2154. Comparing the Clinical Outcomes of Human Rhinovirus/Enterovirus to Influenza and Respiratory Syncytial Virus Among Children in an Outpatient Setting


 
 
 Human Rhinovirus/Enterovirus (HRV/ENT) infections are common among children and their full clinical impact is still being studied. We aimed to compare the clinical outcomes of children with HRV/ENT infection to other common respiratory viruses in the outpatient setting.
 
 
 
 We conducted a retrospective analysis of nasopharyngeal samples positive for HRV/ENT, Influenza A/B (FLU), or Respiratory Syncytial Virus (RSV) from patients ≤ 17 years, submitted for testing via Multiplex polymerase chain reaction, between 2016 and 2019. Samples positive for more than one virus or arising from the same patient within 3 months were excluded. Outcome measures within proximity to the positive result were assessed via chart review and were: days of symptoms; outpatient visits for respiratory symptoms; bacterial diagnosis; and hospital admission. Between the 3 viruses: multivariable linear regression was used to compare the number of days of symptoms; Kruskal-Wallis test was used to compare the number of outpatient visits; and multivariable logistic regression was used to compare bacterial diagnosis as well as hospitalization.
 
 
 
 There were 1359 positive samples analyzed; 746 HRV/ENT, 304 FLU, and 309 RSV. After controlling for comorbid conditions and age, children with FLU had 29% fewer days of respiratory symptoms prior to testing versus HRV/ENT [β -0.34; 95% CI -0.54,-0.15; p < 0.001] (Fig1A) and had fewer outpatient visits (median [M] = 1) for respiratory symptoms in proximity to a positive result versus HRV/ENT (M=2) or RSV (M= 2) (Fig 1B). After adjusting for age and comorbid conditions, children with FLU had ∼ 80% decreased odds of hospitalization versus children with HRV/ENT and those with RSV infection had 3 times the odds of bacterial infection than children with HRV/ENT (Fig 2).
 
 
 
 We highlight the clinical significance of HRV/ENT in the outpatient setting. Children with HRV/ENT had more outpatient visits and higher odds of hospitalization as compared to those with FLU. Outcomes between HRV/ENT and RSV were similar, with the exception of bacterial infection. Clinicians should have a high level of vigilance when managing children with HRV/ENT infections given the potential for clinical outcomes similar to, and in some cases, worse than established pathogenic viruses.
 
 
 
 All Authors: No reported disclosures.
