Viral co-detection of influenza virus and other respiratory viruses in hospitalized Brazilian patients during the first three years of the coronavirus disease (COVID)-19 pandemic: an epidemiological profile

Bianca Aparecida Siqueira; Ketlyn Oliveira Bredariol; Matheus Negri Boschiero; Fernando Augusto Lima Marson

doi:10.3389/fmicb.2024.1462802

Viral co-detection of influenza virus and other respiratory viruses in hospitalized Brazilian patients during the first three years of the coronavirus disease (COVID)-19 pandemic: an epidemiological profile

Front Microbiol. 2024 Oct 16:15:1462802. doi: 10.3389/fmicb.2024.1462802. eCollection 2024.

Authors

Bianca Aparecida Siqueira^#^{1

2

3}, Ketlyn Oliveira Bredariol^#^{1

2

3}, Matheus Negri Boschiero^#^{3

4}, Fernando Augusto Lima Marson^#^{1

2

3}

Affiliations

¹ Laboratory of Molecular Biology and Genetics, São Francisco University, Bragança Paulista, Brazil.
² Laboratory of Clinical and Molecular Microbiology, São Francisco University, Bragança Paulista, Brazil.
³ LunGuardian Research Group-Epidemiology of Respiratory and Infectious Diseases, São Francisco University, Bragança Paulista, Brazil.
⁴ Medical Resident of Infectious Diseases at the Federal University of São Paulo, São Paulo, Brazil.

^# Contributed equally.

Abstract

Introduction: In Brazil, few studies were performed regarding the co-detection of respiratory viruses in hospitalized patients. In this way, the study aimed to describe the epidemiological profile of hospitalized patients due to influenza virus infection that presented co-detection with another respiratory virus.

Methods: The epidemiological analysis was made by collecting data from Open-Data-SUS. The study comprised patients infected by the influenza A or B virus with positive co-detection of another respiratory virus, such as adenovirus, bocavirus, metapneumovirus, parainfluenza virus (types 1, 2, 3, and 4), rhinovirus, and respiratory syncytial virus (RSV). The markers [gender, age, clinical signs and symptoms, comorbidities, need for intensive care unit (ICU) treatment, and need for ventilatory support] were associated with the chance of death. The data was collected during the first three years of the coronavirus disease (COVID)-19 pandemic-from December 19, 2019, to April 06, 2023.

Results: A total of 477 patients were included, among them, the influenza A virus was detected in 400 (83.9%) cases. The co-detection occurred, respectively, for RSV (53.0%), rhinovirus (14.0%), adenovirus (13.4%), parainfluenza virus type 1 (10.7%), parainfluenza virus type 3 (5.2%), metapneumovirus (3.8%), parainfluenza virus type 2 (3.6%), bocavirus (3.4%), and parainfluenza virus type 4 (1.5%). The co-detection rate was higher in the male sex (50.7%), age between 0-12 years of age (65.8%), and white individuals (61.8%). The most common clinical symptoms were cough (90.6%), dyspnea (78.8%), and fever (78.6%). A total of 167 (35.0%) people had at least one comorbidity, mainly cardiopathy (14.3%), asthma (8.4%), and diabetes mellitus (7.3%). The need for ICU treatment occurred in 147 (30.8%) cases, with most of them needing ventilatory support (66.8%), mainly non-invasive ones (57.2%). A total of 33 (6.9%) patients died and the main predictors of death were bocavirus infection (OR = 14.78 [95%CI = 2.84-76.98]), metapneumovirus infection (OR = 8.50 [95%CI = 1.86-38.78]), race (other races vs. white people) (OR = 3.67 [95%CI = 1.39-9.74]), cardiopathy (OR = 3.48 [95%CI = 1.13-10.71]), and need for ICU treatment (OR = 7.64 [95%CI = 2.44-23.92]).

Conclusion: Co-detection between the influenza virus and other respiratory viruses occurred, mainly with RSV, rhinovirus, and adenovirus being more common in men, white people, and in the juvenile phase. Co-detection of influenza virus with bocavirus and metapneumovirus was associated with an increased chance of death. Other factors such as race, cardiopathy, and the need for an ICU were also associated with a higher chance of death.

Keywords: adenovirus; bocavirus; influenza virus; metapneumovirus; parainfluenza virus; respiratory syncytial virus; rhinovirus; severe acute respiratory syndrome coronavirus 2.

Grants and funding

The author(s) declare that financial support was received for the research, authorship, and/or publication of this article. BS and KB received a grant from the National Council for Scientific and Technological Development (Conselho Nacional de Desenvolvimento Científico e Tecnológico—CNPq), respectively no. 88887.823897/2023-00 and no. 122168/2023-2. The Article Processing Fee for the publication of this research was paid by the Higher Education Improvement Coordination (Coordenação de Aperfeiçoamento de Pessoal de Nível Superior—CAPES). For open-access purposes, the authors have assigned the Creative Commons CC BY license to any accepted version of the article.