Independent and interactive effects of viral species on early-life lower respiratory tract illness.

2025

https://researcherprofiles.org/profile/754171401

41015263

Moore CM, Secor EA, Fairbanks-Mahnke A, Everman JL, Elhawary JR, Witonsky JI, Pruesse E, Chang CH, Contreras MG, Eng C, Canales K, Rosado T, Hu D, Huntsman S, Jackson ND, Li Y, Lopez N, Valentin AM, Medina V, Montanez-Lopez CA, Morin A, Nieves NA, Oh SS, Otero RA, Colon R, Rodriguez L, Sajuthi SP, Salazar S, Serrano G, Morales EV, Vazquez G, Morales NV, Williams BJM, Zhang P, Sheppard D, Santana JRR, Seibold MA

Abstract

OBJECTIVES

To determine the association between viral species and odds of severe lower respiratory tract illnesses (sLRI) versus upper respiratory illness (URI) among children under 2 years of age.

METHODS

Infants (n=2061) enrolled in the Puerto Rican Infant Metagenomic and Epidemiologic Study of Respiratory Outcomes were surveilled for respiratory illnesses until age 2 years (March 2020 to April 2024). Nasal swabs from 1363 illnesses (774 participants) were screened for 21 pathogens.

RESULTS

RSV infections occurred in 23% of sLRIs and increased odds of sLRI vs URI (OR=9.28; 95% CI, 5.43-15.85). Metapneumovirus, parainfluenza, and non-SARS-CoV-2 coronavirus also increased odds of sLRIs, while SARS-CoV-2 was associated with lower risk of sLRIs. Rhinovirus (43%) and bocavirus (16.1%) were commonly detected, but were not associated with sLRI risk. Co-infection with multiple viral species was associated with 2.92-fold greater odds of sLRI (95% CI, 2.05-4.16) compared to single viral species infections. Rhinovirus-bocavirus was the most common co-infection, and interaction between these viruses was associated with increased odds of sLRI.

CONCLUSIONS

Diverse viral pathogens drive early-life sLRIs. Some (e.g. RSV and metapneumovirus) have an intrinsic propensity to cause sLRIs, while other viruses' lower airway pathogenicity depends on other factors, including co-infection.

Journal Issue

Volume 91 of Issue 4