Evaluación del efecto de la coinfección viral sobre las posibilidades de diagnóstico de neumonía en niños y adolescentes con influenza
Assessing the Effect of Viral Coinfection on Pneumonia Diagnosis Odds in Children and Adolescents with Influenza

Esta obra está bajo una licencia internacional Creative Commons Atribución-NoComercial-SinDerivadas 4.0.
Mostrar biografía de los autores
Introducción. Las infecciones por influenza son un importante problema de salud pública, especialmente en niños y adolescentes con alto riesgo de sufrir neumonía grave. Las coinfecciones con múltiples patógenos exacerban las infecciones respiratorias. Este estudio evaluó el efecto de las coinfecciones en el diagnóstico de neumonía en esta población.
Métodos. Se realizó un análisis transversal utilizando datos de un sistema de vigilancia epidemiológica a nivel nacional en México. Se analizaron los datos de 2.057 casos de influenza confirmados por RT-PCR en pacientes de 15 años o menos, registrados entre enero y el 26 de octubre de 2024. El evento primario fue el diagnóstico de neumonía, con asociaciones con la coinfección y otros factores de riesgo evaluados mediante odds ratios (OR) e intervalos de confianza (IC) del 95%.
Resultados. Se diagnosticó neumonía en el 36.0% de los casos, y la coinfección fue más común entre los diagnosticados con neumonía (7.4% vs. 3.1%, < 0,001). En el modelo de regresión múltiple, la coinfección se asoció con un aumento del 95% en las posibilidades de neumonía (OR = 1.95, IC 95 % 1.27 – 3.00). La edad más joven, la obesidad y la inmunosupresión también se asociaron con mayores posibilidades de neumonía.
Conclusiones. Nuestros hallazgos sugieren que las coinfecciones virales aumentan la probabilidad de neumonía en casos pediátricos de influenza. La vacunación generalizada contra la influenza sigue siendo fundamental para reducir la carga de enfermedad asociada, mientras que la detección sistemática de coinfecciones permitiría intervenciones clínicas oportunas.
Visitas del artículo 42 | Visitas PDF 22
- Machado CM, Souza ACMF, Romano CM, Freire WS, Costa AA, Figueiredo WM, et al. Influenza A and B in a cohort of outpatient children and adolescent with influenza like-illness during two consecutive influenza seasons. Braz J Infect Dis [Internet]. 2020;24(1):73-80. doi: https://doi.org/10.1016/j.bjid.2019.12.005
- Nolan VG, Arnold SR, Bramley AM, Ampofo K, Williams DJ, Grijalva CG, et al. Etiology and Impact of Coinfections in Children Hospitalized With Community-Acquired Pneumonia. J Infect Dis [Internet]. 2018;218(2):179-88. doi: https://doi.org/10.1093/infdis/jix641
- Chertow DS, Memoli MJ. Bacterial coinfection in influenza: a grand rounds review. JAMA [Internet]. 2013;309(3):275-82. doi: https://doi.org/10.1001/jama.2012.194139
- Sharma-Chawla N, Sender V, Kershaw O, Gruber AD, Volckmar J, Henriques-Normark B, et al. Influenza A Virus Infection Predisposes Hosts to Secondary Infection with Different Streptococcus pneumoniae Serotypes with Similar Outcome but Serotype-Specific Manifestation. Infect Immun [Internet]. 2016;84(12):3445-57. doi: https://doi.org/10.1128/IAI.00422-16
- Choo S, Lee YY, Lee E. Clinical significance of respiratory virus coinfection in children with Mycoplasma pneumoniae pneumonia. BMC Pulm Med [Internet]. 2022;22(1):212. doi: https://doi.org/10.1186/s12890-022-02005-y
- Jiang W, Wu M, Zhou J, Wang Y, Hao C, Ji W, et al. Etiologic spectrum and occurrence of coinfections in children hospitalized with community-acquired pneumonia. BMC Infect Dis [Internet]. 2017;17(1):787. doi: https://doi.org/10.1186/s12879-017-2891-x
- Ozaras R, Cirpin R, Duran A, Duman H, Arslan O, Bakcan Y, et al. Influenza and COVID-19 coinfection: Report of six cases and review of the literature. J Med Virol [Internet]. 2020;92(11):2657-65. doi: https://doi.org/10.1002/jmv.26125
- General Directorate of Epidemiology, Government of Mexico. [Standardized Guidelines for Epidemiological and Laboratory Surveillance of Viral Respiratory Disease] [Internet]. Mexico City: Health Department, Government of Mexico; 2023 Sep [cited 2024 Nov 21]. 124 p. Available from: https://www.gob.mx/salud/documentos/lineamiento-estandarizado-para-la-vigilancia-epidemiologica-y-por-laboratorio-de-la-enfermedad-respiratoria-viral
- El Guerche-Seblain C, Etcheto A, Parmentier F, Afshar M, Macias AE, Puentes E, et al. Hospital admissions with influenza and impact of age and comorbidities on severe clinical outcomes in Brazil and Mexico. PLoS One [Internet]. 2022;17(11):e0273837. doi: https://doi.org/10.1371/journal.pone.0273837
- Fernandes-Matano L, Monroy-Muñoz IE, Bermudez de Leon M, Leal-Herrera YA, Palomec-Navia ID, Ruiz-Pacheco JA, et al. Analysis of influenza data generated by four epidemiological surveillance laboratories in Mexico, 2010-2016. Epidemiol Infect [Internet]. 2019;147:e183. doi: https://doi.org/10.1017/S0950268819000694
- Torres A, Cilloniz C, Niederman MS, Menendez R, Chalmers JD, Wunderink RG, et al. Pneumonia. Nat Rev Dis Primers [Internet]. 2021;7(1):25. doi: https://doi.org/10.1038/s41572-021-00259-0
- Ferreira HLS, Costa KLP, Cariolano MS, Oliveira GS, Felipe KKP, Silva ESA, et al. High incidence of rhinovirus infection in children with community-acquired pneumonia from a city in the Brazilian pre-Amazon region. J Med Virol [Internet]. 2019;91(10):1751-8. doi: https://doi.org/10.1002/jmv.25524
- Yan Y, Sun J, Ji K, Guo J, Han L, Li F, et al. High incidence of the virus among respiratory pathogens in children with lower respiratory tract infection in northwestern China. J Med Virol [Internet]. 2023;95(1):e28367. doi: https://doi.org/10.1002/jmv.28367
- Reina J, Dueñas Morales J. Respiratory co-infections between influenza viruses and respiratory syncytial virus (2014-2017). An Pediatr [Internet]. 2019;90(2):118-9. doi: https://doi.org/10.1016/j.anpede.2018.02.011
- Sanz I, Perez D, Rojo S, Domínguez-Gil M, Ortiz de Lejarazu R, Eiros JM. [Coinfections of influenza and other respiratory viruses are associated to children]. An Pediatr [Internet]. 2022;96(4):334-41. doi: https://doi.org/10.1016/j.anpedi.2020.12.024
- Le-Corre N, Pérez R, Vizcaya C, Martínez-Valdebenito C, López T, Monge M, et al. Relevance of codetection of respiratory viruses in the severity of acute respiratory infection in hospitalized children. Andes pediatr [Internet]. 2021;92(3):349-58. doi: https://doi.org/10.32641/andespediatr.v92i3.1756
- Del Riccio M, Caini S, Bonaccorsi G, Lorini C, Paget J, Velden K, et al. Global analysis of respiratory viral circulation and timing of epidemics in the pre–COVID-19 and COVID-19 pandemic eras, based on data from the Global Influenza Surveillance and Response System (GISRS). Int J Infect Dis [Internet]. 2024;144:107052. doi: https://doi.org/10.1016/j.ijid.2024.107052
- Oweidat, KA, Toubasi AA, Alghrabli A, Khater Y, Saleh N, Albtoosh AS, et al. Alterations in Patients’ Clinical Outcomes and Respiratory Viral Pathogen Activity following the COVID-19 Pandemic. Viruses [Internet]. 2023;15(10):1975. doi: https://doi.org/10.3390/v15101975
- Chen SJ, Walker PJB, Mulholland K, Graham HR, ARI Review group. Childhood pneumonia in humanitarian emergencies in low- and middle-income countries: A systematic scoping review. J Glob Health [Internet]. 2022;12:10001. doi: https://doi.org/10.7189/jogh.12.10001
- Wishaupt JO, Ploeg T, Groot R, Versteegh FGA, Hartwig NG. Single- and multiple viral respiratory infections in children: disease and management cannot be related to a specific pathogen. BMC Infect Dis [Internet]. 2017;17(1):62. doi: https://doi.org/10.1186/s12879-016-2118-6
- Costa LF, Silveira HL, Queiroz DAO, Mantese OC, Yokosawa J. Respiratory virus infections in hospitalized and non-hospitalized children: determinants of severe course of the disease. J Infect Dev Ctries [Internet]. 2022;16(1):196-205. doi: https://doi.org/10.3855/jidc.15117
- Qiao M, Moyes G, Zhu F, Li Y, Wang X. The prevalence of influenza bacterial co-infection and its role in disease severity: A systematic review and meta-analysis. J Glob Health [Internet]. 2023;13:04063. doi: https://doi.org/10.7189/jogh.13.04063
- Hernandez-Garduno E. Comorbidities that predict acute respiratory syndrome coronavirus 2 test positivity in Mexican Children: A case-control study. Pediatr Obes [Internet]. 2021;16(5):e12740. doi: https://doi.org/10.1111/ijpo.12740
- Moreno-Noguez M, Rivas-Ruiz R, Roy-Garcia I, Pacheco-Rosas DO, Moreno-Espinosa S, Flores-Pulido AA. Risk factors associated with SARS-CoV-2 pneumonia in the pediatric population. Bol Med Hosp Infant Mex [Internet]. 2021;78(4):251-8. doi: https://doi.org/10.24875/BMHIM.20000263
- Honce R, Schultz-Cherry S. Impact of Obesity on Influenza A Virus Pathogenesis, Immune Response, and Evolution. Front Immunol [Internet]. 2019;10:1071. doi: https://doi.org/10.3389/fimmu.2019.01071
- Shamah-Levy T, Cuevas-Nasu L, Gaona-Pineda EB, Valenzuela-Bravo DG, Gomez-Humaran IM, Avila-Arcos MA. Childhood obesity in Mexico: Influencing factors and prevention strategies. Front Public Health [Internet]. 2022;10:949893. doi: https://doi.org/10.3389/fpubh.2022.949893
- Ministry of Health of the Government of Mexico. [Epidemiological Situation of COVID-19, Influenza, and Other Respiratory Viruses in Mexico. Epidemiological Week 51, 2024]. Mexico City: Health Department, Government of Mexico; 2024 [cited 2025 Apr 13]. 19 p. Available from: https://www.gob.mx/cms/uploads/attachment/file/963830/ERV_SE51_2024.pdf
- World Health Organization. Recommended composition of influenza virus vaccines for use in the 2023-2024 northern hemisphere influenza season. Geneva: World Health Organization (WHO); 2024 Feb 24 [cited 2025 Apr 13]. 11 p. Available from: https://www.who.int/publications/m/item/recommended-composition-of-influenza-virus-vaccines-for-use-in-the-2023-2024-northern-hemisphere-influenza-season
- Paradowska-Stankiewicz I, Pancer K, Poznańska A, Hordowicz M, Skibicka M, Słowiński, et al. Tick-borne encephalitis epidemiology and surveillance in Poland, and comparison with selected European countries before and during the COVID-19 pandemic, 2008 to 2020. Euro Surveill [Internet]. 2023;28(18):2200452. doi: https://doi.org/10.2807/1560-7917.ES.2023.28.18.2200452
- Aakjaer M, Bruin ML, Kulahci M, Andersen M. Surveillance of Antidepressant Safety (SADS): Active Signal Detection of Serious Medical Events Following SSRI and SNRI Initiation Using Big Healthcare Data. Drug Saf [Internet]. 2021;44(11):1215-30. doi: https://doi.org/10.1007/s40264-021-01110-x