{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,30]],"date-time":"2026-06-30T03:27:13Z","timestamp":1782790033231,"version":"3.54.5"},"reference-count":37,"publisher":"Cambridge University Press (CUP)","issue":"5","license":[{"start":{"date-parts":[[2023,12,11]],"date-time":"2023-12-11T00:00:00Z","timestamp":1702252800000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/www.cambridge.org\/core\/terms"}],"content-domain":{"domain":["cambridge.org"],"crossmark-restriction":true},"short-container-title":["Infect. Control Hosp. Epidemiol."],"published-print":{"date-parts":[[2024,5]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec id=\"S0899823X23002635_as1\"><jats:title>Background:<\/jats:title><jats:p>Although the incidence of hospital-associated respiratory virus infection (HARVI) is well recognized, the risk factors for infection and impact on patient outcomes are not well characterized.<\/jats:p><\/jats:sec><jats:sec id=\"S0899823X23002635_as2\"><jats:title>Methods:<\/jats:title><jats:p>We identified a cohort of all inpatient admissions \u226524 hours duration at a single academic medical center from 2017 to 2020. HARVI were defined as respiratory virus detected in a test ordered after the 95th percentile of the virus-specific incubation period. Risk factors for HARVI were assessed using Cox proportional hazards models of the competing outcomes of HARVI and discharge. The associations between time-varying HARVI status and the rates of ICU admission, discharge, and in-hospital death were estimated using Cox-proportional hazards models in a competing risk framework.<\/jats:p><\/jats:sec><jats:sec id=\"S0899823X23002635_as3\"><jats:title>Results:<\/jats:title><jats:p>HARVI incidences were 8.8 and 3.0 per 10,000 admission days for pediatric and adult patients, respectively. For adults, congestive heart failure, renal disease, and cancer increased HARVI risk independent of their associations with length of stay. HARVI risk was also elevated for patients admitted in September\u2013June relative to July admissions. For pediatric patients, cardiovascular and respiratory conditions, cancer, medical device dependence, and admission in December increased HARVI risk. Lengths of stay were longer for adults with HARVI compared to those without, and hospital-associated influenza A was associated with increased risk of death. Rates of ICU admission were increased in the 5 days after HARVI identification for adult and pediatric patients. HARVI was not associated with length of stay or death among pediatric patients.<\/jats:p><\/jats:sec><jats:sec id=\"S0899823X23002635_as4\"><jats:title>Conclusions:<\/jats:title><jats:p>HARVI is associated chronic health conditions and increases morbidity and mortality.<\/jats:p><\/jats:sec>","DOI":"10.1017\/ice.2023.263","type":"journal-article","created":{"date-parts":[[2023,12,11]],"date-time":"2023-12-11T10:09:27Z","timestamp":1702289367000},"page":"618-629","update-policy":"https:\/\/doi.org\/10.1017\/policypage","source":"Crossref","is-referenced-by-count":5,"title":["Incidence and outcomes of hospital-associated respiratory virus infections by viral species"],"prefix":"10.1017","volume":"45","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5696-965X","authenticated-orcid":false,"given":"Joshua G.","family":"Petrie","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Riley","family":"Moore","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2906-8335","authenticated-orcid":false,"given":"Adam S.","family":"Lauring","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Keith S.","family":"Kaye","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"56","published-online":{"date-parts":[[2023,12,11]]},"reference":[{"key":"S0899823X23002635_ref7","doi-asserted-by":"crossref","first-page":"ofx006","DOI":"10.1093\/ofid\/ofx006","article-title":"Hospital-acquired respiratory viral infections: incidence, morbidity, and mortality in pediatric and adult patients","volume":"4","author":"Chow","year":"2017","journal-title":"Open Forum Infect Dis"},{"key":"S0899823X23002635_ref19","doi-asserted-by":"crossref","first-page":"291","DOI":"10.1016\/S1473-3099(09)70069-6","article-title":"Incubation periods of acute respiratory viral infections: a systematic review","volume":"9","author":"Lessler","year":"2009","journal-title":"Lancet Infect Dis"},{"key":"S0899823X23002635_ref12","doi-asserted-by":"crossref","first-page":"584","DOI":"10.1093\/infdis\/jiv323","article-title":"Respiratory viral detection in children and adults: comparing asymptomatic controls and patients with community-acquired pneumonia","volume":"213","author":"Self","year":"2016","journal-title":"J Infect Dis"},{"key":"S0899823X23002635_ref11","first-page":"010408","article-title":"Aetiological role of common respiratory viruses in acute lower respiratory infections in children under five years: a systematic review and meta-analysis","volume":"5","author":"Shi","year":"2015","journal-title":"J Glob Health"},{"key":"S0899823X23002635_ref29","doi-asserted-by":"crossref","first-page":"104206","DOI":"10.1016\/j.jcv.2019.104206","article-title":"Use of whole-genome sequencing in the molecular investigation of care-associated HCoV-OC43 infections in a hematopoietic stem cell transplant unit","volume":"122","author":"Beury","year":"2020","journal-title":"J Clin Virol"},{"key":"S0899823X23002635_ref30","doi-asserted-by":"crossref","first-page":"1002","DOI":"10.1002\/jmv.26362","article-title":"More than just a common cold: endemic coronaviruses OC43, HKU1, NL63, and 229E associated with severe acute respiratory infection and fatality cases among healthy adults","volume":"93","author":"Veiga","year":"2021","journal-title":"J Med Virol"},{"key":"S0899823X23002635_ref36","doi-asserted-by":"crossref","first-page":"218","DOI":"10.1017\/ice.2020.425","article-title":"Absence of nosocomial influenza and respiratory syncytial virus infection in the coronavirus disease 2019 (COVID-19) era: implication of universal masking in hospitals","volume":"42","author":"Wong","year":"2021","journal-title":"Infect Control Hosp Epidemiol"},{"key":"S0899823X23002635_ref2","doi-asserted-by":"crossref","first-page":"835","DOI":"10.1056\/NEJMoa1405870","article-title":"Community-acquired pneumonia requiring hospitalization among US children","volume":"372","author":"Jain","year":"2015","journal-title":"N Engl J Med"},{"key":"S0899823X23002635_ref33","doi-asserted-by":"crossref","first-page":"2","DOI":"10.1017\/ice.2022.295","article-title":"Asymptomatic screening for severe acute respiratory coronavirus virus 2 (SARS-CoV-2) as an infection prevention measure in healthcare facilities: challenges and considerations","volume":"44","author":"Talbot","year":"2023","journal-title":"Infect Control Hosp Epidemiol"},{"key":"S0899823X23002635_ref31","doi-asserted-by":"crossref","first-page":"g5060","DOI":"10.1136\/bmj.g5060","article-title":"Interpreting and comparing risks in the presence of competing events","volume":"349","author":"Wolkewitz","year":"2014","journal-title":"BMJ"},{"key":"S0899823X23002635_ref22","doi-asserted-by":"crossref","first-page":"33","DOI":"10.1017\/S0195941700052371","article-title":"Nosocomial viral infections: I. Epidemiology and significance","volume":"1","author":"Valenti","year":"1980","journal-title":"Infect Control"},{"key":"S0899823X23002635_ref28","doi-asserted-by":"crossref","first-page":"1964","DOI":"10.3201\/eid2410.180862","article-title":"Severe respiratory illness outbreak associated with human coronavirus NL63 in a long-term care facility","volume":"24","author":"Hand","year":"2018","journal-title":"Emerg Infect Dis"},{"key":"S0899823X23002635_ref1","doi-asserted-by":"crossref","first-page":"415","DOI":"10.1056\/NEJMoa1500245","article-title":"Community-acquired pneumonia requiring hospitalization among US adults","volume":"373","author":"Jain","year":"2015","journal-title":"N Engl J Med"},{"key":"S0899823X23002635_ref23","doi-asserted-by":"crossref","first-page":"18","DOI":"10.1093\/jpids\/piw072","article-title":"Burden of healthcare-associated viral respiratory infections in children\u2019s hospitals","volume":"7","author":"Quach","year":"2018","journal-title":"J Pediatr Infect Dis"},{"key":"S0899823X23002635_ref32","unstructured":"32. WHO statement on the fifteenth meeting of the IHR (2005) Emergency Committee on the COVID-19 Pandemic. World Health Organization website. https:\/\/www.who.int\/news\/item\/05-05-2023-statement-on-the-fifteenth-meeting-of-the-international-health-regulations-(2005)-emergency-committee-regarding-the-coronavirus-disease-(covid-19)-pandemic. Accessed May 8, 2023."},{"key":"S0899823X23002635_ref9","doi-asserted-by":"crossref","first-page":"ofaa200","DOI":"10.1093\/ofid\/ofaa200","article-title":"Hospital-associated respiratory virus infection in children and adults: it does not just occur during cold and flu season","volume":"7","author":"Petrie","year":"2020","journal-title":"Open Forum Infect Dis"},{"key":"S0899823X23002635_ref27","doi-asserted-by":"crossref","first-page":"e20161675","DOI":"10.1542\/peds.2016-1675","article-title":"Outcomes of nosocomial viral respiratory infections in high-risk neonates","volume":"138","author":"Zinna","year":"2016","journal-title":"Pediatrics"},{"key":"S0899823X23002635_ref21","doi-asserted-by":"crossref","first-page":"496","DOI":"10.1080\/01621459.1999.10474144","article-title":"A Proportional hazards model for the subdistribution of a competing risk","volume":"94","author":"Fine","year":"1999","journal-title":"J Am Statist Assoc"},{"key":"S0899823X23002635_ref14","doi-asserted-by":"crossref","first-page":"1171","DOI":"10.1016\/j.jclinepi.2012.04.008","article-title":"Time-dependent study entries and exposures in cohort studies can easily be sources of different and avoidable types of bias","volume":"65","author":"Wolkewitz","year":"2012","journal-title":"J Clin Epidemiol"},{"key":"S0899823X23002635_ref26","doi-asserted-by":"crossref","first-page":"262","DOI":"10.1086\/430915","article-title":"Rhinovirus outbreak in a long-term care facility for elderly persons associated with unusually high mortality","volume":"41","author":"Louie","year":"2005","journal-title":"Clin Infect Dis"},{"key":"S0899823X23002635_ref4","doi-asserted-by":"crossref","first-page":"1253","DOI":"10.15585\/mmwr.mm7140a1","article-title":"Respiratory virus surveillance among children with acute respiratory illnesses\u2014new vaccine surveillance network, United States, 2016\u20132021","volume":"71","author":"Perez","year":"2022","journal-title":"Morb Mortal Wkly Rep"},{"key":"S0899823X23002635_ref24","doi-asserted-by":"crossref","first-page":"135","DOI":"10.1128\/CMR.00077-12","article-title":"St. George K, Walsh TJ. Human rhinoviruses","volume":"26","author":"Jacobs","year":"2013","journal-title":"Clin Microbiol Rev"},{"key":"S0899823X23002635_ref25","doi-asserted-by":"crossref","first-page":"2047","DOI":"10.1093\/infdis\/jiac355","article-title":"A proposal to refer to four coronaviruses of limited human virulence \u2018common cold coronaviruses.\u2019","volume":"226","author":"McIntosh","year":"2022","journal-title":"J Infect Dis"},{"key":"S0899823X23002635_ref10","doi-asserted-by":"crossref","first-page":"55","DOI":"10.1017\/ice.2022.33","article-title":"Contrasting definitions and incidence of healthcare-associated respiratory viral infections in a pediatric hospital","volume":"44","author":"Most","year":"2023","journal-title":"Infect Control Hosp Epidemiol"},{"key":"S0899823X23002635_ref15","doi-asserted-by":"crossref","first-page":"1502","DOI":"10.1093\/ije\/dyt111","article-title":"Hospital-acquired infections\u2014appropriate statistical treatment is urgently needed!","volume":"42","author":"Schumacher","year":"2013","journal-title":"Int J Epidemiol"},{"key":"S0899823X23002635_ref34","doi-asserted-by":"crossref","first-page":"62","DOI":"10.3201\/eid2801.211099","article-title":"Effects of nonpharmaceutical COVID-19 interventions on pediatric hospitalizations for other respiratory virus infections, Hong Kong","volume":"28","author":"Chiu","year":"2022","journal-title":"Emerg Infect Dis"},{"key":"S0899823X23002635_ref8","doi-asserted-by":"crossref","first-page":"e45","DOI":"10.1016\/j.ajic.2017.01.009","article-title":"Laboratory-based surveillance of hospital-acquired respiratory virus infection in a tertiary-care hospital","volume":"45","author":"Choi","year":"2017","journal-title":"Am J Infect Control"},{"key":"S0899823X23002635_ref37","doi-asserted-by":"crossref","first-page":"312","DOI":"10.1097\/QCO.0000000000000655","article-title":"Beyond personal protective equipment: adjunctive methods for control of healthcare-associated respiratory viral infections","volume":"33","author":"Most","year":"2020","journal-title":"Curr Opin Infect Dis"},{"key":"S0899823X23002635_ref13","doi-asserted-by":"crossref","first-page":"S563","DOI":"10.1093\/infdis\/jiy662","article-title":"The etiological role of common respiratory viruses in acute respiratory infections in older adults: a systematic review and meta-analysis","volume":"222","author":"Shi","year":"2020","journal-title":"J Infect Dis"},{"key":"S0899823X23002635_ref18","doi-asserted-by":"crossref","first-page":"199","DOI":"10.1186\/1471-2431-14-199","article-title":"Pediatric complex chronic conditions classification system version 2: updated for ICD-10 and complex medical technology dependence and transplantation","volume":"14","author":"Feudtner","year":"2014","journal-title":"BMC Pediatr"},{"key":"S0899823X23002635_ref16","doi-asserted-by":"crossref","first-page":"175","DOI":"10.1016\/j.idh.2020.02.002","article-title":"Hospital-acquired viral respiratory tract infections: an underrecognized nosocomial infection","volume":"25","author":"Manchal","year":"2020","journal-title":"Infect Dis Health"},{"key":"S0899823X23002635_ref17","doi-asserted-by":"crossref","first-page":"1130","DOI":"10.1097\/01.mlr.0000182534.19832.83","article-title":"Coding algorithms for defining comorbidities in ICD-9-CM and ICD-10 administrative data","volume":"43","author":"Quan","year":"2005","journal-title":"Med Care"},{"key":"S0899823X23002635_ref6","doi-asserted-by":"crossref","first-page":"1055","DOI":"10.1016\/j.idc.2021.07.007","article-title":"Healthcare-acquired viral respiratory diseases","volume":"35","author":"Petrie","year":"2021","journal-title":"Infect Dis Clin N Am"},{"key":"S0899823X23002635_ref20","doi-asserted-by":"crossref","first-page":"244","DOI":"10.1093\/aje\/kwp107","article-title":"Competing risk regression models for epidemiologic data","volume":"170","author":"Lau","year":"2009","journal-title":"Am J Epidemiol"},{"key":"S0899823X23002635_ref35","doi-asserted-by":"crossref","first-page":"1579","DOI":"10.1016\/j.cmi.2020.06.027","article-title":"Reduction in healthcare-associated respiratory viral infections during a COVID-19 outbreak","volume":"26","author":"Wee","year":"2020","journal-title":"Clin Microbiol Infect"},{"key":"S0899823X23002635_ref3","doi-asserted-by":"crossref","first-page":"507","DOI":"10.1016\/j.jinf.2014.07.023","article-title":"Adults hospitalised with acute respiratory illness rarely have detectable bacteria in the absence of COPD or pneumonia; 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Published by Cambridge University Press on behalf of The Society for Healthcare Epidemiology of America","name":"copyright","label":"Copyright","group":{"name":"copyright_and_licensing","label":"Copyright and Licensing"}}]}}