title: Single, dual and multiple respiratory virus infections and risk of hospitalization and mortality.
abstract: Respiratory virus infections cause a significant number of hospitalization and deaths globally. This study investigated the association between single and multiple respiratory virus infections and risk of admission to a general ward, intensive care unit or death in patients aged 0-105 years (mean ± s.d. = 24·4 ± 24·1 years), from North West England, that were tested for respiratory virus infections between January 2007 and June 2012. The majority of infections were in children aged ⩽5 years. Dual or multiple infections occurred in 10·4% (1214/11 715) of patients, whereas single infection occurred in 89·6% (10 501/11 715). Rhinovirus was the most common co-infecting virus (occurring in 69·5%; 844/1214 of co-infections). In a multivariate logistic regression model, multiple infections were associated with an increased risk of admission to a general ward [odds ratio (OR) 1·43, 95% confidence interval (CI) 1·2-1·7, P < 0·0001]. On the other hand, patients with respiratory syncytial virus (RSV) and human parainfluenza virus types 1-3 (hPIV1-3), as a single infection, had a higher risk of being admitted to a general ward (OR 1·49, 95% CI 1·28-1·73, P < 0·0001 and OR 1·34, 95% CI 1·003-1·8, P = 0·05, respectively); admitted to an intensive-care unit or dying (OR 1·5, 95% CI 1·20-2·0, P = 0·001 and OR 1·60, 95% CI 1·02-2·40, P = 0·04, respectively). This result emphasizes the importance of RSV, hPIV and mixed infections and calls for research on vaccines, drugs and diagnostic tests targeting these respiratory viruses.
authors.affiliation: Institute of Inflammation and Repair, Faculty of Medical and Human Sciences,University of Manchester,Manchester,UK.
authors.forename: E A
authors.initials: EA
authors.lastname: Goka
authors.affiliation: Institute of Inflammation and Repair, Faculty of Medical and Human Sciences,University of Manchester,Manchester,UK.
authors.forename: P J
authors.initials: PJ
authors.lastname: Vallely
authors.affiliation: Institute of Inflammation and Repair, Faculty of Medical and Human Sciences,University of Manchester,Manchester,UK.
authors.forename: K J
authors.initials: KJ
authors.lastname: Mutton
authors.affiliation: Institute of Inflammation and Repair, Faculty of Medical and Human Sciences,University of Manchester,Manchester,UK.
authors.forename: P E
authors.initials: PE
authors.lastname: Klapper
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002648:Child; D002675:Child, Preschool; D060085:Coinfection / Q000453:epidemiology* / Q000401:mortality*; D003430:Cross-Sectional Studies; D004739:England / Q000453:epidemiology; D005260:Female; D006760:Hospitalization; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D008875:Middle Aged; D016019:Survival Analysis; D014777:Virus Diseases / Q000453:epidemiology* / Q000401:mortality*; D055815:Young Adult