Detection of respiratory viruses in adults with suspected COVID-19 in Kuala Lumpur, Malaysia

Document Type

Article

Publication Date

12-1-2021

Abstract

Background: Reports of co-circulation of respiratory viruses during the COVID-19 pandemic and co-infections with SARS-CoV-2 vary. However, limited information is available from developing countries. Objectives: We aimed to investigate the incidence of respiratory viruses in adult patients with suspected COVID19 in Kuala Lumpur, Malaysia. Study Design: We collected 198 respiratory samples from adult patients hospitalized with suspected COVID-19 in a single teaching hospital in Kuala Lumpur in February-May 2020 and tested combined oro-nasopharyngeal swabs with the NxTAG Respiratory Pathogen Panel (Luminex) and Allplex RV Essential (Seegene) assays. Forty-five negative samples further underwent viral metagenomics analysis. Results: Of the 198 samples, 74 (37.4%) had respiratory pathogens, including 56 (28.3%) with SARS-CoV-2 and 18 (9.1%) positive for other respiratory pathogens. There were five (2.5%) SARS-CoV-2 co-infections, all with rhinovirus/enterovirus. Three samples (6.7%; 3/45) had viruses identified by metagenomics, including one case of enterovirus D68 and one of Saffold virus genotype 6 in a patient requiring ICU care. Most of the COVID-19 patients (91.1%; 51/56) had mild symptoms but 5.4% (3/56) died. Conclusion: During the early COVID-19 period, common respiratory viruses other than SARS-CoV-2 only accounted for 9.1% of hospitalization cases with ARI and co-infections with SARS-CoV-2 were rare. Continued surveillance is important to understand the impact of COVID-19 and its associated public health control measures on circulation of other respiratory viruses. Metagenomics can identify unexpected or rare pathogens, such as Saffold virus, which is rarely described in adults.

Keywords

COVID-19, Malaysia, Viral metagenomics, SARS-CoV-2, Respiratory viruses, Saffold virus

Divisions

fac_med

Funders

United States Department of Defense [Grant No: HDTRA1-6],Defense Threat Reduction Agency [Grant No: HDTRA1-17-1-0027],Seegene Inc. [Grant No: IF059-2020]

Publication Title

Journal of Clinical Virology

Volume

145

Publisher

Elsevier

Publisher Location

RADARWEG 29, 1043 NX AMSTERDAM, NETHERLANDS

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