Juan Ambrosioni1, Pierre-Olivier Bridevaux2, John-David Aubert3, Paola Soccal4, Ghislaine Wagner5, Laurent Kaiser6. 1. Laboratory of Virology, Division of Laboratory Medicine, University Hospitals of Geneva, Geneva, Switzerland; Division of Infectious Diseases, University Hospitals of Geneva, Geneva, Switzerland. Electronic address: jambrosioni@intramed.net. 2. Division of Respiratory Medicine, University Hospitals of Geneva, Geneva, Switzerland; Service of Respiratory Medicine, Hôpital du Valais, Sion, Switzerland. 3. Division of Respiratory Medicine, University Hospital of Lausanne, Lausanne, Switzerland. 4. Division of Respiratory Medicine, University Hospitals of Geneva, Geneva, Switzerland. 5. Laboratory of Virology, Division of Laboratory Medicine, University Hospitals of Geneva, Geneva, Switzerland. 6. Laboratory of Virology, Division of Laboratory Medicine, University Hospitals of Geneva, Geneva, Switzerland; Division of Infectious Diseases, University Hospitals of Geneva, Geneva, Switzerland; School of Medicine, University of Geneva, Geneva, Switzerland.
Abstract
BACKGROUND: Rhinovirus is the most common cause of respiratory viral infections and leads to frequent respiratory symptoms in lung transplant recipients. However, it remains unknown whether the rhinovirus load correlates with the severity of symptoms. OBJECTIVES: This study aimed to better characterize the pathogenesis of rhinoviral infection and the way in which viral load correlates with symptoms. STUDY DESIGN: We assessed rhinovirus load in positive upper respiratory specimens of patients enrolled prospectively in a cohort of 116 lung transplant recipients. Rhinovirus load was quantified according to a validated in-house, real-time, reverse transcription polymerase chain reaction in pooled nasopharyngeal and pharyngeal swabs. Symptoms were recorded in a standardised case report form completed at each screening/routine follow-up visit, or during any emergency visit occurring during the 3-year study. RESULTS: Rhinovirus infections were very frequent, including in asymptomatic patients not seeking a specific medical consultation. Rhinovirus load ranged between 4.1 and 8.3 log copies/ml according to the type of visit and clinical presentation. Patients with highest symptom scores tended to have higher viral loads, particularly those presenting systemic symptoms. When considering symptoms individually, rhinovirus load was significantly higher in the presence of symptoms such as sore throat, fever, sputum production, cough, and fatigue. There was no association between tacrolimus levels and rhinovirus load. CONCLUSIONS: Rhinovirus infections are very frequent in lung transplant recipients and rhinoviral load in the upper respiratory tract is relatively high even in asymptomatic patients. Patients with the highest symptom scores tend to have a higher rhinovirus load.
BACKGROUND: Rhinovirus is the most common cause of respiratory viral infections and leads to frequent respiratory symptoms in lung transplant recipients. However, it remains unknown whether the rhinovirus load correlates with the severity of symptoms. OBJECTIVES: This study aimed to better characterize the pathogenesis of rhinoviral infection and the way in which viral load correlates with symptoms. STUDY DESIGN: We assessed rhinovirus load in positive upper respiratory specimens of patients enrolled prospectively in a cohort of 116 lung transplant recipients. Rhinovirus load was quantified according to a validated in-house, real-time, reverse transcription polymerase chain reaction in pooled nasopharyngeal and pharyngeal swabs. Symptoms were recorded in a standardised case report form completed at each screening/routine follow-up visit, or during any emergency visit occurring during the 3-year study. RESULTS:Rhinovirus infections were very frequent, including in asymptomatic patients not seeking a specific medical consultation. Rhinovirus load ranged between 4.1 and 8.3 log copies/ml according to the type of visit and clinical presentation. Patients with highest symptom scores tended to have higher viral loads, particularly those presenting systemic symptoms. When considering symptoms individually, rhinovirus load was significantly higher in the presence of symptoms such as sore throat, fever, sputum production, cough, and fatigue. There was no association between tacrolimus levels and rhinovirus load. CONCLUSIONS:Rhinovirus infections are very frequent in lung transplant recipients and rhinoviral load in the upper respiratory tract is relatively high even in asymptomatic patients. Patients with the highest symptom scores tend to have a higher rhinovirus load.
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Authors: Vicky L Baillie; David P Moore; Azwifarwi Mathunjwa; Henry C Baggett; Abdullah Brooks; Daniel R Feikin; Laura L Hammitt; Stephen R C Howie; Maria Deloria Knoll; Karen L Kotloff; Orin S Levine; Katherine L O'Brien; Anthony G Scott; Donald M Thea; Martin Antonio; Juliet O Awori; Amanda J Driscoll; Nicholas S S Fancourt; Melissa M Higdon; Ruth A Karron; Susan C Morpeth; Justin M Mulindwa; David R Murdoch; Daniel E Park; Christine Prosperi; Mohammed Ziaur Rahman; Mustafizur Rahman; Rasheed A Salaudeen; Pongpun Sawatwong; Somwe Wa Somwe; Samba O Sow; Milagritos D Tapia; Eric A F Simões; Shabir A Madhi Journal: Viruses Date: 2021-06-27 Impact factor: 5.048