Rhinovirus was the most frequently detected respiratory pathogen among children and adolescents during the period of social distancing imposed in response to the COVID-19 pandemic. During this time, hospitalizations associated with COVID-19 infection also occurred less frequently among this population compared with other respiratory infections. These findings were published in the Jornal de Pediatria.

This cohort study was conducted at 2 hospitals in Southern Brazil. Eligible participants were aged between 2 months and 17 years with symptoms suggestive of COVID-19 infection. All participants were tested for COVID-19 infection as well as 20 community-acquired respiratory pathogens via reverse transcription-polymerase chain reaction assay.

Among a total of 436 children included in the analysis, the median age was 5.4 (IQR, 2.0-10.2) years, 53.4% were girls were included, 10.3% were hospitalized, and the median time from symptom onset to enrollment was 3.0 (IQR, 1.0-4.0) days.


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The researchers found that 49.5% of participants were positive for COVID-19 infection, 22.2% were positive for rhinovirus, and 7.1% were coinfected with rhinovirus and COVID-19.

Other respiratory pathogens were found among 24 participants, including adenovirus in 6, Chlamydophila pneumoniae in 1, coronavirus NL63 in 2, human enterovirus in 7, human metapneumovirus in 2, and Mycoplasma pneumoniae in 6.

The researchers noted a significantly decreased association between positive COVID-19 infection and hospitalization (P =.001), as only 1 of 92 participants with the infection required hospitalization.

Multivariable analysis showed that children younger than 5 years were at increased risk for hospitalization due to COVID-19 infection (odds ratio [OR], 1.09; 95% CI, 1.03-1.15; P =.002). Of note, the risk for hospitalization was not significantly different among the 64 children with asthma (OR, 1.03; 95% CI, 0.96-1.12; P =.408).

Respiratory symptoms were the most commonly reported among the participants. Headache (55.5%) and sore throat (43.6%) were reported more frequently among participants who received outpatient care vs dyspnea (65.1%), nausea (44.2%), and vomiting (42.2%) among those who were hospitalized. The frequency of diarrhea, conjunctivitis, and skin rash did not significantly differ between inpatients vs outpatients.

This study was limited by the potential inclusion of participants with either nonrespiratory pathogens or noninfectious diseases. In addition, the effect of potentially virulent strains of rhinovirus was not assessed.

According to the researchers, “this study provides important information about the epidemiology of respiratory viruses in periods of social distancing.”

Reference

Varela FH, Sartor ITS, Polese-Bonatto M, et al. Rhinovirus as the main co-circulating virus during the COVID-19 pandemic in children. J Pediatria (Rio J). Published online April 19, 2022. doi:10.1016/j.jped.2022.03.003