Non-influenza respiratory viruses in adult patients admitted with influenza-like illness a 3-year prospective multicenter study

François Benezit (1) , Paul Loubet (2, 3, 4) , Florence Galtier (5, 2) , Charlotte Pronier (1) , Nezha Lenzi (2, 3, 4) , Zineb Lesieur (3, 4) , Stéphane Jouneau (6, 1) , Gisèle Lagathu (1) , Anne-Sophie L'Honneur (7) , Vincent Foulongne (8) , Christine Vallejo (9) , Sophie Alain (10) , Xavier Duval (2) , Nawal Houhou (11) , Yolande Costa (2) , Philippe Vanhems (12, 13) , Sélilah Amour (12) , Fabrice Carrat (14) , Bruno Lina (15) , Odile Launay (2, 4) , Pierre Tattevin (1, 6)

1 CHU Pontchaillou [Rennes]
2 F-CRIN, Innovative clinical research network in vaccinology (I-REIVAC)
3 CIC 1417 - CIC Cochin Pasteur
4 UPCité - Université Paris Cité
5 CIC Montpellier
6 CIC - Centre d'Investigation Clinique [Rennes]
7 Service de Virologie [CHU Cochin]
8 CHRU Montpellier - Hôpital Saint Eloi
9 CIC1435 - Centre d'Investigation Clinique de Limoges
10 RESINFIT - Anti-infectieux : supports moléculaires des résistances et innovations thérapeutiques
11 AP-HP - Hôpital Bichat - Claude Bernard [Paris]
12 Service d'Hygiène, Epidémiologie et Prévention [Hôpital Edouard Herriot - HCL]
13 LPE-Fondation Mérieux - Laboratoire des pathogènes émergents -- Emerging Pathogens Laboratory
14 iPLESP - Institut Pierre Louis d'Epidémiologie et de Santé Publique
15 HCL - Hospices Civils de Lyon

Purpose - To describe the burden, and characteristics, of influenza-like illness (ILI) associated with non-influenza respiratory viruses (NIRV). Methods - We performed a prospective, multicenter, observational study of adults admitted with ILI during three influenza seasons (2012-2015). Patients were screened for picornavirus, respiratory syncytial virus (RSV), coronavirus, human metapneumovirus, adenovirus, bocavirus, parainfluenza virus, and influenza, by PCR on nasopharyngeal samples. We excluded patients coinfected with NIRV and influenza.Results - Among 1421 patients enrolled, influenza virus was detected in 535 (38%), and NIRV in 215 (15%), mostly picornavirus (n = 61), RSV (n = 53), coronavirus 229E (n = 48), and human metapneumovirus (n = 40). In-hospital mortality was 5% (NIRV), 4% (influenza), and 5% (no respiratory virus). As compared to influenza, NIRV were associated with age (median, 73 years vs. 68, P = 0.026), chronic respiratory diseases (53% vs. 45%, P = 0.034), cancer (14% vs. 9%, P = 0.029), and immunosuppressive drugs (21% vs. 14%, P = 0.028), and inversely associated with diabetes (18% vs. 25%, P = 0.038). On multivariable analysis, only chronic respiratory diseases (OR 1.5 [1.1-2.0], P = 0.008), and diabetes (OR 0.5 [0.4-0.8], P = 0.01) were associated with NIRV detection.Conclusions - NIRV are common in adults admitted with ILI during influenza seasons. Outcomes are similar in patients with NIRV, influenza, or no respiratory virus.

Keywords: Respiratory syncytial virus; Influenza-like illness; Picornavirus; Coronavirus; Human metapneumovirus; Influenza

Domains: Life Sciences [q-bio]; Human health and pathology; Infectious diseases; Life Sciences [q-bio]; Santé publique et épidémiologie

François Benezit, Paul Loubet, Florence Galtier, Charlotte Pronier, Nezha Lenzi, et al.. Non-influenza respiratory viruses in adult patients admitted with influenza-like illness a 3-year prospective multicenter study. Infection, 2020, 48 (4), pp.489-495. ⟨10.1007/s15010-019-01388-1⟩. ⟨hal-02498632⟩