Comparison of Viral Loads in Patients with Co-infections vs. Single-virus Infections
Abstract Background Molecular testing for respiratory viruses in clinical practice is common, often with multiple viruses detected. Viral load has been correlated with illness severity, but correlation of co-detection of viruses and viral load is less clear. We sought to compare cycle threshold (Ct)...
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description | Abstract
Background
Molecular testing for respiratory viruses in clinical practice is common, often with multiple viruses detected. Viral load has been correlated with illness severity, but correlation of co-detection of viruses and viral load is less clear. We sought to compare cycle threshold (Ct) values, a marker inversely related to viral load, between single vs. co-detection of common respiratory viruses.
Methods
Children |
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Background
Molecular testing for respiratory viruses in clinical practice is common, often with multiple viruses detected. Viral load has been correlated with illness severity, but correlation of co-detection of viruses and viral load is less clear. We sought to compare cycle threshold (Ct) values, a marker inversely related to viral load, between single vs. co-detection of common respiratory viruses.
Methods
Children <18 years with respiratory symptoms and/or fever who presented to the ED or were admitted were enrolled. Nasal/throat specimens were obtained and combined. Singleplex qRT-PCR was used to test for 11 respiratory viruses. Clinical and demographic information were collected.
Results
From 11/15/15-7/15/16, 1255 children were enrolled, with median age of 26.5 months, 53.4% male, 54.3% White, 38.7% Black, 6.4% other, and 23.5% Hispanic. The median days of illness were 3 days. Of the total cohort, 904 (72%) tested positive for at least one viral pathogen. Table 1compares Ct values of single vs. co-detection for each individual virus.
Table 1.
N
Ct-Median
(IQR)
p-value
Days of Ilness - Median (IQR)
p-value
Respiratory Syncytial Virus (RSV)
Single
144
25.5
(22.86-29.03)
0.05
4 (3-5)
0.82
RSV-Co-detection
63
27.0
(23.47-33.82)
3 (3-7)
Human Rhinovirus (HRV)-Single
289
27.5
(23.79-32.50)
0.000
3 (2-4)
0.002
HRV-Co-detection
117
32.8
(29.08-35.49)
3 (2-6)
Adenovirus (AdV)-Single
79
28.7
(23.84-33.62)
0.001
3 (2-4)
0.06
Adv-Co-detection
7
32.8
(27.40–36.69)
3 (2-4)
Human metapneumovirus (HMPV)-Single
75
28.8
(25.37-32.22)
0.75
4 (3-6)
0.45
HMPV-Co-detection
30
28.2
(24.86-33.11)
4 (3-7)
Parainfluenza (PIV)-Single
36
25.2
(23.75-28.76)
0.005
3.5 (2-5.5)
0.34
PIV-Co-detection
15
28.8
(26.04-34.50)
3 (1–4)
Flu-Single
127
26.6
(24.71-30.51)
0.34
3 (2-5)
0.83
Flu-Co-detection
26
28.0
(25.98-30.14)
3.5 (2-6)
Conclusion
Single detection with RSV, HRV, AdV, and PIV had lower Ct values, indicating higher viral loads, compared with co-detection with other viruses. Additional research is needed to understand the reason for lower viral loads for co-detection vs. single detection in select respiratory viruses.
Disclosures
W. Schaffner, Pfizer: Scientific Advisor, Consulting fee. Merck: Scientific Advisor, Consulting fee. Novavax: Consultant, Consulting fee. Dynavax: Consultant, Consulting fee. Sanofi-pasteur: Consultant, Consulting fee. GSK: Consultant, Consulting fee. Seqirus: Consultant, Consulting fee. N. B. Halasa, sanofi pasteur: Research Contractor, Research support. Astra Zeneca: Research Contractor, Grant recipient.</description><identifier>ISSN: 2328-8957</identifier><identifier>EISSN: 2328-8957</identifier><identifier>DOI: 10.1093/ofid/ofx163.723</identifier><language>eng</language><publisher>US: Oxford University Press</publisher><ispartof>Open forum infectious diseases, 2017-10, Vol.4 (suppl_1), p.S310-S310</ispartof><rights>The Author 2017. Published by Oxford University Press on behalf of Infectious Diseases Society of America. 2017</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c1623-6c3cc2d238631a31ec00af450d7d4a744103f5988a86f5683f1959fc7ecf65493</citedby></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,780,784,864,27924,27925</link.rule.ids></links><search><creatorcontrib>Beveridge, Stockton</creatorcontrib><creatorcontrib>Piya, Bhinnata</creatorcontrib><creatorcontrib>Stewart, Laura</creatorcontrib><creatorcontrib>Lindegren, Mary Louise</creatorcontrib><creatorcontrib>Markus, Tiffanie</creatorcontrib><creatorcontrib>Schaffner, William</creatorcontrib><creatorcontrib>Halasa, Natasha B</creatorcontrib><title>Comparison of Viral Loads in Patients with Co-infections vs. Single-virus Infections</title><title>Open forum infectious diseases</title><description>Abstract
Background
Molecular testing for respiratory viruses in clinical practice is common, often with multiple viruses detected. Viral load has been correlated with illness severity, but correlation of co-detection of viruses and viral load is less clear. We sought to compare cycle threshold (Ct) values, a marker inversely related to viral load, between single vs. co-detection of common respiratory viruses.
Methods
Children <18 years with respiratory symptoms and/or fever who presented to the ED or were admitted were enrolled. Nasal/throat specimens were obtained and combined. Singleplex qRT-PCR was used to test for 11 respiratory viruses. Clinical and demographic information were collected.
Results
From 11/15/15-7/15/16, 1255 children were enrolled, with median age of 26.5 months, 53.4% male, 54.3% White, 38.7% Black, 6.4% other, and 23.5% Hispanic. The median days of illness were 3 days. Of the total cohort, 904 (72%) tested positive for at least one viral pathogen. Table 1compares Ct values of single vs. co-detection for each individual virus.
Table 1.
N
Ct-Median
(IQR)
p-value
Days of Ilness - Median (IQR)
p-value
Respiratory Syncytial Virus (RSV)
Single
144
25.5
(22.86-29.03)
0.05
4 (3-5)
0.82
RSV-Co-detection
63
27.0
(23.47-33.82)
3 (3-7)
Human Rhinovirus (HRV)-Single
289
27.5
(23.79-32.50)
0.000
3 (2-4)
0.002
HRV-Co-detection
117
32.8
(29.08-35.49)
3 (2-6)
Adenovirus (AdV)-Single
79
28.7
(23.84-33.62)
0.001
3 (2-4)
0.06
Adv-Co-detection
7
32.8
(27.40–36.69)
3 (2-4)
Human metapneumovirus (HMPV)-Single
75
28.8
(25.37-32.22)
0.75
4 (3-6)
0.45
HMPV-Co-detection
30
28.2
(24.86-33.11)
4 (3-7)
Parainfluenza (PIV)-Single
36
25.2
(23.75-28.76)
0.005
3.5 (2-5.5)
0.34
PIV-Co-detection
15
28.8
(26.04-34.50)
3 (1–4)
Flu-Single
127
26.6
(24.71-30.51)
0.34
3 (2-5)
0.83
Flu-Co-detection
26
28.0
(25.98-30.14)
3.5 (2-6)
Conclusion
Single detection with RSV, HRV, AdV, and PIV had lower Ct values, indicating higher viral loads, compared with co-detection with other viruses. Additional research is needed to understand the reason for lower viral loads for co-detection vs. single detection in select respiratory viruses.
Disclosures
W. Schaffner, Pfizer: Scientific Advisor, Consulting fee. Merck: Scientific Advisor, Consulting fee. Novavax: Consultant, Consulting fee. Dynavax: Consultant, Consulting fee. Sanofi-pasteur: Consultant, Consulting fee. GSK: Consultant, Consulting fee. Seqirus: Consultant, Consulting fee. N. B. Halasa, sanofi pasteur: Research Contractor, Research support. Astra Zeneca: Research Contractor, Grant recipient.</description><issn>2328-8957</issn><issn>2328-8957</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2017</creationdate><recordtype>article</recordtype><sourceid>TOX</sourceid><recordid>eNqFkEtLxDAURoMoOIyzdpu10E4eTZospfgYKCg4ug0hTTTSSUrSGfXf26Ei7tzce-H7zl0cAC4xKjGSdB2d76bxiTkta0JPwIJQIgohWX365z4Hq5zfEUIYI4ZquQDbJu4GnXyOAUYHX3zSPWyj7jL0AT7q0dswZvjhxzfYxMIHZ83oY8jwkEv45MNrb4uDT_sMN7_ZBThzus929bOX4Pn2ZtvcF-3D3aa5bguDOaEFN9QY0hEqOMWaYmsQ0q5iqKu7StdVhRF1TAqhBXeMC-qwZNKZ2hrHWSXpEqznvybFnJN1akh-p9OXwkgdvaijFzV7UZOXibiaibgf_i1_A0XdZXM</recordid><startdate>20171001</startdate><enddate>20171001</enddate><creator>Beveridge, Stockton</creator><creator>Piya, Bhinnata</creator><creator>Stewart, Laura</creator><creator>Lindegren, Mary Louise</creator><creator>Markus, Tiffanie</creator><creator>Schaffner, William</creator><creator>Halasa, Natasha B</creator><general>Oxford University Press</general><scope>TOX</scope><scope>AAYXX</scope><scope>CITATION</scope></search><sort><creationdate>20171001</creationdate><title>Comparison of Viral Loads in Patients with Co-infections vs. Single-virus Infections</title><author>Beveridge, Stockton ; Piya, Bhinnata ; Stewart, Laura ; Lindegren, Mary Louise ; Markus, Tiffanie ; Schaffner, William ; Halasa, Natasha B</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c1623-6c3cc2d238631a31ec00af450d7d4a744103f5988a86f5683f1959fc7ecf65493</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2017</creationdate><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Beveridge, Stockton</creatorcontrib><creatorcontrib>Piya, Bhinnata</creatorcontrib><creatorcontrib>Stewart, Laura</creatorcontrib><creatorcontrib>Lindegren, Mary Louise</creatorcontrib><creatorcontrib>Markus, Tiffanie</creatorcontrib><creatorcontrib>Schaffner, William</creatorcontrib><creatorcontrib>Halasa, Natasha B</creatorcontrib><collection>Access via Oxford University Press (Open Access Collection)</collection><collection>CrossRef</collection><jtitle>Open forum infectious diseases</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Beveridge, Stockton</au><au>Piya, Bhinnata</au><au>Stewart, Laura</au><au>Lindegren, Mary Louise</au><au>Markus, Tiffanie</au><au>Schaffner, William</au><au>Halasa, Natasha B</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Comparison of Viral Loads in Patients with Co-infections vs. Single-virus Infections</atitle><jtitle>Open forum infectious diseases</jtitle><date>2017-10-01</date><risdate>2017</risdate><volume>4</volume><issue>suppl_1</issue><spage>S310</spage><epage>S310</epage><pages>S310-S310</pages><issn>2328-8957</issn><eissn>2328-8957</eissn><abstract>Abstract
Background
Molecular testing for respiratory viruses in clinical practice is common, often with multiple viruses detected. Viral load has been correlated with illness severity, but correlation of co-detection of viruses and viral load is less clear. We sought to compare cycle threshold (Ct) values, a marker inversely related to viral load, between single vs. co-detection of common respiratory viruses.
Methods
Children <18 years with respiratory symptoms and/or fever who presented to the ED or were admitted were enrolled. Nasal/throat specimens were obtained and combined. Singleplex qRT-PCR was used to test for 11 respiratory viruses. Clinical and demographic information were collected.
Results
From 11/15/15-7/15/16, 1255 children were enrolled, with median age of 26.5 months, 53.4% male, 54.3% White, 38.7% Black, 6.4% other, and 23.5% Hispanic. The median days of illness were 3 days. Of the total cohort, 904 (72%) tested positive for at least one viral pathogen. Table 1compares Ct values of single vs. co-detection for each individual virus.
Table 1.
N
Ct-Median
(IQR)
p-value
Days of Ilness - Median (IQR)
p-value
Respiratory Syncytial Virus (RSV)
Single
144
25.5
(22.86-29.03)
0.05
4 (3-5)
0.82
RSV-Co-detection
63
27.0
(23.47-33.82)
3 (3-7)
Human Rhinovirus (HRV)-Single
289
27.5
(23.79-32.50)
0.000
3 (2-4)
0.002
HRV-Co-detection
117
32.8
(29.08-35.49)
3 (2-6)
Adenovirus (AdV)-Single
79
28.7
(23.84-33.62)
0.001
3 (2-4)
0.06
Adv-Co-detection
7
32.8
(27.40–36.69)
3 (2-4)
Human metapneumovirus (HMPV)-Single
75
28.8
(25.37-32.22)
0.75
4 (3-6)
0.45
HMPV-Co-detection
30
28.2
(24.86-33.11)
4 (3-7)
Parainfluenza (PIV)-Single
36
25.2
(23.75-28.76)
0.005
3.5 (2-5.5)
0.34
PIV-Co-detection
15
28.8
(26.04-34.50)
3 (1–4)
Flu-Single
127
26.6
(24.71-30.51)
0.34
3 (2-5)
0.83
Flu-Co-detection
26
28.0
(25.98-30.14)
3.5 (2-6)
Conclusion
Single detection with RSV, HRV, AdV, and PIV had lower Ct values, indicating higher viral loads, compared with co-detection with other viruses. Additional research is needed to understand the reason for lower viral loads for co-detection vs. single detection in select respiratory viruses.
Disclosures
W. Schaffner, Pfizer: Scientific Advisor, Consulting fee. Merck: Scientific Advisor, Consulting fee. Novavax: Consultant, Consulting fee. Dynavax: Consultant, Consulting fee. Sanofi-pasteur: Consultant, Consulting fee. GSK: Consultant, Consulting fee. Seqirus: Consultant, Consulting fee. N. B. Halasa, sanofi pasteur: Research Contractor, Research support. Astra Zeneca: Research Contractor, Grant recipient.</abstract><cop>US</cop><pub>Oxford University Press</pub><doi>10.1093/ofid/ofx163.723</doi><oa>free_for_read</oa></addata></record> |
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title | Comparison of Viral Loads in Patients with Co-infections vs. Single-virus Infections |
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