Inpatient outcomes for hospitalized older adults with rhinovirus

  1. Olivier Del Corpo
  2. Emily G. McDonald
  3. Luisa Smyth
  4. Elizabeth Smyth
  5. Moneeza Walji
  6. Matthew P. Cheng
  7. Charles Frenette
  8. Ramy R. Saleh
  9. Todd C. Lee

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Abstract

Background

Rhinoviruses account for many cases of the “common cold” and infection is often self-limiting. As such, there is a lack of data regarding the inpatient outcomes of individuals hospitalized with rhinovirus infection. Given the generalized poorer prognosis of elderly admitted with respiratory viral infections, we assessed the mortality rate of general medical patients admitted with rhinovirus infection along with the major risk factors associated to mortality.

Methods

We performed a retrospective chart review of patients admitted to our clinical teaching ward from December 2013 to June 2017.

Results

Overall, 12.5% of patients admitted with rhinovirus infection died within 90 days of admission. The median age of admitted patients was 70 years-old. In univariable analysis, age (OR 1.05; 95% confidence interval (CI) 1.01-1.09) and the need for oxygen at presentation (OR 3.23; 95% CI 1.06-9.86) were associated with death while obstructive pulmonary disease or asthma (OR 0.10; 95% CI 0.01-0.81) was associated with survival. In the multivariable model, age (aOR 1.04; 95% CI 1.00-1.09) and obstructive lung disease (aOR 0.09 95%CI 0.01-0.73) remained significant whereas the requirement for oxygen at presentation did not (aOR 2.78; 95% CI 0.84-9.23).

Conclusion

Our study reveals that rhinovirus is an important cause of both morbidity and mortality in the elderly and further highlights the need for studies of potentially effective treatment options. In the meantime, we suggest that rigorous respiratory hygiene measures and quality older adult care should be practiced when caring for at-risk adults.

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  1. ScreenIT

    SciScore for 10.1101/2021.04.09.21255232: (What is this?)

    Please note, not all rigor criteria are appropriate for all manuscripts.

    Table 1: Rigor

    Institutional Review Board Statementnot detected.
    Randomizationnot detected.
    Blindingnot detected.
    Power Analysisnot detected.
    Sex as a biological variablenot detected.

    Table 2: Resources

    Software and Algorithms
    SentencesResources
    Statistical testing was conducted using STATA version 15.1.
    STATA
    suggested: (Stata, RRID:SCR_012763)

    Results from OddPub: We did not detect open data. We also did not detect open code. Researchers are encouraged to share open data when possible (see Nature blog).

    Results from LimitationRecognizer: We detected the following sentences addressing limitations in the study:
    Our study does have several limitations. Our findings are from a single Canadian tertiary care hospital and may not be generalizable to other hospitals and countries. Furthermore, the population of patients admitted to a clinical teaching include those with multiple comorbidities which may result in an elevated mortality rate. Moreover, patients were tested for rhinovirus by RT-PCR; however, agents isolated from the nasopharynx can represent asymptomatic colonization rather than pathogenic infection. Also, as testing is a clinical decision, only those patients where the treating team specifically looked for respiratory viruses were included. Finally, as previously discussed, attribution of mortality is extremely challenging. However, 30 patients were admitted with a diagnosis of pneumonia, 23 with COPD or asthma exacerbation and 12 with upper respiratory tract infection so for a large number of these patients the rhinovirus seems to have been directly contributory. The strengths of our study are the large overall sample size of admitted patients with rhinovirus and the longitudinal nature over several years such that the results are not restricted to a single circulating strain.

    Results from TrialIdentifier: No clinical trial numbers were referenced.

    Results from Barzooka: We did not find any issues relating to the usage of bar graphs.

    Results from JetFighter: We did not find any issues relating to colormaps.

    Results from rtransparent:
    • Thank you for including a conflict of interest statement. Authors are encouraged to include this statement when submitting to a journal.
    • Thank you for including a funding statement. Authors are encouraged to include this statement when submitting to a journal.
    • No protocol registration statement was detected.

    About SciScore

    SciScore is an automated tool that is designed to assist expert reviewers by finding and presenting formulaic information scattered throughout a paper in a standard, easy to digest format. SciScore checks for the presence and correctness of RRIDs (research resource identifiers), and for rigor criteria such as sex and investigator blinding. For details on the theoretical underpinning of rigor criteria and the tools shown here, including references cited, please follow this link.

  2. Version published to 10.1101/2021.04.09.21255232v1 on medRxiv