Impact of Non-Influenza Respiratory Viruses on Emergency Department Utilization and Hospitalization

Non-influenza community-acquired respiratory virus (CARV) infections worsen underlying health conditions, increase hospitalization demand, and impose significant burdens on healthcare systems and economies. However, there is a lack of research on which virus species have a major impact. This study aims to investigate the frequency and impacts of respiratory virus infections among emergency department patients. Using residual nasal swab samples from cases attending Okinawa Chubu Hospital's emergency department from February 2020 to January 2021, multiplex PCR for CARVs was conducted. Cases testing positive for influenza virus and the novel coronavirus were excluded. Among 501 cases, including 119 Rhinovirus (HRV), 24 Respiratory Syncytial Virus (RSV), 19 Human Metapneumovirus (MPV), 19 Seasonal Coronaviruses (CoV), 16 Parainfluenza (PIV), 2 Adenovirus, and 29 co-infections (≥2 strains), the CoV and viral co-infection groups exhibited a hospitalization rate of 73-74%, surpassing other virus groups (42-52%) and the non-virus infection group (55%). The HRV and RSV groups predominantly presented with upper respiratory tract infections (36-42%), while the CoV, MPV, PIV, and viral co-infection groups showed higher pneumonia rates (37-52%). In the CoV group, underlying conditions like chronic heart failure, cerebrovascular diseases, and dementia were slightly more prevalent (32-37%) compared to other groups. In conclusion, while the frequency of CoV infections and viral co-infections was relatively low among emergency department attendees, a higher incidence of respiratory failure, pneumonia, and hospitalization rates had been observed.