This paper reports on the results of a prospective study conducted during 2009-2013, which assessed acute respiratory illness (ARI) soon after onset of symptoms and 3-4 weeks later in adults 60 years of age and older with chronic lung and heart diseases (group 1, n = 100) and in healthy adults 18-40 years old (group 2, n = 101). Samples of respiratory secretions were tested by polymerase chain reaction (PCR) for multiple pathogens (including several human coronaviruses, respiratory syncytial virus, influenza A and B, parainfluenza, metapneumovirus, enterovirus/rhinovirus, adenovirus, and bocavirus). In addition, some subjects’ serum was later tested by an EIA for coronavirus antibodies. ARI symptoms were assessed and severity was scored.
Illnesses more commonly occurred during fourth and first quarters of all years. Of virus-associated illnesses, coronavirus was seen in 19% of group 1 and 22% of group 2 patients. Enterovirus/rhinovirus was seen in 19% of group 1 and 31% of group 2 patients. Virus coinfection occurred in 10 patients. Group 1 patients more commonly experienced multiple symptoms and symptoms of greater severity; they experienced longer duration of symptoms, and dyspnea was more commonly seen in this cohort than in group 2 patients. In addition, more group 1 patients received treatment with antibiotics and prednisone. Of various symptoms recorded in patients with coronavirus-associated illness, myalgia was more commonly seen in group 2 patients (68% vs 21% in group 1 patients), whereas dyspnea was more commonly seen in group 1 patients (71% vs 24% in group 2 patients). Other symptoms, such as chills, headache, malaise, cough, sputum production, sore throat, and nasal congestion, were seen in similar percentages of group 1 and group 2 patients.
COMMENTARY
This is an interesting paper that prospectively evaluated a good-sized cohort of adults with ARI over 4 years in a rigorous manner. The study showed that coronaviruses and enteroviruses/rhinoviruses were responsible for the largest number of infections. Older, chronically ill adults had more severe illness and experienced a longer duration of symptoms than young, healthy patients. Dyspnea was more commonly seen in older adults with underlying cardiac and pulmonary disease. Lastly, older and chronically ill adults were more likely to receive antibiotics and steroids. This latter observation is particularly important since the use of antibiotics in patients with viral ARIs (in the absence of bacterial co-infection) may be harmful.
A prospective study of acute respiratory illness was conducted between 2009 and 2013. Coronavirus and rhinovirus/enterovirus were the most common viral pathogens. Among patients older than age 60 with chronic lung and heart disease (vs healthy adults 18-40 years old), dyspnea, more prolonged illness, and treatment with prednisone and antibiotics were more commonly seen. Myalgia was more common in younger patients.
You have reached your article limit for the month. Subscribe now to access this article plus other member-only content.
- Award-winning Medical Content
- Latest Advances & Development in Medicine
- Unbiased Content