1752. Rhinovirus Is Associated with Severe Respiratory Illness and Failure in Hospitalized Adults
Session: Poster Abstract Session: Viral Infections; Pathogenesis and Epidemiology
Saturday, October 5, 2013
Room: The Moscone Center: Poster Hall C
Background: The recent availability of molecular assays to detect multiple viruses in a single sample has led to increased detection of rhinovirus. The aim of this study is to describe the presentation and clinical course of hospitalized patients with a positive rhinovirus PCR from a respiratory specimen. 

Methods: Electronic medical records from adult inpatients with rhinovirus positive molecular testing from November 2009-October 2011 were retrospectively reviewed for patient characteristics, microbiology results, clinical course and in-hospital mortality. 

Results: One hundred forty-nine patients tested positive for rhinovirus. The mean age was 52 years (range 18-95). One hundred eight patients (72%) were admitted with a respiratory complaint. The most common presenting symptom was cough (58%), followed by tachypnea (48%) and fever (27%). In addition to rhinovirus, other viruses were isolated in 6 patients (4%): influenza A (2), human metapneumovirus (3), and parainfluenza 2 (1). Seventy patients (47%) were immunocompromised (hematologic malignancy, solid organ transplant, HIV, or receiving immunosuppressive drugs). Sixty-two (41%) experienced respiratory failure; ARDS developed in 22 (35%) of these. Pulmonary disease was significantly associated with respiratory failure, but being immunocompromised or obese was not (Table). Fourteen patients (22%) with respiratory failure died. The cause of death was listed as respiratory failure for eight (57%) of these. 

No. (%) Select Comorbidities in Patients with Rhinovirus

 

Respiratory Failure

(n=62)

No Respiratory Failure

(n=87)

p-value

COPD

19 (30)

10 (11)

0.03

Structural lung disease

4 (6)

0 (0)

0.006

Home Oxygen

9 (14)

2 (2)

0.008

Inhaled corticosteroids

22 (35)

6 (18)

0.02

Immunocompromised

15 (24)

55 (63)

<0.001

Obesity

22 (35)

30 (34)

1.00

Diabetes mellitus

14 (22)

17 (19)

0.69

ESRD

2 (3)

5 (6)

0.70

Conclusion: Molecular assays allow for rapid detection of rhinovirus and other respiratory viruses. Rhinovirus is a cause of severe respiratory illness and respiratory failure in hospitalized adults. In this study, having pulmonary disease was associated with respiratory failure.

Harry Scholtz IV, D.O, Internal Medicine, Wake Forest University, Winston Salem, NC, Vera Luther, MD, IM-Section On Infectious Diseases, Wake Forest School of Medicine, Winston-Salem, NC and Elizabeth Palavecino, MD, Pathology, Wake Forest School of Medicine, Winston Salem, NC

Disclosures:

H. Scholtz IV, None

V. Luther, None

E. Palavecino, None

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