title: Severity of rhinovirus infection in hospitalized adults is unrelated to genotype.
abstract: OBJECTIVE
  To determine whether rhinovirus (RV) species is associated with more severe clinical illness in adults.
  
  
  METHODS
  Seventy-two RV-positive viral respiratory samples from adult patients were sequenced and analyzed phylogenetically after reverse transcriptase polymerase chain reaction of the region spanning the VP4 gene and 5' terminus of the VP2 gene. The clinical features and severity of illness associated with the different RV species were compared.
  
  
  RESULTS
  Phylogenetic analysis identified three distinct clusters as RV-A (54%), B (11%), or C (35%) species. In an unadjusted model, patients with RV-B infection were significantly more likely to have the composite outcome variable of death or intensive care unit admission (P=.03), but this effect diminished when controlling for patient sex. A logistic model of the relationship between RV species and adverse outcomes produced nonsignificant odds ratios when controlling for patient sex.
  
  
  CONCLUSIONS
  Infection with RV-A or RV-B was associated with greater severity of illness in our adult population; however, the association disappeared after controlling for confounders.
authors.affiliation: From the Emory University School of Medicine.
authors.forename: Denise J
authors.initials: DJ
authors.lastname: McCulloch
authors.affiliation: Division of Infectious Diseases, Department of Medicine.
authors.forename: Marti H
authors.initials: MH
authors.lastname: Sears
authors.affiliation: Division of Infectious Diseases, Department of Medicine.
authors.forename: Jesse T
authors.initials: JT
authors.lastname: Jacob
authors.affiliation: Division of Infectious Diseases, Department of Medicine.
authors.forename: G Marshall
authors.initials: GM
authors.lastname: Lyon
authors.affiliation: Division of Infectious Diseases, Department of Medicine, Department of Pathology and Laboratory Medicine, Emory University School of Medicine, Atlanta, GA;
authors.forename: Eileen M
authors.initials: EM
authors.lastname: Burd
authors.affiliation: Division of Infectious Diseases, Department of Medicine, Brown University School of Medicine, Providence, RI; and.
authors.forename: Angela M
authors.initials: AM
authors.lastname: Caliendo
authors.affiliation: Department of Pathology and Laboratory Medicine, Emory University School of Medicine, Atlanta, GA;
authors.forename: Charles E
authors.initials: CE
authors.lastname: Hill
authors.affiliation: Centers for Disease Control and Prevention, Atlanta, GA.
authors.forename: W Allan
authors.initials: WA
authors.lastname: Nix
authors.affiliation: Centers for Disease Control and Prevention, Atlanta, GA.
authors.forename: M Steven
authors.initials: MS
authors.lastname: Oberste
authors.affiliation: Division of Infectious Diseases, Department of Medicine, Department of Pathology and Laboratory Medicine, Emory University School of Medicine, Atlanta, GA; colleen.kraft@emory.edu.
authors.forename: Colleen S
authors.initials: CS
authors.lastname: Kraft
mesh_terms: D000328:Adult; D000368:Aged; D001249:Asthma / Q000175:diagnosis / Q000821:virology*; D005260:Female; D005820:Genetic Testing / Q000379:methods; D005838:Genotype; D006760:Hospitalization; D006801:Humans; D008297:Male; D008875:Middle Aged; D010850:Picornaviridae Infections / Q000821:virology*; D012367:RNA, Viral / Q000032:analysis; D012141:Respiratory Tract Infections / Q000175:diagnosis / Q000821:virology*; D020133:Reverse Transcriptase Polymerase Chain Reaction / Q000379:methods; D012229:Rhinovirus / Q000235:genetics*
chemical_list: D012367:RNA, Viral
keywords: Genotype; Rhinovirus; Severity; Species