Viral Etiology of Acute Respiratory Infections During 2014–2016 in Riyadh, Saudi Arabia

Figures & data

Table 1. Age-wise distribution of viral infections with clinical manifestation of the study patients and positive percentage.

Age group (months)	Cases	Gender		p-value	Symptoms
		Male	Female		Fever	Nasal discharge	Cough	Sore throat
0–6	217 (37.4)	129 (59.4)	88 (40.6)	0.99	205 (94.5)	203 (93.5)	197 (90.8)	199 (91.7)
7–12	175 (30.2)	105 (60)	70 (40)		166 (94.9)	160 (91.4)	155 (88.6)	156 (89.1)
13–24	96 (16.6)	55 (57.3)	41 (42.7)		89 (92.7)	92 (95.8)	85 (88.5)	86 (89.6)
25–36	58 (10)	35 (60.3)	23 (39.7)		51 (87.9)	49 (84.5)	52 (89.7)	48 (82.8)
37–60	34 (5.9)	21 (61.8)	13 (38.2)		30 (88.2)	25 (73.5)	28 (82.4)	29 (85.3)
Total	580	345 (59.5)	235 (40.5)		541 (93.3)	529 (91.2)	517 (89.1)	518 (89.3)

Data are presented as frequency (%). The difference between the distributions among different age groups by gender is calculated by chi-square test.

Table 2. Distribution of viral etiological agents among different age groups and gender.

All subjects
Age group (months)	RSV (164)	Inf (64)	PIV (47)	HMPV (40)	AdV (77)	Total (392)
						Freq (%)	OR (95% CI)	p-value
0–6	66 (40.2)	30 (46.9)	20 (42.6)	25 (62.5)	38 (49.4)	179 (45.7)	14.1 (8.8–22.7)	<0.001
7–12	47 (28.7)	19 (29.7)	10 (21.3)	9 (22.5)	19 (24.7)	104 (26.5)	6.10 (3.7–9.9)	<0.001
13–24	27 (16.5)	5 (7.8)	7 (14.9)	4 (10)	9 (11.7)	52 (13.3)	2.58 (1.5–4.3)	<0.001
25–36	13 (7.9)	6 (9.4)	5 (10.6)	2 (5)	9 (11.7)	35 (8.9)	1.65 (0.9–2.9)	NS
37–60	11 (6.7)	4 (6.3)	5 (10.6)	0 (0)	2 (2.6)	22 (5.6)	Reference
Boys
	RSV (102)	Inf (40)	PIV (28)	HMPV (26)	AdV (47)	Total (243)
						Freq (%)	OR (95% CI)	p-value
0–6	41 (40.2)	19 (47.5)	13 (46.4)	16 (61.5)	23 (48.9)	112 (46.1)	16.5 (8.7–30.9)	<0.001
7–12	29 (28.4)	13 (32.5)	6 (21.4)	6 (23.1)	11 (23.4)	65 (26.7)	7.03 (3.7–13.4)	<0.001
13–24	16 (15.7)	2 (5)	3 (10.7)	2 (7.7)	6 (12.8)	29 (11.9)	2.61 (1.3–5.2)	0.006
25–36	9 (8.8)	4 (10)	4 (14.3)	2 (7.7)	6 (12.8)	25 (10.3)	2.21 (1.1–4.5)	0.03
37–60	7 (6.9)	2 (5)	2 (7.1)	0 (0)	1 (2.1)	12 (4.9)	Reference
Girls
	RSV (62)	Inf (24)	PIV (19)	HMPV (14)	AdV (30)	Total (149)
						Freq (%)	OR (95% CI)	p-value
0–6	25 (40.3)	11 (45.8)	7 (36.8)	9 (64.3)	15 (50)	67 (45)	11.4 (5.5–23.3)	<0.001
7–12	18 (29)	6 (25)	4 (21.1)	3 (21.4)	8 (26.7)	39 (26.2)	4.92 (2.3–10.3)	<0.001
13–24	11 (17.7)	3 (12.5)	4 (21.1)	2 (14.3)	3 (10)	23 (15.4)	2.54 (1.2–5.5)	0.02
25–36	4 (6.5)	2 (8.3)	1 (5.3)	0 (0)	3 (10)	10 (6.7)	1.00 (0.4–2.5)	NS
37–60	4 (6.5)	2 (8.3)	3 (15.8)	0 (0)	1 (3.3)	10 (6.7)	Reference

The reference group for calculating odds of having viruses in a particular age-group is taken as highest age-group. p < 0.05 is considered significant.

AdV: Adenovirus; Freq: Frequency; HMPV: Human metapneumovirus; Inf: Influenza; OR: Odds ratio; PIV: Parainfluenza virus; RSV: Respiratory syncytial virus.

Table 3. Distribution of viral etiological agents and coinfections.

Virus	Total infections (%)	Single-virus infections (%)	Coinfections (%)
RSV	164 (41.8)	154 (93.9)	10 (6.1)
INF	64 (16.3)	51 (79.7)	13 (20.3)
Inf A	44 (68.7)	35 (79.5)	9 (20.5)
Inf B	20 (31.3)	16 (80)	4 (20)
PIV	47 (11.9)	42 (89.4)	5 (10.6)
PIV-1	12 (25.5)	11 (91.7)	1 (8.3)
PIV-2	6 (12.8)	5 (83.3)	1 (16.7)
PIV-3	14 (29.8)	11 (78.6)	3 (21.4)
PIV-4	15 (32)	15 (100)	0 (0)
HMPV	40 (10.2)	34 (85)	6 (15)
AdV	77 (19.6)	69 (89.6)	8 (10.4)
Total	392	350 (89.3)	42 (10.7)

Common coinfections include 4 RSV + InfA; 3 RSV + AdV; 2 each for RSV+ InfB, InfA + HMPVA, InfA + AdV, InfB + PIV3, HMPV-A + AdV; and 1 each for RSV + HMPV, InfA + PIV1, PIV2 + AdV, PIV3 + HMPVA.

AdV: Adenovirus; HMPV: Human metapneumovirus; InfA: Influenza A; InfB: Influenza B; PIV: Parainfluenza virus; RSV: Respiratory syncytial virus.

Figure 1. Flow diagram for samples collected form KKUH and KFMC, Riyadh, with inclusion and exclusion criteria.

ARTI: Acute respiratory tract infections; KFMC: King Fahad Medical City KKUH: King Khalid University Hospital; NPAs: Nasopharyngeal aspirates.

Figure 2. Monthly samples collected and corresponding viral infections detected during the study period.

Figure 3. Circulation of respiratory viruses during 2014–15 and 2015–16.

Total sample collected from both the hospitals. Total viruses refers to the total number of viruses detected in samples and counted twice for double viral infections.

AdV: Adenovirus; HMPV: Human metapneumovirus; INF: Influenza; PIV: Parainfluenza virus; RSV: Respiratory syncytial virus.