus associated with severe disease. Prematurity, cardiomyopathies, and noninfectious respiratory diseases were comorbidities that also were associated with disease severity (P = .007).
  
  
  CONCLUSIONS
  Our study showed that HRV was a common pathogen of respiratory disease in children and was also involved in severe cases, causing symptoms of the lower respiratory tract. Severe disease in HRV infections were caused mainly by presence of RSV in coinfections, prematurity, congenital heart disease, and noninfectious respiratory disease.
authors.affiliation: Laboratory of Virology, Instituto de Ciências Biomédicas.
authors.forename: Lourenço Faria
authors.initials: LF
authors.lastname: Costa
authors.forename: Divina Aparecida Oliveira
authors.initials: DA
authors.lastname: Queiróz
authors.forename: Hélio
authors.initials: H
authors.lastname: Lopes da Silveira
authors.forename: Morun
authors.initials: M
authors.lastname: Bernardino Neto
authors.forename: Nayhanne Tizzo
authors.initials: NT
authors.lastname: de Paula
authors.forename: Thelma Fátima Mattos Silva
authors.initials: TF
authors.lastname: Oliveira
authors.forename: Aline Lavado
authors.initials: AL
authors.lastname: Tolardo
authors.forename: Jonny
authors.initials: J
authors.lastname: Yokosawa
mesh_terms: D002675:Child, Preschool; D005260:Female; D006801:Humans; D007223:Infant; D008297:Male; D010850:Picornaviridae Infections / Q000175:diagnosis; D012141:Respiratory Tract Infections / Q000175:diagnosis / Q000821:virology*; D012189:Retrospective Studies; D012229:Rhinovirus / Q000302:isolation & purification*; D012307:Risk Factors; D012720:Severity of Illness Index
keywords: children; coinfections; comorbidities; human rhinovirus; respiratory disease severity