Severity of rhinovirus infection in hospitalized adults is unrelated to genotype 公开

Abstract

Background: Differences in the severity of clinical illness due to rhinovirus (RV) species type (A, B or C) have been found in pediatric populations. In adults, however, the relationship between RV species and clinical illness is less well characterized.

Objectives: To determine whether RV species is associated with more severe clinical illness in adults.

Study design: Seventy-two RV-positive viral respiratory samples from adult patients were sequenced and analyzed phylogenetically. The clinical features and severity of illness were compared for the different RV species using ANOVA. Logistic regression was used to model the relationship between RV type and severity of illness.

Results: Phylogenetic analysis identified three distinct clusters as RV-A (54%), B (19%) or C (26%) species. The groups were demographically similar except that in the RV-C group, there were more females (p=0.05), and in the RV-B group, a larger proportion of patients had diabetes (p=0.04). In an unadjusted model, patients with RV-B infection as compared to patients with RV-C infection were significantly more likely to have the composite outcome variable of death or ICU admission (p=0.03), but this effect diminished when controlling for patient sex. A logistic model of the relationship between RV species and adverse outcomes produced nonsignificant odds ratios when controlling for patient sex.

Conclusions: Infection with RV-A or RV-B was associated with greater severity of illness in an adult population; however, the association disappeared after multivariate analysis controlling for the confounding effect of gender.

Table of Contents

Background....................................................................8 - Introduction...................................................................8 - Rhinovirus Virology and Taxonomy....................................9 - Rhinovirus species and severity of clinical illness................10 Methods.......................................................................12 Results.........................................................................16 Discussion....................................................................20 - Strengths and Limitations...............................................22 - Conclusion...................................................................23 - Implications.................................................................23 - Future Directions..........................................................24 Tables..........................................................................30 Figures and Figure Legends............................................38 Appendix......................................................................39

About this Master's Thesis

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School	Rollins School of Public Health
Department	Epidemiology
Degree	MPH
Submission	Master's Thesis
Language	English
Research Field	Biology, Virology Health Sciences, Epidemiology
关键词	epidemiology genotype rhinovirus
Committee Chair / Thesis Advisor	McGowan Jr., John E, Emory University
Committee Members	Kraft, Colleen S, Emory University
Partnering Agencies	CDC

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