Rhinovirus is a common cause of upper and lower respiratory tract infections in adults especially among the elderly and immunocompromised. Nevertheless, its clinical characteristics and mortality risks have not been well described.
A retrospective analysis on a prospective cohort was conducted in a single teaching hospital center. We compared adult patients hospitalized for rhinovirus infection with those hospitalized for influenza infection during the same period. All recruited patients were follow-up for at least 26 weeks. Independent risk factors associated with mortality for rhinovirus infection were identified.
Between 1st March and 31st October 2014, a total of 781 patients were consecutively included for analysis. Of these, 372 patients were hospitalized for rhinovirus infection and 409 patients were hospitalized for influenza infection. Significantly more patients hospitalized for rhinovirus infection were elderly home residents (p<0.01) and had a past medical history of chronic lung diseases (p=0.02); otherwise there were no difference in the Charlson comorbidity index between the two groups. More patients in the rhinovirus group developed pneumonia complication (p<0.01), required oxygen therapy (p<0.01) and had a longer hospitalization period; whereas more patients in the influenza virus group presented with upper respiratory tract symptoms (p<0.001) and developed cardiovascular complications (p<0.001). The 1-year mortality rate was significantly higher in the rhinovirus group than the influenza virus group (p<0.01). Elderly home residents (OR:2.7; 95%C.I. 1.45-5.04), requirement of oxygen therapy (OR:1.91; 95%C.I. 1.06-3.45), increased frequency of hospitalization (OR:1.07; 95%C.I. 1-1.4) and reduced hemoglobin level upon admission (OR:1.18; 95%C.I. 1.04-1.32) were independent risk factors associated with 1-year mortality in patients hospitalized for rhinovirus infection.
Rhinovirus infection in the adults was associated with significantly higher mortality and longer hospitalization when compared with influenza virus infection. Institutionalized older adults were particularly at risk. More stringent infection control among the health care workers in the elderly homes could lower the infection rate before an effective vaccine and antiviral become available.
I. F. N. Hung,
K. To, None
J. F. Chan, None
K. Yuen, None