APIM243887242 - CME/CMLE - Coinfections: Respiratory Viruses-APIM243887242

APIM243887242 - Educational Activity

Pdf Summary

This educational commentary by Linsey Donner, PhD, MPH, provides a comprehensive overview of respiratory virus coinfections, emphasizing their clinical significance, epidemiology, diagnosis, treatment, and prevention strategies. Respiratory viruses such as influenza, coronaviruses (including SARS-CoV-2), respiratory syncytial virus (RSV), human rhinoviruses, parainfluenza viruses, adenoviruses, and human metapneumovirus cause respiratory illnesses ranging from mild colds to severe pneumonia. Coinfections occur when two or more viruses infect an individual concurrently or sequentially, often resulting in more severe disease, especially in vulnerable populations like young children, older adults, and immunocompromised persons. <br /><br />The prevalence of coinfections fluctuates by season, location, population, and diagnostic capabilities. Commonly reported coinfections include influenza with RSV or rhinoviruses, and SARS-CoV-2 with influenza or RSV, potentially leading to worsened outcomes. Respiratory viruses spread mainly via direct contact, droplets, aerosols, indirect contact with contaminated surfaces, and sometimes vertically from mother to offspring.<br /><br />Accurate diagnosis is essential for managing coinfections and relies heavily on molecular assays, including multiplex PCR panels that detect multiple viruses simultaneously with high sensitivity and specificity. Rapid antigen tests are useful for quick, point-of-care screening but are less sensitive. Serologic tests help assess past exposure but are not suitable for acute diagnosis.<br /><br />Treatment primarily involves supportive care—hydration, fever reduction, symptom relief—along with antiviral therapies tailored to specific viruses, such as neuraminidase inhibitors for influenza or antiviral agents for COVID-19 in high-risk patients. Prevention strategies include vaccination (influenza, COVID-19, RSV), strict infection control practices, good hand hygiene, respiratory etiquette, use of personal protective equipment, and public health interventions like social distancing.<br /><br />Overall, understanding the epidemiology, diagnosis, and management of respiratory virus coinfections is critical for improving patient outcomes and reducing transmission, especially during peak respiratory virus seasons.

Keywords

respiratory virus coinfections

influenza

SARS-CoV-2

respiratory syncytial virus (RSV)

diagnosis of respiratory viruses

multiplex PCR

antiviral treatment

vaccination

infection control

epidemiology of respiratory infections