Viral circulation causing severe acute respiratory infection confirmed by multiple tests in the E.S.E. Erasmo Meoz University Hospital

Abstract

Introduction: In the group of infectious diseases, Acute Respiratory Infection (ARI) is the leading cause of morbidity and mortality in the global population. The main causal agents of ARI include viruses such as: Sars-CoV-2, Influenza viruses types A, B and C, Parainfluenza types 1, 2, 3 and 4, Respiratory Syncytial Virus, Coronavirus, Adenovirus, Rhinovirus, Metapneumovirus, Bocavirus and bacteria: Streptococcus pneumoniae and Haemophilus influenzae. The Infectious Diseases Society of America (IDSA) recommends the use of molecular tests such as Real- Time Polymerase Chain Reaction (rRT-PCR) over other tests, the objective of the study was to characterize the circulation in severe acute respiratory infection (SARI).
) based on molecular diagnostic tests for the detection of seven respiratory viruses: Influenza A, Infuenza A (H3N2), Influenza B, Adenovirus, Metapneumovirus, Sars- CoV-2 and Respiratory Syncytial Virus (RSV). Materials and Methods Cross- sectional descriptive study that included the entire population admitted to the Erasmo Meoz University Hospital for Severe Acute Respiratory Infection with hospitalization criteria consecutively from 2021 to 2022. Viral circulation was represented by life cycle monthly. Viral co-infection was identified, and matching was performed to determine the most common one. Results Of the total of 803 patients, a higher proportion of SARI in infants was found of 65% (n=523) with a similar percentage distribution between Colombians and migrants. The next population group with the highest proportion were older adults with 9% of the cases (n=76), having a greater distribution between Colombians versus migrants (11% vs 3%); Men were the most affected, 55% and 54%, respectively. The social security regime most served among the Colombian population was the subsidized one with 87% (n=542). However, great differences were noted in the migrant population where non-insurance predominated in 92% of the cases (n=165); which indicates the clever work of social responsibility of the institution and the attention with a differential approach. When determining circulation patterns by life cycle, RSV and adenovirus were especially prevalent in younger and older infants during most of both years, while SARS-CoV-2 in preschoolers, schoolchildren, adults, and older adults toward the end 2022. In addition, virus-virus coinfection patterns were identified, with RSV and adenovirus being the most frequent with the other viral agents. Mortality from SARI decreased from 2.6 to 1.1 per 1,000 hospital discharges in Colombians and from 1.0 to 0.8 in migrants between 2021 and 2022. Conclusions Multiple RT-PCR is especially useful in epidemiological surveillance systems since it allows documenting patterns of viral circulation in Severe Acute Respiratory Infections causing morbidity and mortality in our region and patterns of possible virus-virus coinfection. Current prevention models should be aimed at patients under 5 years of age and over 60 years of age where the possibility of hospitalization is greater. The ages with the highest reports of infections and coinfections belong to the life cycles of older infants and preschoolers, with a wonderful opportunity to generate early recognition and follow-up strategies.