title: Hospitalizations and outpatient visits for rhinovirus-associated acute respiratory illness in adults.
abstract: BACKGROUND
  Rhinovirus is linked to asthma exacerbations and chronic obstructive pulmonary disease exacerbations in adults. The severity and rates of rhinovirus acute respiratory illnesses (ARIs) in adults are uncertain.
  
  
  OBJECTIVE
  We sought to determine rhinovirus-associated ARI rates in adults presenting for care in multiple settings and identify factors associated with rhinovirus detection.
  
  
  METHODS
  This prospective, population-based cohort enrolled Tennessee residents 18 years or older in the emergency department (ED), outpatient clinics, or hospitalized for ARI from December 2008 to May 2010. Nasal/throat swabs were collected and tested for rhinovirus and other viruses by using RT-PCR. Rates of ED visits and hospitalizations were calculated and rhinovirus-positive and rhinovirus-negative patients were compared.
  
  
  RESULTS
  Among 2351 enrollees, rhinovirus was detected in 247 (11%). There were 7 rhinovirus-associated ED visits and 3 hospitalizations per 1000 adults annually. Patients with rhinovirus, compared with virus-negative ARI, were more likely to present with wheezing (odds ratio [OR], 1.7; 95% CI, 1.23-2.35; P < .001), to be a current smoker (OR, 2.31; 95% CI, 1.68-3.19) or live with a smoker (OR, 1.72; 95% CI, 1.10-2.67), have a history of chronic respiratory disease (OR, 1.61; 95% CI, 1.17-2.22), and were less likely to be hospitalized versus seen in the outpatient setting (OR, 0.58; 95% CI, 0.41-0.83).
  
  
  CONCLUSIONS
  Rhinovirus is associated with a substantial number of ED visits and hospitalizations for ARIs in adults. There may be modifiable factors that can reduce the likelihood of presenting with rhinovirus-associated ARIs.
authors.affiliation: Department of Pediatrics, Vanderbilt University Medical Center, Nashville, Tenn. Electronic address: eva.k.miller@Vanderbilt.edu.
authors.forename: E Kathryn
authors.initials: EK
authors.lastname: Miller
authors.affiliation: Department of Pediatrics, Vanderbilt University Medical Center, Nashville, Tenn.
authors.forename: Jodell
authors.initials: J
authors.lastname: Linder
authors.affiliation: Department of Pediatrics, Vanderbilt University Medical Center, Nashville, Tenn.
authors.forename: David
authors.initials: D
authors.lastname: Kraft
authors.affiliation: Department of Pediatrics, Vanderbilt University Medical Center, Nashville, Tenn.
authors.forename: Monika
authors.initials: M
authors.lastname: Johnson
authors.affiliation: Department of Biostatistics, Vanderbilt University Medical Center, Nashville, Tenn.
authors.forename: Pengcheng
authors.initials: P
authors.lastname: Lu
authors.affiliation: Department of Biostatistics, Vanderbilt University Medical Center, Nashville, Tenn.
authors.forename: Benjamin R
authors.initials: BR
authors.lastname: Saville
authors.affiliation: Department of Pediatrics, University of Pittsburgh School of Medicine, Children's Hospital of Pittsburgh of University of Pittsburgh Medical Center, Pittsburgh, Pa.
authors.forename: John V
authors.initials: JV
authors.lastname: Williams
authors.affiliation: Department of Medicine, Vanderbilt University Medical Center, Nashville, Tenn; Department of Healthy Policy, Vanderbilt University Medical Center, Nashville, Tenn; Mid-South Geriatric Research Education and Clinical Center and Clinical Research Center of Excellence, VA TN Valley Health Care System, Nashville, Tenn.
authors.forename: Marie R
authors.initials: MR
authors.lastname: Griffin
authors.affiliation: Department of Medicine, Vanderbilt University Medical Center, Nashville, Tenn.
authors.forename: H Keipp
authors.initials: HK
authors.lastname: Talbot
mesh_terms: D000208:Acute Disease; D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000553:Ambulatory Care; D004636:Emergency Service, Hospital; D005260:Female; D006760:Hospitalization; D006801:Humans; D008297:Male; D008875:Middle Aged; D016017:Odds Ratio; D010850:Picornaviridae Infections / Q000453:epidemiology*; D015995:Prevalence; D062486:Public Health Surveillance; D012135:Respiratory Sounds; D012141:Respiratory Tract Infections / Q000453:epidemiology* / Q000821:virology*; D012229:Rhinovirus; D012307:Risk Factors; D012621:Seasons; D013714:Tennessee / Q000453:epidemiology; D055815:Young Adult
keywords: Rhinovirus; acute respiratory illness; adults; emergency department; hospitalized; smoking