Pediatric Critical Care Fellow Arkansas Children's Hospital Little Rock, Arkansas, United States
Background: While SARS-CoV-2 with bacterial co-infections in children complicates the disease, little is known regarding the influence of viral co-detection on disease severity. Implementing NPIs unexpectedly decreased respiratory illnesses due to other viruses. In March 2021, the state of Arkansas removed NPIs, and the re-emergence of common respiratory viruses, including respiratory syncytial viral (RSV) and entero/rhinovirus (ERV), increased to a level higher than the pre-COVID baseline. Effects of viral co-detection are unclear Objective: Determine the clinical severity of symptomatic children with single viral detection (SARS-CoV-2, RSV, and ERV) and SARS-CoV-2 co-detection (RSV or ERV). We hypothesize symptomatic children with RSV/SARS-CoV-2 co-detection will have increased severity compared to symptomatic children with single viral detection of RSV or SARS-COV-2 and symptomatic children with ERV/SARS-COV-2 will have increased severity compared to symptomatic children with single viral detection of ERV or SARS-COV-2. Design/Methods: RSV and ERV are the two most common respiratory viruses in children, so these viruses, along with SARS-CoV-2 were chosen for evaluation in this study. A retrospective chart review was performed on all patients who were seen in the Arkansas Children's (AC) System between March 2021 and June 2023. Patients were included if they had viral symptoms and were tested using respiratory viral panel. Patients were filtered if they were positive for single virus SARS-CoV2, RSV, ER or SARS-CoV-2 with codetection of RSV or ERV. Data collected included demographics, hospital and ICU admission, length of stay, and maximum oxygen flow received. Based on chart review, WHO disease severity scores were retrospectively calculated for each patient. Patients were excluded if the viral swab was not performed at AC. Patients were distributed into Ambulatory (0-2), Hospitalized with mild disease (3-4), and hospitalized with severe disease (5-7) categories. Chi-square analysis was performed to compare the differences in WHO severity scale among single vs Co-detection group.
