{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,14]],"date-time":"2026-10-14T11:51:08Z","timestamp":1791978668807,"version":"4.4.0"},"reference-count":24,"publisher":"Wiley","issue":"10","license":[{"start":{"date-parts":[[2026,10,5]],"date-time":"2026-10-05T00:00:00Z","timestamp":1791158400000},"content-version":"vor","delay-in-days":4,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,10,1]],"date-time":"2026-10-01T00:00:00Z","timestamp":1790812800000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Health Science Reports"],"published-print":{"date-parts":[[2026,10]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background and Aims<\/jats:title>\n                    <jats:p>Pathogenic viruses represent a principal etiology of acute respiratory tract disease. Concurrent detection of multiple respiratory pathogens has been associated with diagnostic challenges, therapeutic complications, and unfavorable outcomes in patients with COVID\u201019. This investigation aimed to characterize the frequency of concurrent SARS\u2010CoV\u20102, influenza virus, and human respiratory syncytial virus (RSV) infections among individuals presenting with suspected COVID\u201019 symptoms during the pandemic period in Lorestan Province, Iran.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A retrospective observational study was conducted among 196 participants who presented with suspected COVID\u201019 and clinically compatible respiratory symptoms at regional healthcare facilities in Lorestan Province from July through December 2022. Nasopharyngeal specimens were obtained from all participants, maintained at 2\u00b0C\u20138\u00b0C during transit on ice, and subsequently subjected to nucleic acid extraction and multiplex quantitative reverse\u2010transcription polymerase chain reaction (qRT\u2010PCR) analysis at the Molecular Virology Laboratory.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Of 196 participants evaluated, positivity rates were as follows: SARS\u2010CoV\u20102, 40.81%; influenza virus, 30.10%; and RSV, 5.10%. Dual infections were identified in the following proportions: SARS\u2010CoV\u20102 with RSV 3.57%, SARS\u2010CoV\u20102 with influenza virus 11.22%, and RSV with influenza 3.06%. Simultaneous detection of all three pathogens was documented in 2.04% of the study population.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>This study documents the circulation of SARS\u2010CoV\u20102, influenza virus, and RSV among symptomatic outpatients in Lorestan Province during the study period, including a limited number of dual and triple coinfections. These findings highlight the importance of continued respiratory virus surveillance and multiplex molecular testing in outpatient settings. Nevertheless, the small numbers of RSV\u2010positive patients, triple\u2010infection cases, and children younger than 6 years limit the strength of subgroup\u2010based inferences; therefore, age\u2010specific, pediatric, and symptom\u2010related findings should be interpreted cautiously. Further studies with larger and more diverse populations are warranted.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/hsr2.73242","type":"journal-article","created":{"date-parts":[[2026,10,5]],"date-time":"2026-10-05T08:48:48Z","timestamp":1791190128000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["SARS\u2010CoV\u20102, Influenza Virus, and Respiratory Syncytial Virus Coinfections Among Symptomatic Outpatients in Lorestan Province, Iran: A Retrospective Cross\u2010Sectional Study"],"prefix":"10.1002","volume":"9","author":[{"ORCID":"https:\/\/orcid.org\/0009-0005-7177-6396","authenticated-orcid":false,"given":"Ardalan","family":"Maleki Chegeni","sequence":"first","affiliation":[{"name":"Department of Virology, School of Medicine Lorestan University of Medical Sciences Khorramabad Lorestan Iran"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2093-819X","authenticated-orcid":false,"given":"Zahra","family":"Heydarifard","sequence":"additional","affiliation":[{"name":"Hepatitis Research Center, Department of Virology, School of Medicine Lorestan University of Medical Sciences Khorramabad Lorestan Iran"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6697-3337","authenticated-orcid":false,"given":"Gholam Reza","family":"Talei","sequence":"additional","affiliation":[{"name":"Hepatitis Research Center, Department of Virology, School of Medicine Lorestan University of Medical Sciences Khorramabad Lorestan Iran"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mohsen","family":"Mohammadi","sequence":"additional","affiliation":[{"name":"Hepatitis Research Center, Department of Pharmacognosy and Pharmaceutical Biotechnology, Faculty of Pharmacy Lorestan University of Medical Sciences Khorramabad Lorestan Iran"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9415-5446","authenticated-orcid":false,"given":"Sayyad","family":"Khanizadeh","sequence":"additional","affiliation":[{"name":"Hepatitis Research Center, Department of Virology, School of Medicine Lorestan University of Medical Sciences Khorramabad Lorestan Iran"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,10,5]]},"reference":[{"key":"e_1_2_15_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/S1473-3099(24)00176-2"},{"key":"e_1_2_15_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.vaccine.2005.07.046"},{"key":"e_1_2_15_4_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1500245"},{"key":"e_1_2_15_5_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41579-020-00459-7"},{"key":"e_1_2_15_6_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41586-020-2012-7"},{"key":"e_1_2_15_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(22)00478-0"},{"key":"e_1_2_15_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(17)33293-2"},{"key":"e_1_2_15_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.immuni.2020.05.004"},{"key":"e_1_2_15_10_1","doi-asserted-by":"publisher","DOI":"10.1186\/s13054-021-03871-4"},{"key":"e_1_2_15_11_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.mayocp.2023.08.024"},{"key":"e_1_2_15_12_1","doi-asserted-by":"publisher","DOI":"10.1007\/s40121-024-01080-4"},{"key":"e_1_2_15_13_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(22)00383-X"},{"key":"e_1_2_15_14_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.antiviral.2021.105227"},{"key":"e_1_2_15_15_1","doi-asserted-by":"publisher","DOI":"10.1097\/JU.0000000000000001"},{"key":"e_1_2_15_16_1","doi-asserted-by":"publisher","DOI":"10.3390\/v15040865"},{"key":"e_1_2_15_17_1","doi-asserted-by":"publisher","DOI":"10.3389\/fmed.2021.681469"},{"key":"e_1_2_15_18_1","doi-asserted-by":"publisher","DOI":"10.1099\/jmm.0.001350"},{"key":"e_1_2_15_19_1","doi-asserted-by":"publisher","DOI":"10.3389\/fpubh.2023.1264632"},{"key":"e_1_2_15_20_1","doi-asserted-by":"publisher","DOI":"10.15585\/mmwr.mm6937a6"},{"key":"e_1_2_15_21_1","volume-title":"WHO Consultation to Adapt Influenza Sentinel Surveillance Systems to Include COVID\u201019 Virological Surveillance: Virtual Meeting, 6\u20138 October 2020","author":"Organization W. 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