Hospitalizations and outpatient visits for rhinovirus-associated acute respiratory illness in adults

J Allergy Clin Immunol. 2016 Mar;137(3):734-43.e1. doi: 10.1016/j.jaci.2015.06.017. Epub 2015 Aug 6.

Abstract

Background: Rhinovirus is linked to asthma exacerbations and chronic obstructive pulmonary disease exacerbations in adults. The severity and rates of rhinovirus acute respiratory illnesses (ARIs) in adults are uncertain.

Objectives: We sought to determine rhinovirus-associated ARI rates in adults presenting for care in multiple settings and identify factors associated with rhinovirus detection.

Methods: This prospective, population-based cohort enrolled Tennessee residents 18 years or older in the emergency department (ED), outpatient clinics, or hospitalized for ARI from December 2008 to May 2010. Nasal/throat swabs were collected and tested for rhinovirus and other viruses by using RT-PCR. Rates of ED visits and hospitalizations were calculated and rhinovirus-positive and rhinovirus-negative patients were compared.

Results: Among 2351 enrollees, rhinovirus was detected in 247 (11%). There were 7 rhinovirus-associated ED visits and 3 hospitalizations per 1000 adults annually. Patients with rhinovirus, compared with virus-negative ARI, were more likely to present with wheezing (odds ratio [OR], 1.7; 95% CI, 1.23-2.35; P < .001), to be a current smoker (OR, 2.31; 95% CI, 1.68-3.19) or live with a smoker (OR, 1.72; 95% CI, 1.10-2.67), have a history of chronic respiratory disease (OR, 1.61; 95% CI, 1.17-2.22), and were less likely to be hospitalized versus seen in the outpatient setting (OR, 0.58; 95% CI, 0.41-0.83).

Conclusions: Rhinovirus is associated with a substantial number of ED visits and hospitalizations for ARIs in adults. There may be modifiable factors that can reduce the likelihood of presenting with rhinovirus-associated ARIs.

Keywords: Rhinovirus; acute respiratory illness; adults; emergency department; hospitalized; smoking.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • Acute Disease
  • Adolescent
  • Adult
  • Aged
  • Aged, 80 and over
  • Ambulatory Care*
  • Emergency Service, Hospital
  • Female
  • Hospitalization*
  • Humans
  • Male
  • Middle Aged
  • Odds Ratio
  • Picornaviridae Infections / epidemiology*
  • Prevalence
  • Public Health Surveillance
  • Respiratory Sounds
  • Respiratory Tract Infections / epidemiology*
  • Respiratory Tract Infections / virology*
  • Rhinovirus*
  • Risk Factors
  • Seasons
  • Tennessee / epidemiology
  • Young Adult