Clinical Impact of Mixed Respiratory Viral Infection in Children with Adenoviral Infection

Lee, Hyun Jun; Seo, Young Eun; Han, Seung Beom; Jeong, Dae Chul; Kang, Jin Han

Recently, multiplex polymerase chain reaction (PCR) tests, which are more sensitive and cost-effective than conventional antigen detection and culture methods, have been used for diagnosing respiratory viral infections [12, 13] . More cases of multiple respiratory viral infections have been diagnosed using these multiplex PCR tests than were reported before using conventional testing methods [12] [13] [14] . Consequently, the clinical impact of respiratory viral coinfections, especially coinfection with respiratory syncytial virus (RSV), has been evaluated since the 2000s [15] . In a recently published meta-analysis, respiratory viral coinfections were not reported to result in a significant increase in the clinical severity of respiratory infections compared with single viral infections [15] . However, their clinical effects vary depending on the coinfected viruses and the subjects enrolled in each study. Therefore, while respiratory viral coinfections reportedly manifest as more severe illnesses in some studies [16, 17] , other investigators report a lack of association between viral coinfection and disease severity in ADV infected children [18] . Furthermore, even as ADV infection occurs steadily all year round in Korea, the clinical impact of respiratory viral coinfection on childhood ADV infection has rarely been reported [19] . In addition, previous studies on ADV coinfections included only children younger than 1 or 3 years of age, or children with lower respiratory tract infections [18, 20, 21] . This retrospective study was performed to investigate the clinical impact of respiratory viral coinfections in Korean children with ADV infection.