Clinical Outcomes Associated with SARS-CoV-2 Co-Infection with Rhinovirus and Adenovirus in Adults—A Retrospective Matched Cohort Study
Abstract
:1. Introduction
2. Materials and Methods
2.1. Study Population and Setting
2.2. Matching Process
2.3. Clinical Outcome Assessment
2.4. Baseline Laboratory Biomarker Assessment
2.5. Statistical Analysis
3. Results
3.1. Study Disposition
3.2. Baseline Characteristics of Patients with SARS-CoV-2 + Rhinovirus Co-Infection
3.3. Baseline Characteristics of Patients with SARS-CoV-2 + Adenovirus Co-Infection
3.4. Clinical Outcomes for Patients with SARS-CoV-2 + Rhinovirus Co-Infection
3.5. Laboratory Biomarkers for Patients with SARS-CoV-2 + Rhinovirus Co-Infection
3.6. Clinical Outcomes for Patients with SARS-CoV-2 + Adenovirus Co-Infection
3.7. Laboratory Biomarkers for Patients with SARS-CoV-2 + Adenovirus Co-Infection
4. Discussion
5. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Conflicts of Interest
References
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Overall | SARS-CoV-2 + Rhinovirus n = 23 | SARS-CoV-2 n = 69 | p-Value |
---|---|---|---|
Age | 77 | 75 | 0.71 |
[IQR] | [52–86] | [53–81] | |
Patient Sex | - | ||
Female | 10 (43.5%) | 30 (43.5%) | |
Male | 13 (56.5%) | 39 (56.5%) | |
Race/Ethnicity | - | ||
Non-Hispanic White | 8 (34.8%) | 24 (34.8%) | |
Hispanic or Latino | 9 (39.1%) | 27 (39.1%) | |
Non-Hispanic Black | 2 (8.7%) | 6 (8.7%) | |
Other/Unknown | 4 (17.4%) | 12 (17.4%) | |
Time Period | - | ||
December 2020–January 2021 | 3 (13.0%) | 9 (13.0%) | |
February 2021–June 2021 | 3 (13.0%) | 9 (13.0%) | |
July 2021–December 2021 | 10 (43.5%) | 30 (43.5%) | |
January 2022–March 2022 | 7 (30.4%) | 21 (30.4%) | |
Oxygen Support * | 0.05 | ||
Room Air | 13 (56.5%) | 41 (59.4%) | |
Low Flow | 6 (26.1%) | 26 (37.7%) | |
High Flow | 4 (17.4%) | 2 (2.9%) | |
No. of Elixhauser Comorbidities | 0.219 | ||
0 | 2 (8.7%) | 12 (17.4%) | |
1–3 | 8 (34.8%) | 27 (39.1%) | |
4–6 | 6 (26.1%) | 22 (31.9%) | |
≥7 | 7 (30.4%) | 8 (11.6%) | |
COVID-19 Vaccination Status ** | 1.00 | ||
No | 14 (60.9%) | 43 (62.3%) | |
Yes | 9 (39.1%) | 26 (37.7%) | |
Remdesivir Use *** | 0.231 | ||
No | 14 (60.9%) | 31 (44.9%) | |
Yes | 9 (39.1%) | 38 (55.1%) | |
Corticosteroid Use *** | 0.608 | ||
No | 6 (26.1%) | 24 (34.8%) | |
Yes | 17 (73.9%) | 45 (65.2%) |
Overall | SARS-CoV-2 + Adenovirus n = 9 | SARS-CoV-2 n = 27 | p-Value |
---|---|---|---|
Age | 50 | 58 | 0.80 |
[IQR] | [48–76] | [42–72] | |
Patient Sex | - | ||
Female | 2 (22.2%) | 6 (22.2%) | |
Male | 7 (77.8%) | 21 (77.8%) | |
Race/Ethnicity | - | ||
Non-Hispanic White | 4 (44.4%) | 12 (44.4%) | |
Hispanic or Latino | 3 (33.3%) | 9 (33.3%) | |
Non-Hispanic Black | 1 (11.1%) | 3 (11.1%) | |
Other/Unknown | 1 (11.1%) | 3 (11.1%) | |
Time Period | - | ||
December 2020–January 2021 | 6 (66.7%) | 18 (66.7%) | |
February 2021–June 2021 | 1 (11.1%) | 3 (11.1%) | |
July 2021–December 2021 | 1 (11.1%) | 3 (11.1%) | |
January 2022–March 2022 | 1 (11.1%) | 3 (11.1%) | |
Oxygen Support * | 0.146 | ||
Room Air | 3 (33.3%) | 17 (63.0) | |
Low Flow | 6 (66.7%) | 10 (37.0%) | |
High Flow | 0 (0%) | 0 (0%) | |
No. of Elixhauser Comorbidities | 0.946 | ||
0 | 3 (33.3%) | 6 (22.2%) | |
1–3 | 3 (33.3%) | 11 (40.7%) | |
4–6 | 2 (22.2%) | 6 (22.2%) | |
≥7 | 1 (11.1%) | 4 (14.8%) | |
COVID-19 Vaccination Status ** | 0.558 | ||
No | 9 (100%) | 24 (88.9%) | |
Yes | 0 (0%) | 3 (11.1%) | |
Remdesivir Use *** | 0.252 | ||
No | 2 (22.2%) | 13 (48.2%) | |
Yes | 7 (77.8%) | 14 (51.9%) | |
Corticosteroid Use *** | 0.223 | ||
No | 1 (11.1%) | 10 (37.0%) | |
Yes | 8 (88.9%) | 17 (63.0%) |
Total n = 92 | SARS-CoV-2 + Rhinovirus n = 23 | SARS-CoV-2 n = 69 | p-Value | |
---|---|---|---|---|
30-day all-cause mortality | 0.02 | |||
No | 76 (82.6%) | 15 (65.2%) | 61 (88.4%) | |
Yes | 16 (17.4%) | 8 (34.8%) | 8 (11.6%) | |
30-day all-cause readmission * | n = 83 | n = 19 | n = 64 | 0.66 |
No | 76 (91.6%) | 17 (89.5%) | 59 (92.2%) | |
Yes | 7 (8.4%) | 2 (10.5%) | 5 (7.8%) | |
ICU admission ** | n = 91 | n = 23 | n = 68 | 0.17 |
No | 85 (93.4%) | 20 (87.0%) | 65 (95.6%) | |
Yes | 6 (6.6%) | 3 (13.0%) | 3 (4.4%) | |
Mechanical Ventilation | 0.26 | |||
No | 88 (95.7%) | 21 (91.3%) | 67 (97.1%) | |
Yes | 4 (4.3%) | 2 (8.7%) | 2 (2.9%) |
SARS-CoV-2 + Rhinovirus | SARS-CoV-2 | p-Value | |
---|---|---|---|
Room Air | 0.242 | ||
No | 11 (84.6%) | 39 (95.1%) | |
Yes | 2 (15.4%) | 2 (4.9%) | |
Low Flow | 0.310 | ||
No | 4 (66.7%) | 22 (84.6%) | |
Yes | 2 (33.3%) | 4 (15.4%) | |
High Flow | - | ||
No | 0 (0%) | 0 (0%) | |
Yes | 4 (100%) | 2 (100%) |
Overall | SARS-CoV-2 + Rhinovirus n = 23 | SARS-CoV-2 n = 69 | p-Value |
---|---|---|---|
ALT | n = 21 | n = 58 | 0.03 |
Median (IU/L) | 13 | 24 | |
[IQR] | [9–27] | [16–40] | |
AST | n = 21 | n = 58 | 0.04 |
Median (IU/L) | 25 | 36 | |
[IQR] | [18–34] | [25–53] | |
CRP | n = 16 | n = 53 | 0.02 |
Median (mg/L) | 34.86 | 94.68 | |
[IQR] | [11.62–87.42] | [43.25–142.02] | |
Creatinine | n = 23 | n = 66 | 0.99 |
Median (mg/dL) | 0.94 | 0.90 | |
[IQR] | [0.60–1.47] | [0.74–1.27] | |
D-dimer | n = 15 | n = 50 | 0.49 |
Median (ng/mL) | 269 | 384 | |
[IQR] | [180–721] | [240–592] | |
TLC | n = 23 | n = 66 | 0.16 |
Median (×109/L) | 0.9 | 0.8 | |
[IQR] | [0.5–1.7] | [0.5–1.2] | |
Platelets | n = 23 | n = 67 | 0.63 |
Median (×109/L) | 223 | 198 | |
[IQR] | [152–274] | [154–273] | |
WBC | n = 23 | n = 67 | 0.95 |
Median (×109/L) | 7.4 | 6.9 | |
[IQR] | [4.1–9.3] | [5.6–9.0] |
Total n = 36 | SARS-CoV-2 + Adenovirus n = 9 | SARS-CoV-2 n = 27 | p-Value | |
---|---|---|---|---|
30-day all-cause mortality | 0.56 | |||
No | 33 (91.7%) | 9 (100%) | 24 (88.9%) | |
Yes | 3 (8.3%) | 0 (0%) | 3 (11.1%) | |
30-day all-cause readmission * | n = 32 | n = 9 | n = 23 | 0.54 |
No | 29 (90.6%) | 9 (100%) | 20 (87.0%) | |
Yes | 3 (9.4%) | 0 (0%) | 3 (13.0%) | |
ICU admission | 0.58 | |||
No | 31 (86.1%) | 7 (77.8%) | 24 (88.9%) | |
Yes | 5 (13.9%) | 2 (22.2%) | 3 (11.1%) | |
Mechanical Ventilation | 1.00 | |||
No | 32 (88.9%) | 8 (88.9%) | 24 (88.9%) | |
Yes | 4 (11.1%) | 1 (11.1%) | 3 (11.1%) |
Overall | SARS-CoV-2 + Adenovirus n = 9 | SARS-CoV-2 n = 27 | p-Value |
---|---|---|---|
ALT | n = 8 | n = 26 | 0.33 |
Median (IU/L) | 38.5 | 28.5 | |
[IQR] | [21–78.5] | [18–35] | |
AST | n = 8 | n = 26 | 0.97 |
Median (IU/L) | 36 | 29.5 | |
[IQR] | [19–40] | [21–41] | |
CRP | n = 7 | n = 18 | 0.59 |
Median (mg/dL) | 88.92 | 85.59 | |
[IQR] | [36.55–299.01] | [33.52–189.70] | |
Creatinine | n = 9 | n = 27 | 0.73 |
Median (mg/dL) | 0.77 | 0.80 | |
[IQR] | [0.72–1.14] | [0.64–1.05] | |
D-dimer | n = 8 | n = 17 | 0.50 |
Median (ng/mL) | 272.5 | 302 | |
[IQR] | [169.50–449] | [279–479] | |
TLC | n = 9 | n = 26 | 0.65 |
Median (×109/L) | 1.2 | 1.0 | |
[IQR] | [0.6–1.3] | [0.4–1.2] | |
Platelets | n = 9 | n = 27 | 0.38 |
Median (×109/L) | 181 | 206 | |
[IQR] | [132–223] | [150–258] | |
WBC | n = 9 | n = 27 | 0.16 |
Median (×109/L) | 7.2 | 6 | |
[IQR] | [6.9–8.3] | [5–8] |
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Tran, Q.-L.; Benitez, G.; Shehadeh, F.; Kaczynski, M.; Mylonakis, E. Clinical Outcomes Associated with SARS-CoV-2 Co-Infection with Rhinovirus and Adenovirus in Adults—A Retrospective Matched Cohort Study. Int. J. Environ. Res. Public Health 2023, 20, 646. https://doi.org/10.3390/ijerph20010646
Tran Q-L, Benitez G, Shehadeh F, Kaczynski M, Mylonakis E. Clinical Outcomes Associated with SARS-CoV-2 Co-Infection with Rhinovirus and Adenovirus in Adults—A Retrospective Matched Cohort Study. International Journal of Environmental Research and Public Health. 2023; 20(1):646. https://doi.org/10.3390/ijerph20010646
Chicago/Turabian StyleTran, Quynh-Lam, Gregorio Benitez, Fadi Shehadeh, Matthew Kaczynski, and Eleftherios Mylonakis. 2023. "Clinical Outcomes Associated with SARS-CoV-2 Co-Infection with Rhinovirus and Adenovirus in Adults—A Retrospective Matched Cohort Study" International Journal of Environmental Research and Public Health 20, no. 1: 646. https://doi.org/10.3390/ijerph20010646