P2.097: Likelihood of PICU admission in patients with SARS-CoV-2 AND viral co-detection

Background: SARS-CoV-2 with bacterial co-infections in children complicates the disease, little is known regarding the influence of viral co-detection on disease severity. Recent research indicates that viral co-infections exacerbate the severity of diseases. Specifically, children co-infected with other viruses alongside SARS-CoV-2 demonstrate an elevated likelihood of ICU admission compared to those without co-infection. We sought to determine the clinical severity of symptomatic children with single viral detection (SARS-CoV-2, RSV, and ERV) and SARS-CoV-2 co-detection (SARS-CoV-2+RSV or SARS-CoV-2+ERV). We hypothesize symptomatic children with SARS-CoV-2 co-detection will have increased risk of PICU admission compared to symptomatic children with single viral detection

Methods: A retrospective chart review was performed on all patients who were seen in the Arkansas Children's (AC) System between March 2021 and June 2023. Patients aged 0-5 years were included if they had viral symptoms and were tested using respiratory viral panel at an AC laboratory. Patients were filtered if they were positive for single virus A retrospective chart review was performed on all patients who were seen in the Arkansas Children's (AC) System between March 2021 and June 2023. Patients aged 0-5 years were included if they had viral symptoms and were tested using respiratory viral panel at an AC laboratory. Patients were filtered if they were positive for single virus SARS-CoV2, RSV, ERV or SARS-CoV-2 with codetection of RSV or ERV. Patients were excluded: if the viral swab was not performed at AC, Age >5 years, patient with home oxygen requirement at baseline, Patients with home ventilator or NIV requirement at baseline, patients with congenital heart disease with baseline saturations lower than 94%, patients tested positive for any other viruses other than above mentioned combination in inclusion criteria.
Data collected included demographics, hospital and ICU admission, length of stay, and maximum oxygen flow received. Based on chart review, WHO disease severity scores were retrospectively calculated for each patient: Mild (0-2), Moderate (3-4), and Severe disease (5-7) categories. Odds ratio was calculated for patients and compared among patients with RSV, SARS-CoV-2+RSV, SARS-CoV-2 and patients with ERV, SARS-CoV-2+ERV and SARS-CoV-2

Results: Table 1 and Table 2 shows no significant difference in odds ratio of admission to PICU when single viral infection groups are compared with co-infection group. There was no difference in odds ratio of PICU admission among ERV, Sars-CoV-2 and ERV+Sars-CoV-2. Similarly, there was no difference in odds ratio of PICU admission among RSV, Sars-CoV-2 and RSV+Sars-CoV-2.

Conclusion: These results indicate that patients with viral co-detection are not at increased risk of admission to PICU when compared to patients with single viral infection within the same group. More longitudinal studies are needed to determine the causality and relationship of different viruses.