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fellowship","award":["VPPCB-005-FIO-20-2"],"award-info":[{"award-number":["VPPCB-005-FIO-20-2"]}]},{"name":"CNPq productivity research fellowship","award":["VPPCB-007-FIO-18-2-30"],"award-info":[{"award-number":["VPPCB-007-FIO-18-2-30"]}]},{"name":"CNPq productivity research fellowship","award":["311759\/2022-0"],"award-info":[{"award-number":["311759\/2022-0"]}]},{"name":"CNPq productivity research fellowship","award":["313403\/2018-0"],"award-info":[{"award-number":["313403\/2018-0"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Mem. Inst. Oswaldo Cruz"],"abstract":"<jats:p>BACKGROUND  Respiratory viral infections in children are characterised by the co-circulation of multiple viral pathogens, but the relevance of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) co-detection with other respiratory viruses remains unclear.  OBJECTIVES  To evaluate the clinical and epidemiological implications of respiratory viral co-detection and the impact of viral diversity in paediatric SARS-CoV-2 infection.  METHODS  We conducted a retrospective-prospective molecular epidemiology study including children (0-11 years) with reverse transcription-polymerase chain reaction (RT-PCR)-confirmed SARS-CoV-2 infection in Natal, northeast Brazil, between 2021 and 2024. Samples were analysed by multiplex RT-PCR for ten respiratory viruses. Associations between co-detection, the number of co-detected viruses, and clinical manifestations were assessed using multivariable logistic regression.  FINDINGS  Among 545 cases, 13.2% showed viral co-detection. Co-detection was associated with dyspnoea, respiratory distress, low oxygen saturation, and diarrhoea, and inversely associated with cough. An increasing number of co-detected viruses was linked to more severe manifestations. Distinct viral combinations were associated with different clinical profiles. SARS-CoV-2 viral load and variants were not associated with co-detection.  MAIN CONCLUSIONS Respiratory viral co-detection is associated with distinct clinical and epidemiological profiles influenced by the number of co-detected viruses and viral combinations. These findings highlight the role of viral co-circulation and suggest interactions among respiratory viruses in the clinical expression of disease in children.<\/jats:p>","DOI":"10.1590\/0074-02760260121","type":"journal-article","created":{"date-parts":[[2026,9,4]],"date-time":"2026-09-04T11:49:07Z","timestamp":1788522547000},"source":"Crossref","is-referenced-by-count":0,"title":["Respiratory viral co-detection in paediatric SARS-CoV-2 infection: associations with viral co-circulation and clinical phenotypes"],"prefix":"10.1590","volume":"121","author":[{"given":"Jayra Juliana Paiva","family":"Alves","sequence":"first","affiliation":[{"name":"Funda\u00e7\u00e3o Oswaldo Cruz-Fiocruz,  Brazil; Laborat\u00f3rio Central de Sa\u00fade P\u00fablica do Estado do Rio Grande do Norte,  Brazil; Universidade Federal do Rio Grande do Norte,  Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Iago de 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