Rhinovirus viremia in adult patients with high viral load in bronchoalveolar lavages

摘要

Highlights ? Demonstrates rhinovirus viremia in adults. ? The percentage (15%) of viremia in these highly immunocompromised adults is low. ? Rhinovirus A01, A24, B52 and B92 were found in the viremic patients. ? Significantly higher mortality in viremic patients. Abstract Background In children, rhinovirus viremia has been associated with higher nasopharyngeal loads and increase in severity of clinical signs and symptoms. Objectives This study aims to detect rhinovirus viremia in adult patients and to establish potential correlations with the clinical course. Study design Adult patients with rhinovirus strongly positive bronchoalveolar lavages (BAL, quantitation cycle, Cq values Results Twenty-seven of 43 patients with rhinovirus positive BAL at Cq values Viremic patients were not significantly different with regard to underlying conditions, respiratory symptoms, radiological findings, co-pathogens nor the number of blood samples tested for RV. However, patients with rhinovirus viremia had significant higher mortality rates compared to patients without viremia, as all four died as a consequence of respiratory problems (100%) versus 22% (5/23), p=0.007 (Fisher’s exact). Conclusions Rhinovirus viremia can occur in adult patients with a high viral load in BAL fluid. Rhinovirus viremia may be considered a negative prognostic factor, although a causative role with regard to the adverse outcome has yet to be demonstrated.