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Cited by 1,067Respiratory viral infections researchViral Infections and Immunology ResearchPediatric health and respiratory diseases

The common cold

Open access
Heikkinen, Terho, Järvinen, Asko·2003·The Lancet
DOI 10.1016/s0140-6736(03)12162-9PMC PMC7112468
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Abstract

Summary Despite great advances in medicine, the common cold continues to be a great burden on society in terms of human suffering and economic losses. Of the several viruses that cause the disease, the role of rhinoviruses is most prominent. About a quarter of all colds are still without proven cause, and the recent discovery of human metapneumovirus suggests that other viruses could remain undiscovered. Research into the inflammatory mechanisms of the common cold has elucidated the complexity of the virus-host relation. Increasing evidence is also available for the central role of viruses in predisposing to complications. New antivirals for the treatment of colds are being developed, but optimum use of these agents would require rapid detection of the specific virus causing the infection. Although vaccines against many respiratory viruses could also become available, the ultimate prevention of the common cold seems to remain a distant aim.

AI snapshot

Written from the paper’s full text.

TL;DR

The common cold is a heterogeneous, usually self-limited viral upper respiratory illness caused predominantly by rhinoviruses, with substantial economic and clinical burden. This 2003 Lancet seminar reviews its virology, epidemiology, pathogenesis, diagnosis, treatment, and prevention, emphasizing that about 20–30% of colds still lack a proven viral cause and that universal treatment or prevention remains distant.

Key findings

  • Rhinoviruses are the most common cause across age groups: they account for about 30–50% of all respiratory illnesses yearly and up to 80% of upper respiratory infections during the autumn peak; more than 100 serotypes exist.
  • About 20–30% of colds remain without a proven viral cause, and two or more viruses are found simultaneously in about 5% of cold patients; human metapneumovirus was recently discovered and may indicate other undiscovered respiratory viruses.
  • Incidence is inversely proportional to age: children average 6–8 colds per year and adults 2–4; mean cold duration is 7–10 days. Acute otitis media occurs in about 20% of children with viral upper respiratory infections, and sinusitis is estimated as a complication in 0·5–2% of colds.
  • No universal effective treatment exists. Influenza antivirals zanamivir and oseltamivir reduce illness duration by 1–2 days when started within 48 h; pleconaril started within 24–36 h reduces duration by 1–1·5 days. Prospects for a rhinovirus vaccine seem poor because of serotype diversity.

Methods

  • Narrative review/seminar; no primary data collection or new patient sample.
  • Data were identified by computer-aided searches of PubMed and the Cochrane Library, plus journal reference lists, standard textbooks, existing knowledge, and new data from international scientific meetings.
  • Reports were selected for substantial contribution to current knowledge; the main analysis is a narrative synthesis by topic, with no formal meta-analysis or quantitative pooling.

Limitations

  • The paper does not include a formal limitations section; it states that about 20–30% of colds lack a proven viral cause, that PCR is still too laborious for everyday clinical practice, and that data are scarce on some topics (e.g., coronavirus role, optimum sampling methods, zinc efficacy).
  • Evident: as a narrative review, report selection was not systematic (“selected reports that… have contributed substantially”), and no quantitative synthesis is performed.
  • Evident: the review is time-bound to literature available by 2003, as indicated by its “Future considerations” section and reliance on then-current diagnostic and antiviral developments.

Model-written summary. Check it against the paper before relying on it.

Integrity signals

Registry

Crossref · 10.1016/s0140-6736(03)12162-9

Cites

155 of 155 references verified0 citation errors · 0 not checkable

Statistics

Nothing to recompute.

Claims the paper makes

0 of 185 cited sources checked · 0 supported · 0 flagged

  • Premisecitation

    The relative proportions of different viruses in the cause of the common cold vary dependent on several factors, such as age, season, and viral sampling and detection methods.

    “The relative proportions of different viruses in the cause of the common cold vary dependent on several factors, such as age, season, and viral sampling and detection methods.”
    Quote in the paperNot a substantial claim0 of 3 sources checked
    • cites [8] Arruda, 1997, Frequency and natural history of rhinovirus infections in adults during autumn, J Clin Microbiol source

      Not checked in the free run.

    • cites [9] Mäkelä, 1998, Viruses and bacteria in the etiology of the common cold, J Clin Microbiol source

      Not checked in the free run.

    • cites [10] Monto, 1987, Rhinovirus infections in Tecumseh, Michigan: frequency of illness and numbers of serotypes, J Infect Dis source

      Not checked in the free run.

  • Premisecitation

    Rhinoviruses have been consistently found to be the most common cause of the common cold in all age groups, irrespective of the viral detection techniques used.

    “However, rhinoviruses have been consistently found to be the most common cause in all age groups, irrespective of the viral detection techniques used (panel ).8, 9, 10, 11, 12”
    Quote in the paperNot a substantial claim0 of 3 sources checked
    • cites [8] Arruda, 1997, Frequency and natural history of rhinovirus infections in adults during autumn, J Clin Microbiol source

      Not checked in the free run.

    • cites [9] Mäkelä, 1998, Viruses and bacteria in the etiology of the common cold, J Clin Microbiol source

      Not checked in the free run.

    • cites [10] Monto, 1987, Rhinovirus infections in Tecumseh, Michigan: frequency of illness and numbers of serotypes, J Infect Dis source

      Not checked in the free run.

  • Premisecitation

    Improvements in viral detection techniques during the past two decades have substantially increased the rates of viral detection in clinical specimens.

    “Improvements in viral detection techniques during the past two decades, including various viral antigen detection methods and particularly the advent of PCR-based assays, have substantially increased the rates of viral detection in clinical specimens.8, 9”
    Quote in the paperNot a substantial claim0 of 2 sources checked
    • cites [8] Arruda, 1997, Frequency and natural history of rhinovirus infections in adults during autumn, J Clin Microbiol source

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    • cites [9] Mäkelä, 1998, Viruses and bacteria in the etiology of the common cold, J Clin Microbiol source

      Not checked in the free run.

  • Premisecitation

    During the autumn peak season, rhinoviruses can cause up to 80% of all upper respiratory infections.

    “but during the autumn peak season these viruses can cause up to 80% of all upper respiratory infections.8”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [8] Arruda, 1997, Frequency and natural history of rhinovirus infections in adults during autumn, J Clin Microbiol source

      Not checked in the free run.

  • Premisecitation

    The viral cause could be proven in only about 25% of patients with respiratory infections during the era when techniques were limited to virus isolation.

    “because during that era the techniques of viral detection were limited to virus isolation, the viral cause could be proven in only about 25% of patients with respiratory infections.7”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [7] Monto, 1994, Studies of the community and family: acute respiratory illness and infection, Epidemiol Rev source

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  • Classified as probably not a substantial claim. 16
  • May combine two claims. 38

  • Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

    Interpretationnone given

    In some patients, the viral infection spreads to adjacent organs, resulting in different clinical manifestations, and occasionally colds predispose to bacterial complications.

    “However, in some patients the viral infection spreads to adjacent organs, resulting in different clinical manifestations, and, occasionally, colds predispose to bacterial complications.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Premisecitation

    The common cold is an enormous economic burden on society in terms of visits to doctors and other health-care providers, treatments, and absences from work, school, or day care.

    “Despite the usually benign nature of the illness, the common cold is an enormous economic burden on society in terms of visits to doctors and other health-care providers, treatments, and absences from work, school, or day care.”
    Quote in the paperNot a substantial claim0 of 2 sources checked
    • cites [2] Gonzales, 2001, Excessive antibiotic use for acute respiratory infections in the United States, Clin Infect Dis source

      Not checked in the free run.

    • cites [3] Adams, 1999, Current estimates from the National Health Interview Survey, Vital Health Stat

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Premisecitation

    Yearly, rhinoviruses account for about 30-50% of all respiratory illnesses.

    “Yearly, rhinoviruses account for about 30–50% of all respiratory illnesses,6, 9”
    Quote in the paperNot a substantial claim0 of 2 sources checked
    • cites [6] Monto, 1993, Acute respiratory illness in the community: frequency of illness and the agents involved, Epidemiol Infect source

      Not checked in the free run.

    • cites [9] Mäkelä, 1998, Viruses and bacteria in the etiology of the common cold, J Clin Microbiol source

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Premisecitation

    Every year in the USA, about 25 million people visit their family doctors with uncomplicated upper respiratory infections.

    “Every year, in the USA, about 25 million people visit their family doctors with uncomplicated upper respiratory infections,2”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [2] Gonzales, 2001, Excessive antibiotic use for acute respiratory infections in the United States, Clin Infect Dis source

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Interpretationnone given

    The common cold is a heterogeneous group of diseases caused by numerous viruses that belong to several different families.

    “the common cold is actually a heterogeneous group of diseases caused by numerous viruses that belong to several different families.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

    Premisecitation

    The common cold syndrome results in about 20 million days of absence from work and 22 million days of absence from school.

    “the common cold syndrome results in about 20 million days of absence from work and 22 million days of absence from school.3”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [3] Adams, 1999, Current estimates from the National Health Interview Survey, Vital Health Stat

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

    Premisecitation

    In most temperate countries, RSV usually causes outbreaks around the turn of the year, but other patterns have also been documented.

    “In most temperate countries, RSV usually causes outbreaks around the turn of the year,31 but other patterns have also been documented.32”
    Quote in the paperNot a substantial claim0 of 2 sources checked
    • cites [31] Monto, 1971, The Tecumseh study of respiratory illness, 2: patterns of occurrence of infection with respiratory pathogens, 1965–1969, Am J Epidemiol source

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    • cites [32] Waris, 1991, Pattern of respiratory syncytial virus epidemics in Finland: two-year cycles with alternating prevalence of groups A and B, J Infect Dis source

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  • Probably not a substantial claim: may not pass S3 (load-bearing), S4 (based). May combine two claims.

    Premisenone given

    Mild instances of streptococcal pharyngitis are clinically indistinguishable from viral pharyngitis and can be misclassified as colds.

    “Mild instances of streptococcal pharyngitis are clinically indistinguishable from viral pharyngitis and can be misclassified as colds.”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Premisecitation

    By age 2 years, rhinovirus infection had been documented by virus culture or PCR in 79% of the children, and 91% had antibodies against rhinoviruses.

    “By age 2 years, rhinovirus infection had been documented by virus culture or PCR in 79% of the children, and 91% had antibodies against rhinoviruses.”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [30] Blomqvist, 2002, Virological and serological analysis of rhinovirus infections during the first two years of life in a cohort of children, J Med Virol source

      Not checked in the free run.

  • May combine two claims.

    Premisecitation

    Although rhinoviruses can be detected throughout the year, the incidence of rhinovirus infections peaks during autumn, with a subsequent smaller outbreak in the spring.

    “Although rhinoviruses can be detected throughout the year, the incidence of rhinovirus infections peaks during autumn, with a subsequent smaller outbreak in the spring.28, 29”
    Quote in the paperNot a substantial claim0 of 2 sources checked
    • cites [28] Gwaltney, 1966, Rhinovirus infections in an industrial population, 1:the occurrence of illness, N Engl J Med source

      Not checked in the free run.

    • cites [29] Monto, 1986, Intranasal interferon-alpha 2b for seasonal prophylaxis of respiratory infection, J Infect Dis source

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  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Premisecitation

    More than 100 different serotypes of rhinoviruses have been identified.

    “More than 100 different serotypes of rhinoviruses have been identified, the relative prevalences of which seem to vary between different geographical areas and also over the course of time.10”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [10] Monto, 1987, Rhinovirus infections in Tecumseh, Michigan: frequency of illness and numbers of serotypes, J Infect Dis source

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

    Premisecitation

    Heavy physical training increases the risk of respiratory infections, whereas moderate physical activity could decrease risk.

    “Finally, some reports27 indicate that heavy physical training increases the risk of respiratory infections, whereas moderate physical activity could decrease risk.”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [27] Nieman, 1994, Exercise, upper respiratory tract infection, and the immune system, Med Sci Sports Exerc source

      Not checked in the free run.

  • May combine two claims.

    Premisecitation

    On average, the youngest children have 6-8 and adults 2-4 colds per year.

    “On average, the youngest children have 6–8 and adults 2–4 colds per year.5, 7”
    Quote in the paperNot a substantial claim0 of 2 sources checked
    • cites [5] Monto, 1974, Acute respiratory illness in an American community: the Tecumseh study, JAMA source

      Not checked in the free run.

    • cites [7] Monto, 1994, Studies of the community and family: acute respiratory illness and infection, Epidemiol Rev source

      Not checked in the free run.

  • May combine two claims.

    Premisecitation

    During the first years of life, boys seem to have more respiratory infections than girls, but this difference is reversed later in life.

    “During the first years of life, boys seem to have more respiratory infections than girls, but this difference is reversed later in life.5”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [5] Monto, 1974, Acute respiratory illness in an American community: the Tecumseh study, JAMA source

      Not checked in the free run.

  • May combine two claims.

    Premisecitation

    Positive findings by PCR do not require the presence of live viruses, and viral genomic materials can be detected in patients long after the subsidence of clinical symptoms.

    “Positive findings by PCR, for instance, do not require the presence of live viruses, and viral genomic materials can be detected in patients long after the subsidence of clinical symptoms.19, 20”
    Quote in the paperNot a substantial claim0 of 2 sources checked
    • cites [19] Johnston, 1993, Use of polymerase chain reaction for diagnosis of picornavirus infection in subjects with and without respiratory symptoms, J Clin Microbiol source

      Not checked in the free run.

    • cites [20] Nokso-Koivisto, 2002, Human picornavirus and coronavirus RNA in nasopharynx of children without concurrent respiratory symptoms, J Med Virol source

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  • May combine two claims.

    Interpretationreasoning

    Influenza's clinical presentation ranges from asymptomatic infection to severe illness and therefore overlaps with the common cold.

    “However, the clinical presentation of influenza ranges from an asymptomatic infection to severe illness and it therefore overlaps with the common cold.”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Interpretationnone given

    The estimated average annual rate of rhinovirus infection is likely an underestimate, and calculations based on PCR data might yield a substantially higher rate.

    “However, this figure is likely an underestimate, and calculations based on PCR data might yield a substantially higher rate.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Premisecitation

    The average annual rate of rhinovirus infection is estimated at about 0·8 per person.

    “The average annual rate of rhinovirus infection is estimated at about 0·8 per person.28”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [28] Gwaltney, 1966, Rhinovirus infections in an industrial population, 1:the occurrence of illness, N Engl J Med source

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

    Premisecitation

    Some genetic factors might affect an individual's susceptibility to respiratory infections, but any potential mechanisms remain largely unidentified.

    “Some genetic factors might also affect an individual's susceptibility to respiratory infections, but any potential mechanisms remain largely unidentified.24, 25”
    Quote in the paperNot a substantial claim0 of 2 sources checked
    • cites [24] Casselbrant, 1999, The heritability of otitis media: a twin and triplet study, JAMA source

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    • cites [25] Pitkäranta, 1999, Lowered yields of virus-induced interferon production in leukocyte cultures and risk of recurrent respiratory infections in children, J Clin Virol source

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  • May combine two claims.

    Premisecitation

    Day-care attendance is a major risk factor for respiratory illnesses in children, and the frequency of colds increases with the number of children in the group.

    “Day-care attendance is another major risk factor for respiratory illnesses in children, and the frequency of colds increases with the number of children in the group.21, 22, 23”
    Quote in the paperNot a substantial claim0 of 3 sources checked
    • cites [21] Wald, 1988, Frequency and severity of infections in day care, J Pediatr source

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    • cites [22] Alho, 1990, Risk factors for recurrent acute otitis media and respiratory infection in infancy, Int J Pediatr Otorhinolaryngol source

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    • cites [23] Ball, 2002, Influence of attendance at day care on the common cold from birth through 13 years of age, Arch Pediatr Adolesc Med source

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

    Premisecitation

    Influenza epidemics typically occur in the winter in the northern hemisphere, often overlapping with RSV.

    “Influenza epidemics also typically occur in the winter in the northern hemisphere, often overlapping with RSV.31, 33”
    Quote in the paperNot a substantial claim0 of 2 sources checked
    • cites [31] Monto, 1971, The Tecumseh study of respiratory illness, 2: patterns of occurrence of infection with respiratory pathogens, 1965–1969, Am J Epidemiol source

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    • cites [33] Izurieta, 2000, Influenza and the rates of hospitalization for respiratory disease among infants and young children, N Engl J Med source

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  • May combine two claims.

    Premisecitation

    Influenza viruses and adenoviruses cause extensive damage to the respiratory epithelium, whereas no histopathological changes are observed in nasal biopsy specimens from individuals infected with rhinoviruses.

    “Whereas influenza viruses and adenoviruses cause extensive damage to the respiratory epithelium,45, 46 no histopathological changes are observed in nasal biopsy specimens from individuals infected with rhinoviruses.37”
    Quote in the paperSubstantial claim0 of 3 sources checked
    • cites [37] Winther, 1986, Sites of rhinovirus recovery after point inoculation of the upper airway, JAMA source

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    • cites [45] Treanor, 2000, Influenza virus

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    • cites [46] Cherry, 1998, Adenoviruses

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    Premisecitation

    The incubation period of influenza ranges from 1 to 7 days.

    “whereas the incubation period of influenza ranges from 1 to 7 days.34”
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    • cites [34] Nicholson, 1998, Human influenza

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  • May combine two claims.

    Premisecitation

    In children, the most common bacterial complication is acute otitis media, which occurs in about 20% of children with viral upper respiratory infections.

    “In children, the most common bacterial complication is acute otitis media, which occurs in about 20% of children with viral upper respiratory infections.74, 75”
    Quote in the paperNot a substantial claim0 of 2 sources checked
    • cites [74] Heikkinen, 1995, Short-term use of amoxicillin-clavulanate during upper respiratory tract infection for prevention of acute otitis media, J Pediatr source

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    • cites [75] Tapiainen, 2002, Xylitol administered only during respiratory infections failed to prevent acute otitis media, Pediatrics source

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  • May combine two claims.

    Premisecitation

    The purulence of the nasal discharge is not associated with changes in the nasopharyngeal bacterial flora and is not considered to indicate a simultaneous bacterial infection of the nasal mucosa.

    “The purulence of the nasal discharge is not associated with changes in the nasopharyngeal bacterial flora71 and is not considered to indicate a simultaneous bacterial infection of the nasal mucosa.”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [71] Winther, 1984, Study of bacteria in the nasal cavity and nasopharynx during naturally acquired common colds, Acta Otolaryngol source

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  • May combine two claims.

    Premisecitation

    The mean duration of the common cold is 7-10 days, but in a proportion of patients some symptoms can still be present after 3 weeks.

    “The mean duration of the common cold is 7–10 days, but in a proportion of patients some symptoms can still be present after 3 weeks.8, 68, 69”
    Quote in the paperNot a substantial claim0 of 3 sources checked
    • cites [8] Arruda, 1997, Frequency and natural history of rhinovirus infections in adults during autumn, J Clin Microbiol source

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    • cites [68] Gwaltney, 1967, Rhinovirus infections in an industrial population, 2: characteristics of illness and antibody response, JAMA source

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    • cites [69] Puhakka, 1998, The common cold: effects of intranasal fluticasone propionate treatment, J Allergy Clin Immunol source

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  • May combine two claims.

    Premisecitation

    The shedding of rhinoviruses peaks on the second day after intranasal inoculation and decreases rapidly thereafter, but small amounts of viruses can be discovered in nasal secretions for up to 3 weeks after infection.

    “The shedding of rhinoviruses peaks on the second day after intranasal inoculation and decreases rapidly thereafter, but small amounts of viruses can be discovered in nasal secretions for up to 3 weeks after infection.37, 44”
    Quote in the paperNot a substantial claim0 of 2 sources checked
    • cites [37] Winther, 1986, Sites of rhinovirus recovery after point inoculation of the upper airway, JAMA source

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    • cites [44] Gustafson, 1996, Oral prednisone therapy in experimental rhinovirus infections, J Allergy Clin Immunol source

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    Premisecitation

    The primary site of replication of influenza viruses is in the tracheobronchial epithelium, whereas rhinovirus replication starts predominantly in the nasopharynx.

    “as indicated by the fact that the primary site of replication of influenza viruses is in the tracheobronchial epithelium,34 whereas rhinovirus replication starts predominantly in the nasopharynx.37”
    Quote in the paperNot a substantial claim0 of 2 sources checked
    • cites [34] Nicholson, 1998, Human influenza

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    • cites [37] Winther, 1986, Sites of rhinovirus recovery after point inoculation of the upper airway, JAMA source

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  • May combine two claims.

    Premisecitation

    Viral infection of the upper respiratory tract often causes dysfunction of the Eustachian tube, which is considered the most important factor in the pathogenesis of acute otitis media.

    “In adults and children, viral infection of the upper respiratory tract often causes dysfunction of the Eustachian tube, which is considered the most important factor in the pathogenesis of acute otitis media.61”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [61] Heikkinen, 2000, The role of respiratory viruses in otitis media, Vaccine source

      Not checked in the free run.

  • May combine two claims.

    Premisecitation

    Fever is an infrequent finding during rhinovirus infections in adults, but it is fairly common in children with upper respiratory infections of any cause.

    “Fever is an infrequent finding during rhinovirus infections in adults, but it is fairly common in children with upper respiratory infections of any cause72, 73”
    Quote in the paperNot a substantial claim0 of 2 sources checked
    • cites [72] Putto, 1986, Fever in respiratory virus infections, Am J Dis Child

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    • cites [73] Dick, 1998, Rhinoviruses

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  • May combine two claims.

    Premisecitation

    PCR-based techniques are still too laborious for use in everyday clinical practice, and the extreme sensitivity of PCR can pose problems for the interpretation of results.

    “However, PCR-based techniques are still too laborious for use in everyday clinical practice, and the extreme sensitivity of PCR can pose problems for the interpretation of results.19, 20”
    Quote in the paperNot a substantial claim0 of 2 sources checked
    • cites [19] Johnston, 1993, Use of polymerase chain reaction for diagnosis of picornavirus infection in subjects with and without respiratory symptoms, J Clin Microbiol source

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    • cites [20] Nokso-Koivisto, 2002, Human picornavirus and coronavirus RNA in nasopharynx of children without concurrent respiratory symptoms, J Med Virol source

      Not checked in the free run.

  • May combine two claims.

    Premisecitation

    Recently developed rapid antigen detection kits for influenza and RSV can provide results within 15-30 min, but there are concerns about their real-life sensitivity and specificity.

    “Recently developed rapid antigen detection kits for influenza and RSV can provide results within 15–30 min,98, 99 but there are concerns about the real-life sensitivity and specificity of these tests.100”
    Quote in the paperNot a substantial claim0 of 3 sources checked
    • cites [98] Cox, 1999, Influenza, Lancet source

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    • cites [99] Krilov, 1994, Evaluation of a rapid diagnostic test for respiratory syncytial virus (RSV): potential for bedside diagnosis, Pediatrics source

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    • cites [100] Monto, 2001

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  • May combine two claims.

    Premisecitation

    PCR has proved valuable in diagnosis of viral infections in general, and especially rhinovirus infections, for which other methods have been suboptimum.

    “PCR has proved valuable in diagnosis of viral infections in general, and especially rhinovirus infections, for which other methods have been suboptimum.8, 9, 101, 102”
    Quote in the paperNot a substantial claim0 of 3 sources checked
    • cites [8] Arruda, 1997, Frequency and natural history of rhinovirus infections in adults during autumn, J Clin Microbiol source

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    • cites [9] Mäkelä, 1998, Viruses and bacteria in the etiology of the common cold, J Clin Microbiol source

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    • cites [101] Hyypiä, 1998, Molecular diagnosis of human rhinovirus infections: comparison with virus isolation, J Clin Microbiol source

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  • May combine two claims.

    Premisecitation

    Nasopharyngeal aspirates and nasal wash specimens are usually considered the specimens of choice for the detection of respiratory viruses, but nasal and throat swabs are also often used because of their greater feasibility.

    “Nasopharyngeal aspirates and nasal wash specimens are usually considered the specimens of choice for the detection of respiratory viruses, but nasal and throat swabs are also often used because of their greater feasibility.103, 104, 105, 106”
    Quote in the paperNot a substantial claim0 of 3 sources checked
    • cites [103] McIntosh, 1993, Report of a workshop on respiratory viral infections: epidemiology, diagnosis, treatment, and prevention, Clin Infect Dis source

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    • cites [104] Hall, 1975, Clinically useful method for the isolation of respiratory syncytial virus, J Infect Dis source

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    • cites [105] Covalciuc, 1999, Comparison of four clinical specimen types for detection of influenza A and B viruses by optical immunoassay (FLU OIA test) and cell culture methods, J Clin Microbiol source

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  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Premisecitation

    In the elderly population, two thirds of patients with colds can be expected to develop lower respiratory illness.

    “although results of surveillance studies13 indicate that two thirds of elderly patients with colds can be expected to develop lower respiratory illness.”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [13] Larson, 1980, Isolation of rhinoviruses and coronaviruses from 38 colds in adults, J Med Virol source

      Not checked in the free run.

  • May combine two claims.

    Premisecitation

    Although the frequencies of colds are similar in patients with and without COPD, the use of medical resources during viral respiratory illnesses is substantially increased in patients with COPD.

    “Although the frequencies of colds are similar in patients with and without COPD, the use of medical resources, including hospital admissions and visits to emergency clinics, during viral respiratory illnesses is substantially increased in patients with COPD.89”
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    • cites [89] Greenberg, 2000, Respiratory viral infections in adults with and without chronic obstructive pulmonary disease, Am J Respir Crit Care Med source

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  • May combine two claims.

    Interpretationcitation

    Pneumonia associated with a viral upper respiratory infection is often a true bacterial complication of the predisposing viral illness, but it can also be a pure extension of the viral illness to the pulmonary level.

    “Pneumonia associated with a viral upper respiratory infection is often a true bacterial complication of the predisposing viral illness, but it can also be a pure extension of the viral illness to the pulmonary level.”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Interpretationreasoning

    Since the common cold is caused by a multitude of different virus types with varying pathogenetic mechanisms, an effective universal treatment for this disorder has not been developed.

    “Since the common cold is caused by a multitude of different virus types with varying pathogenetic mechanisms, that an effective universal treatment for this disorder has not been developed is understandable.”
    Quote in the paperSubstantial claim

  • May combine two claims.

    Premisecitation

    In a study of adult patients with asthma, symptoms of the common cold were reported in 80% of episodes of wheezing or dyspnoea, and rhinoviruses accounted for about 60% of those asthma exacerbations for which the viral cause could be identified.

    “In a study86 of adult patients with asthma, symptoms of the common cold were reported in 80% of episodes of wheezing or dyspnoea, and rhinoviruses accounted for about 60% of those asthma exacerbations for which the viral cause could be identified.”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [86] Nicholson, 1993, Respiratory viruses and exacerbations of asthma in adults, BMJ source

      Not checked in the free run.

  • May combine two claims.

    Premisecitation

    First-generation antihistamines reduce sneezing and rhinorrhoea, probably because of their anticholinergic rather than antihistamine effects.

    “First-generation (but not second-generation) antihistamines reduce sneezing and rhinorrhoea, probably because of their anticholinergic rather than antihistamine effects.111”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites [111] Gwaltney, 1997, Efficacy of brompheniramine maleate for the treatment of rhinovirus colds, Clin Infect Dis source

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Premisecitation

    Sinusitis has been estimated to occur as a complication in 0·5-2% of colds.

    “Sinusitis has been estimated to occur as a complication in 0·5–2% of colds,12”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [12] Gwaltney, 2000, The common cold

      Not checked in the free run.

  • May combine two claims.

    Premisecitation

    In immunocompromised patients, RSV is usually the most common cause of severe viral respiratory illness, but rhinovirus infections have also been associated with severe and even fatal lower respiratory tract disease.

    “In immunocompromised patients, RSV is usually the most common cause of severe viral respiratory illness, but rhinovirus infections have also been associated with severe and even fatal lower respiratory tract disease.90”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [90] Ghosh, 1999, Rhinovirus infections in myelosuppressed adult blood and marrow transplant recipients, Clin Infect Dis source

      Not checked in the free run.

  • May combine two claims.

    Premisecitation

    A recombinant soluble decoy ICAM-1 could reduce the severity of experimental rhinovirus infections, but the effect was modest.

    “Findings of clinical trials showed that this approach could reduce the severity of experimental rhinovirus infections, but the effect was modest.125”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [125] Turner, 1999, Efficacy of tremacamra, a soluble intercellular adhesion molecule 1, for experimental rhinovirus infection: a randomized clinical trial, JAMA source

      Not checked in the free run.

  • May combine two claims.

    Premisecitation

    Nonsteroidal anti-inflammatory drugs reduce fever and soreness of the throat, and might also have some beneficial effect on cough.

    “Nonsteroidal anti-inflammatory drugs reduce fever and soreness of the throat, and might also have some beneficial effect on cough.116”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [116] Sperber, 1992, Effects of naproxen on experimental rhinovirus colds: a randomized, double-blind, controlled trial, Ann Intern Med source

      Not checked in the free run.

  • May combine two claims.

    Premisecitation

    Cough medications, both antitussives and mucolytic agents, are frequently used, although their efficacy has been poorly shown.

    “Cough medications, both antitussives and mucolytic agents, are frequently used, although their efficacy has been poorly shown.115”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [115] Schroeder, 2002

      Not checked in the free run.

  • May combine two claims.

    Premisecitation

    Zanamivir and oseltamivir have fewer side-effects and are effective against both influenza A and B viruses.

    “The new influenza-specific antivirals, zanamivir and oseltamivir, have fewer side-effects and are effective against both influenza A and B viruses.”
    Quote in the paperNot a substantial claim0 of 2 sources checked
    • cites [119] 1998, Randomised trial of efficacy and safety of inhaled zanamivir in treatment of influenza A and B virus infections, Lancet source

      Not checked in the free run.

    • cites [120] Nicholson, 2000, Efficacy and safety of oseltamivir in treatment of acute influenza: a randomised controlled trial, Lancet source

      Not checked in the free run.

  • May combine two claims.

    Premisecitation

    The usability of amantadine and rimantadine is limited by their side-effects, their inefficacy against influenza B viruses, and the rapid development of resistant viral strains during treatment.

    “The usability of amantadine and rimantadine is limited by their side-effects, their inefficacy against influenza B viruses, and the rapid development of resistant viral strains during treatment.118”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [118] Hayden, 1989, Emergence and apparent transmission of rimantadine-resistant influenza A virus in families, N Engl J Med source

      Not checked in the free run.

47 of 47

  • The paper relies on this without support.

    The common cold is usually a self-limited illness confined to the upper respiratory tract.

    “The common cold is usually a self-limited illness confined to the upper respiratory tract.”

  • The paper relies on this without support.

    Antibiotics are not effective against viruses.

    “Although antibiotics are not effective against viruses, they are widely used in the treatment of uncomplicated viral upper respiratory infections.2, 109”

  • The paper relies on this without support.

    The occurrence of the common cold shows clear seasonality.

    “The occurrence of the common cold shows clear seasonality.”

  • The paper relies on this without support.

    Transmission of viruses that cause upper respiratory infections can occur by hand contact, small-particle aerosols, or direct hit by large-particle aerosols.

    “The transmission of viruses that cause upper respiratory infections can occur by any of the three major mechanisms: 1) hand contact with secretions that contain the virus, either directly from an infected person or indirectly from environmental surfaces; 2) small-particle aerosols lingering in the air for an extended time; or 3) direct hit by large-particle aerosols from an infected person.”

  • The paper relies on this without support.

    The pathogenesis of the common cold involves a complex interplay between replicating viruses and the host's inflammatory response.

    “The pathogenesis of the common cold involves a complex interplay between replicating viruses and the host's inflammatory response.”

  • The paper relies on this without support.

    Antibiotics are ineffective in the treatment of uncomplicated colds.

    “In this era of ever-increasing antimicrobial resistance of bacteria, efforts aimed at the education of people about the ineffectiveness of antibiotics in the treatment of uncomplicated colds should be intensified.”
6 of 6

Claims other papers make about this one

Each is checked against this paper’s own text: does it say what the citing paper says it does?

  • Around two-thirds of older patients with common cold develop lower respiratory illness.

    “Around two-thirds of older patients with common cold develop lower respiratory illness [66], while older individuals are 2–10 times more likely to die of infection than younger people [11].”

    From Immune function and micronutrient requirements change over the life course (2018) · cites this paper as [66]

Cites

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Related

Authors
Heikkinen, T., & Järvinen, A.
Affiliations
  • Turku University Hospital (FI)
  • Helsinki University Hospital (FI)
Corresponding author
Heikkinen, Terho
ORCID
Venue
The Lancet
Publisher
Elsevier BV
Published
2003-01
Volume
361
Issue
9351
Pages
51-59
ISSN
  • 0099-5355 (ISSN-L)
  • 0140-6736
DOI
10.1016/s0140-6736(03)12162-9
PMC
PMC7112468
OpenAlex
W2153771979
Semantic Scholar
bf116ddb795b7bf47038d26aa959d7a928878b61
Cited by
1,067
References
159
Citations by year
2026: 44 · 2025: 49 · 2024: 54 · 2023: 67 · 2022: 82 · 2021: 66 · 2020: 99 · 2019: 47 · 2018: 42 · 2017: 47 · 2016: 43 · 2015: 52 · 2014: 42 · 2013: 43 · 2012: 38
FWCI
4.20
Type
journal article
Language
en
Open access
Licence
www.elsevier.com/tdm/userlicense/1.0/ (tdm)
Locations
  • The Lancet (publishedVersion)
  • Europe PMC (PubMed Central) (publishedVersion)
  • PubMed Central (publishedVersion)
  • PubMed (publishedVersion)
Topics
  • Health Sciences › Medicine › Epidemiology › Respiratory viral infections research
  • Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Viral Infections and Immunology Research
  • Health Sciences › Health Professions › Emergency Medical Services › Pediatric health and respiratory diseases
Keywords
common cold, rhinovirus, human metapneumovirus, respiratory viruses, host-virus interaction, inflammation, antiviral agents, virus detection, economic burden
MeSH terms
Adult, Antiviral Agents, Child, Common Cold, Female, Humans, Infant, Male, Respiratory Tract Diseases, Seasons, Incidence, Age Distribution

About these checks

Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.

Claims read by deepseek-v4.1-flash under definition version 3 (extract-v3) on 2026-10-10.

Classified by jev-1.13-20260917 (gold-guideline-v0.2) on 2026-10-10.

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