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Chu B, Qu Y. Comment on: Viral infections in pediatric brain tumor patients treated with targeted therapies. Pediatr Blood Cancer 2023; 70:e30146. [PMID: 36495258 DOI: 10.1002/pbc.30146] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/15/2022] [Revised: 11/19/2022] [Accepted: 11/22/2022] [Indexed: 12/14/2022]
Affiliation(s)
- Bingyang Chu
- Department of Hematology, State Key Laboratory of Biotherapy and Cancer Center, West China Hospital, Sichuan University, Sichuan, China
| | - Ying Qu
- Department of Hematology, State Key Laboratory of Biotherapy and Cancer Center, West China Hospital, Sichuan University, Sichuan, China
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2
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Al-Sweedan SA, Samara DN, Hamaidi MA, Al-Hamad MM, Alsweedan D, Jaradat S. Clinical Characteristics and Outcomes of Children and Adolescents With Cancer Infected With SARS-CoV-2 at a Tertiary Care Medical Center in Jordan. J Pediatr Hematol Oncol 2023; 45:e208-e213. [PMID: 35383653 DOI: 10.1097/mph.0000000000002460] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/11/2021] [Accepted: 03/04/2022] [Indexed: 01/08/2023]
Abstract
BACKGROUND Our knowledge about severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection is still evolving; its effects on children with cancer need to be studied more. The aim of this study is to present our experience with SARS-CoV-2 infection in this population and to highlight specific complications and outcomes. MATERIALS AND METHODS This is a retrospective and prospective observational study, which involved 21 cancer patients below the age of 18 years in north Jordan. Data regarding their age, sex, cancer type and progression, phase of treatment, and others were collected and reviewed. Patients were classified into confirmed, probable, and suspect according to the Centers for Disease Control and Prevention's (CDC) 2021 classification. RESULTS A total of 21 patients with malignancy were included. Ten patients were males (48%). Mean age of 8.8 years (3 mo to 18 y). Two patients (9.5%) had died; one (4.7%) death was coronavirus disease 2019 (COVID-19)-related and the other one (4.7%) was due to cancer progression. Two patients (9.5%) had multisystem inflammatory syndrome in children. Both disease progression and new malignancies were documented in 11 (52%) of our patients. CONCLUSIONS Diagnosis of COVID-19 should not distract physicians from investigating new malignancy or relapse as they may come together or may be related to COVID-19 infection. More studies are needed to identify the contribution of SARS-CoV-2 in the pathogenesis of cancer.
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Affiliation(s)
| | | | | | | | | | - Saied Jaradat
- Princess Haya Biotechnology Center, Jordan University of Science & Technology, Irbid, Jordan
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3
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Mayr L, Steinmaurer T, Weseslindtner L, Madlener S, Strassl R, Gojo J, Azizi AA, Slavc I, Peyrl A. Viral infections in pediatric brain tumor patients treated with targeted therapies. Pediatr Blood Cancer 2023; 70:e30065. [PMID: 36308741 DOI: 10.1002/pbc.30065] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/30/2022] [Revised: 08/31/2022] [Accepted: 09/29/2022] [Indexed: 12/25/2022]
Abstract
BACKGROUND Brain tumors are the most common solid malignancies and the leading cause of cancer-related mortality in children. While numerous studies report on viral infections in children with hematologic malignancies and solid organ transplantation, epidemiologic data on the incidence and outcome of viral infections in pediatric patients with brain tumors treated with targeted therapies are still lacking. OBJECTIVES/STUDY DESIGN We retrospectively reviewed all children with brain tumors receiving targeted therapies in a primary or recurrent setting at the Medical University of Vienna from 2006 to 2021. Demographic variables, quantitative and qualitative parameters of possible infections, and treatment outcomes were recorded. RESULTS In our cohort (n = 117), 36% of the patients developed at least one PCR-proven viral infection. Respiratory and gastrointestinal tract infections were most common, with 31% and 25%, respectively. Central nervous system (CNS) infections occurred in approximately 10%, with an almost equal distribution of varicella-zoster virus, John Cunningham virus (JCV), and enterovirus. Two patients tested PCR-positive for SARS-CoV-2 infection, with one virus-related death caused by a SARS-CoV-2-related acute respiratory distress syndrome. Patients receiving bevacizumab or mTOR inhibitors seem to have a greater susceptibility to viral infections. CONCLUSION Pediatric patients with brain tumors receiving targeted therapies have a higher risk of viral infections when compared to children receiving conventional chemotherapy or the general population, and life-threatening infections can occur. Fast detection and upfront treatment are paramount to prevent life-threatening infections in immunocompromised children suffering from brain tumors receiving targeted therapies.
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Affiliation(s)
- Lisa Mayr
- Department of Pediatrics and Adolescent Medicine, Comprehensive Cancer Center for Pediatrics, Medical University of Vienna, Vienna, Austria
| | - Tobias Steinmaurer
- Department of Pediatrics and Adolescent Medicine, Comprehensive Cancer Center for Pediatrics, Medical University of Vienna, Vienna, Austria
| | | | - Sibylle Madlener
- Department of Pediatrics and Adolescent Medicine, Comprehensive Cancer Center for Pediatrics, Medical University of Vienna, Vienna, Austria
| | - Robert Strassl
- Department of Virology, Medical University of Vienna, Vienna, Austria
| | - Johannes Gojo
- Department of Pediatrics and Adolescent Medicine, Comprehensive Cancer Center for Pediatrics, Medical University of Vienna, Vienna, Austria
| | - Amedeo A Azizi
- Department of Pediatrics and Adolescent Medicine, Comprehensive Cancer Center for Pediatrics, Medical University of Vienna, Vienna, Austria
| | - Irene Slavc
- Department of Pediatrics and Adolescent Medicine, Comprehensive Cancer Center for Pediatrics, Medical University of Vienna, Vienna, Austria
| | - Andreas Peyrl
- Department of Pediatrics and Adolescent Medicine, Comprehensive Cancer Center for Pediatrics, Medical University of Vienna, Vienna, Austria
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4
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Hijazi G, Dakroub F, Khoueiry P, El-Kurdi A, Ezzeddine A, Alkalamouni H, Alansari K, Althani AA, Mathew S, AlKhatib HA, Yassine HM, Zaraket H. Viral metagenomics analysis of stool specimens from children with unresolved gastroenteritis in Qatar. INFECTION, GENETICS AND EVOLUTION : JOURNAL OF MOLECULAR EPIDEMIOLOGY AND EVOLUTIONARY GENETICS IN INFECTIOUS DISEASES 2022; 105:105367. [PMID: 36115643 DOI: 10.1016/j.meegid.2022.105367] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/16/2022] [Revised: 08/26/2022] [Accepted: 09/12/2022] [Indexed: 06/15/2023]
Abstract
Acute gastroenteritis (AGE) is associated with significant global morbidity and mortality, especially among children under five years of age. Viruses are well established as etiologic agents of gastroenteritis since they are the most common pathogens that contribute to the disease burden in developing countries. Despite the advances in molecular diagnosis, a substantial proportion of AGE etiology remain unresolved. We implemented a viral metagenomics pipeline to determine the potential viral etiology associated with AGE among children under the age of five years in Qatar with undiagnosed etiology. Following enriching for the viral genome, ∼1.3 billion sequences were generated from 89 stool specimens using the Illumina HiSeq platform, of which 7% were mapped to viral genomes. Human viruses were detected in 34 specimens (38.2%); 14 were adenovirus, nine coxsackievirus A16, five rotavirus (G9P[8] and G4P[8]), four norovirus (GII), one influenza A virus (H3), and one respiratory syncytial virus A (RSVA). In conclusion, the viral metagenomics approach is useful for determining AGE's etiology when routine molecular diagnostic assays fail.
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Affiliation(s)
- Ghina Hijazi
- Department of Experimental Pathology, Microbiology, and Immunology, Faculty of Medicine, American University of Beirut, Beirut 1107 2020, Lebanon; Center for Infectious Diseases Research, Faculty of Medicine, American University of Beirut, Beirut 1107 2020, Lebanon
| | - Fatima Dakroub
- Department of Experimental Pathology, Microbiology, and Immunology, Faculty of Medicine, American University of Beirut, Beirut 1107 2020, Lebanon; Center for Infectious Diseases Research, Faculty of Medicine, American University of Beirut, Beirut 1107 2020, Lebanon
| | - Pierre Khoueiry
- Department of Biochemistry and Molecular Genetics, Faculty of Medicine, American University of Beirut, Beirut 1107 2020, Lebanon; Pillar Genomics Institute, Faculty of Medicine, American University of Beirut, Beirut, Lebanon
| | - Abdullah El-Kurdi
- Department of Biochemistry and Molecular Genetics, Faculty of Medicine, American University of Beirut, Beirut 1107 2020, Lebanon; Pillar Genomics Institute, Faculty of Medicine, American University of Beirut, Beirut, Lebanon
| | - Amani Ezzeddine
- Department of Experimental Pathology, Microbiology, and Immunology, Faculty of Medicine, American University of Beirut, Beirut 1107 2020, Lebanon; Center for Infectious Diseases Research, Faculty of Medicine, American University of Beirut, Beirut 1107 2020, Lebanon
| | - Habib Alkalamouni
- Department of Experimental Pathology, Microbiology, and Immunology, Faculty of Medicine, American University of Beirut, Beirut 1107 2020, Lebanon; Center for Infectious Diseases Research, Faculty of Medicine, American University of Beirut, Beirut 1107 2020, Lebanon
| | | | - Asmaa A Althani
- Biomedical Research Center, Qatar University, Doha 2713, Qatar
| | - Shilu Mathew
- Biomedical Research Center, Qatar University, Doha 2713, Qatar
| | | | - Hadi M Yassine
- Biomedical Research Center, Qatar University, Doha 2713, Qatar.
| | - Hassan Zaraket
- Department of Experimental Pathology, Microbiology, and Immunology, Faculty of Medicine, American University of Beirut, Beirut 1107 2020, Lebanon; Center for Infectious Diseases Research, Faculty of Medicine, American University of Beirut, Beirut 1107 2020, Lebanon.
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5
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Arjarquah AK, Obodai E, Anie HA, Osei MA, Odoom JK, Bonney JHK, Behene E, Kotey EN, Aboagye J, Nyarko SO, Bentum J, Yeboah C, Kumordjie S, Agbodzi B, Attiku K, Mawuli G, Letizia A, Ampofo WK, Quaye O. Occurrence of influenza and bacterial infections in cancer patients receiving radiotherapy in Ghana. PLoS One 2022; 17:e0271877. [PMID: 35881575 PMCID: PMC9321433 DOI: 10.1371/journal.pone.0271877] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2021] [Accepted: 07/08/2022] [Indexed: 11/30/2022] Open
Abstract
Background Influenza co-infection with bacteria is a leading cause of influenza-related deaths and severe respiratory infections, especially among high-risk groups like cancer patients undergoing treatment. However, acute respiratory infection (ARI)-like symptoms developed by upper-torso cancer (UTC) patients receiving radiotherapy are considered as side-effects of the radiation. Hence influenza and bacterial pathogens implicated in ARI are not investigated. Methods This prospective cohort study examined 85 in-patients with upper-torso cancers undergoing radiotherapy at the National Radiotherapy, Oncology and Nuclear Medicine Centre (NRONMC) of Korle-Bu Teaching Hospital (KBTH) in Accra, Ghana. Eligible patients who consented were recruited into the study from September 2018 to April 2019. Influenza viruses A and B in addition to the following bacteria species Streptococcus pneumonia, Haemophilus influenzae, Neisseria meningitidis and Staphylococcus aureus were detected from oropharyngeal and nasopharyngeal swab specimens collected at three different time points. Presence of respiratory pathogens were investigated by influenza virus isolation in cell culture, bacterial culture, polymerase chain reaction (PCR) and next generation sequencing (NGS) assays. Results Of the 85 eligible participants enrolled into the study, 87% were females. Participants were 17 to 77 years old, with a median age of 49 years. Most of the participants (88%) enrolled had at least one pathogen present. The most prevalent pathogen was N. meningitidis (63.4%), followed by H. influenzae (48.8%), Influenza viruses A and B (32.9%), S. pneumoniae (32.9%) and S. aureus (12.2%). Approximately, 65% of these participants developed ARI-like symptoms. Participants with previous episodes of ARI, did not live alone, HNC and total radiation less than 50 Gy were significantly associated with ARI. All treatment forms were also significantly associated with ARI. Conclusion Data generated from the study suggests that ARI-like symptoms observed among UTC patients receiving radiotherapy in Ghana, could be due to influenza and bacterial single and co-infections in addition to risk factors and not solely the side-effects of radiation as perceived. These findings will be prime importance for diagnosis, prevention, treatment and control for cancer patients who present with such episodes during treatment.
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Affiliation(s)
- Augustina K. Arjarquah
- West African Centre for Cell Biology of Infectious Pathogens (WACCBIP), Department of Biochemistry, Cell and Molecular Biology (DBCMB), University of Ghana, Legon, Ghana
- College of Health Sciences, University of Ghana-Noguchi Memorial Institute for Medical Research (NMIMR), Legon, Ghana
- Cocoa Research Institute of Ghana (CRIG), New Tafo—Akim, Ghana
- * E-mail: (EO); (AKA)
| | - Evangeline Obodai
- College of Health Sciences, University of Ghana-Noguchi Memorial Institute for Medical Research (NMIMR), Legon, Ghana
- * E-mail: (EO); (AKA)
| | - Hannah Ayettey Anie
- National Radiotherapy, Oncology and Nuclear Medicine Centre (NRONMC), Korle-Bu Teaching Hospital, Accra, Ghana
| | - Michael Aning Osei
- National Radiotherapy, Oncology and Nuclear Medicine Centre (NRONMC), Korle-Bu Teaching Hospital, Accra, Ghana
| | - John Kofi Odoom
- College of Health Sciences, University of Ghana-Noguchi Memorial Institute for Medical Research (NMIMR), Legon, Ghana
| | - Joseph H. K. Bonney
- College of Health Sciences, University of Ghana-Noguchi Memorial Institute for Medical Research (NMIMR), Legon, Ghana
| | - Eric Behene
- College of Health Sciences, University of Ghana-Noguchi Memorial Institute for Medical Research (NMIMR), Legon, Ghana
- United States Naval Medical Research Unit No. 3 (US-NAMRU 3), Ghana Detachment, Accra, Ghana
| | - Erasmus N. Kotey
- College of Health Sciences, University of Ghana-Noguchi Memorial Institute for Medical Research (NMIMR), Legon, Ghana
| | - James Aboagye
- College of Health Sciences, University of Ghana-Noguchi Memorial Institute for Medical Research (NMIMR), Legon, Ghana
| | - Stephen O. Nyarko
- College of Health Sciences, University of Ghana-Noguchi Memorial Institute for Medical Research (NMIMR), Legon, Ghana
| | - Jeannette Bentum
- College of Health Sciences, University of Ghana-Noguchi Memorial Institute for Medical Research (NMIMR), Legon, Ghana
- United States Naval Medical Research Unit No. 3 (US-NAMRU 3), Ghana Detachment, Accra, Ghana
| | - Clara Yeboah
- College of Health Sciences, University of Ghana-Noguchi Memorial Institute for Medical Research (NMIMR), Legon, Ghana
- United States Naval Medical Research Unit No. 3 (US-NAMRU 3), Ghana Detachment, Accra, Ghana
| | - Selassie Kumordjie
- College of Health Sciences, University of Ghana-Noguchi Memorial Institute for Medical Research (NMIMR), Legon, Ghana
- United States Naval Medical Research Unit No. 3 (US-NAMRU 3), Ghana Detachment, Accra, Ghana
| | - Bright Agbodzi
- College of Health Sciences, University of Ghana-Noguchi Memorial Institute for Medical Research (NMIMR), Legon, Ghana
- United States Naval Medical Research Unit No. 3 (US-NAMRU 3), Ghana Detachment, Accra, Ghana
| | - Keren Attiku
- College of Health Sciences, University of Ghana-Noguchi Memorial Institute for Medical Research (NMIMR), Legon, Ghana
| | - Gifty Mawuli
- College of Health Sciences, University of Ghana-Noguchi Memorial Institute for Medical Research (NMIMR), Legon, Ghana
| | - Andrew Letizia
- United States Naval Medical Research Unit No. 3 (US-NAMRU 3), Ghana Detachment, Accra, Ghana
| | - William K. Ampofo
- College of Health Sciences, University of Ghana-Noguchi Memorial Institute for Medical Research (NMIMR), Legon, Ghana
| | - Osbourne Quaye
- West African Centre for Cell Biology of Infectious Pathogens (WACCBIP), Department of Biochemistry, Cell and Molecular Biology (DBCMB), University of Ghana, Legon, Ghana
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Li Y, Min L, Zhang X. Usefulness of procalcitonin (PCT), C-reactive protein (CRP), and white blood cell (WBC) levels in the differential diagnosis of acute bacterial, viral, and mycoplasmal respiratory tract infections in children. BMC Pulm Med 2021; 21:386. [PMID: 34836530 PMCID: PMC8620633 DOI: 10.1186/s12890-021-01756-4] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2021] [Accepted: 11/17/2021] [Indexed: 02/11/2023] Open
Abstract
Background There is a lack of studies comparing PCT, CRP and WBC levels in the differential diagnosis of acute bacterial, viral, and mycoplasmal respiratory tract infections. It is necessary to explore the correlation between above markers and different types of ARTI. Methods 108 children with confirmed bacterial infection were regarded as group A, 116 children with virus infection were regarded as group B, and 122 children with mycoplasmal infection were regarded as group C. The levels of PCT, CRP and WBC of the three groups were detected and compared. Results The levels of PCT, CRP and WBC in group A were significantly higher than those in groups B and C (p < 0.05). The positive rate of combined detection of PCT, CRP and WBC was significant higher than that of single detection. There was no significant difference in PCT, CRP and WBC levels between the group of G+ bacterial infection and G− bacterial infection (p > 0.05). ROC curve results showed that the AUC of PCT, CRP and WBC for the diagnosis of bacterial respiratory infections were 0.65, 0.55, and 0.58, respectively. Conclusions PCT, CRP and WBC can be combined as effective indicators for the identification of acute bacterial or no-bacterial infections in children. The levels of PCT and CRP have higher differential diagnostic value than that of WBC in infection, and the combined examination of the three is more valuable in clinic.
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Affiliation(s)
- Yang Li
- Department of Clinical Laboratory, Children's Hospital of Soochow University, Suzhou, 215025, China
| | - Lanfang Min
- Department of Clinical Laboratory, Children's Hospital of Soochow University, Suzhou, 215025, China
| | - Xin Zhang
- Department of Clinical Laboratory, Children's Hospital of Soochow University, Suzhou, 215025, China.
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Nigro O, Sironi G, Bergamaschi L, Gattuso G, Puma N, Livellara V, Chiaravalli S, Ferrari A, Massimino M. SARS-CoV-2 vaccination for adolescents and young adult patients treated at a specialist pediatric oncology unit. Pediatr Blood Cancer 2021; 68:e29240. [PMID: 34264546 PMCID: PMC8441810 DOI: 10.1002/pbc.29240] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/11/2021] [Revised: 06/25/2021] [Accepted: 07/02/2021] [Indexed: 12/24/2022]
Abstract
This brief report describes the SARS-CoV-2 vaccination program at our pediatric oncology unit. Adopting Italian regulations, patients treated for cancer within the previous 6 months were offered vaccination with the Pfizer-BioNtech vaccine if aged ≥16 years, and with the Pfizer-BioNtech or Moderna vaccine if aged ≥18 years. From March 24 to April 28, 2021, 80/89 adolescent and young adult patients enrolled were vaccinated, while nine refused the vaccine due to fear of side effects, disbelief regarding the pandemic, or lack of trust in the scientific community. The refusal rate in our cohort was lower than in the Italian general population.
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Affiliation(s)
- Olga Nigro
- Pediatric Oncology UnitFondazione IRCCS Istituto Nazionale dei TumoriMilanItaly
| | - Giovanna Sironi
- Pediatric Oncology UnitFondazione IRCCS Istituto Nazionale dei TumoriMilanItaly
| | - Luca Bergamaschi
- Pediatric Oncology UnitFondazione IRCCS Istituto Nazionale dei TumoriMilanItaly
| | - Giovanna Gattuso
- Pediatric Oncology UnitFondazione IRCCS Istituto Nazionale dei TumoriMilanItaly
| | - Nadia Puma
- Pediatric Oncology UnitFondazione IRCCS Istituto Nazionale dei TumoriMilanItaly
| | - Virginia Livellara
- Pediatric Oncology UnitFondazione IRCCS Istituto Nazionale dei TumoriMilanItaly
| | - Stefano Chiaravalli
- Pediatric Oncology UnitFondazione IRCCS Istituto Nazionale dei TumoriMilanItaly
| | - Andrea Ferrari
- Pediatric Oncology UnitFondazione IRCCS Istituto Nazionale dei TumoriMilanItaly
| | - Maura Massimino
- Pediatric Oncology UnitFondazione IRCCS Istituto Nazionale dei TumoriMilanItaly
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Dror T, Akerman M, Noor A, Weinblatt ME, Islam S, Glasser CL. Seasonal variation of respiratory viral infections: a comparative study between children with cancer undergoing chemotherapy and children without cancer. Pediatr Hematol Oncol 2021; 38:444-455. [PMID: 33792490 DOI: 10.1080/08880018.2020.1871137] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
Respiratory viral infections (RVIs) affect children year-round, with seasonal-specific patterns. Pediatric oncology patients are uniquely vulnerable to infection, but whether this predisposes them to different patterns of RVIs than healthy children is unknown. There is also limited data on the impact of RVIs on cancer patients. We conducted a retrospective study of children ages 1-21 with cancer presenting to the clinic and emergency department (ED) and a randomly selected subset of patients without cancer presenting to the ED who had positive nasopharyngeal viral polymerase chain reactions at our institution from 2014 to 2019. Sixty-seven cancer patients (206 RVI episodes) and 225 pediatric non-cancer patients (237 RVI episodes) were included. Human rhino/enterovirus (HRE) was the most common infection in both groups in the spring, summer, and fall. In the winter, the most common RVI was influenza in cancer patients verses respiratory syncytial virus in non-cancer patients. On age-adjusted analysis, the likelihood of detecting coronavirus in the winter, HRE in the spring and fall, and parainfluenza in the summer was significantly greater in cancer patients (OR = 2.60, 2.52, 5.73, 3.59 respectively). Among cancer RVI episodes, 50% received parenteral antibiotics, 22% were severely neutropenic, 22% had chemotherapy delays for a median of six days, 16% were hospitalized, and 6% received intravenous immunoglobulin. We conclude that there are differences in the seasonal patterns of RVIs between children with and without cancer. RVIs also cause significant morbidity in children with cancer.
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Affiliation(s)
- Tal Dror
- Department of Pediatrics, NYU Langone Hospital - Long Island, Mineola, New York, USA
| | - Meredith Akerman
- Department of Biostatistics, NYU Langone Hospital - Long Island, Mineola, New York, USA
| | - Asif Noor
- Department of Pediatrics, NYU Langone Hospital - Long Island, Mineola, New York, USA.,Department of Pediatric Infectious Disease, NYU Langone Hospital - Long Island, Mineola, New York, USA.,Department of Pediatric Infectious Disease, NYU Long Island School of Medicine, Mineola, New York, USA
| | - Mark E Weinblatt
- Department of Pediatrics, NYU Langone Hospital - Long Island, Mineola, New York, USA.,Department of Pediatric Hematology/Oncology, NYU Langone Hospital - Long Island, Mineola, New York, USA.,Department of Pediatric Hematology/Oncology, NYU Long Island School of Medicine, Mineola, New York, USA
| | - Shahidul Islam
- Department of Biostatistics, NYU Langone Hospital - Long Island, Mineola, New York, USA
| | - Chana L Glasser
- Department of Pediatrics, NYU Langone Hospital - Long Island, Mineola, New York, USA.,Department of Biostatistics, NYU Langone Hospital - Long Island, Mineola, New York, USA
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Pacheco GA, Gálvez NMS, Soto JA, Andrade CA, Kalergis AM. Bacterial and Viral Coinfections with the Human Respiratory Syncytial Virus. Microorganisms 2021; 9:microorganisms9061293. [PMID: 34199284 PMCID: PMC8231868 DOI: 10.3390/microorganisms9061293] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2021] [Revised: 06/05/2021] [Accepted: 06/08/2021] [Indexed: 02/07/2023] Open
Abstract
The human respiratory syncytial virus (hRSV) is one of the leading causes of acute lower respiratory tract infections in children under five years old. Notably, hRSV infections can give way to pneumonia and predispose to other respiratory complications later in life, such as asthma. Even though the social and economic burden associated with hRSV infections is tremendous, there are no approved vaccines to date to prevent the disease caused by this pathogen. Recently, coinfections and superinfections have turned into an active field of study, and interactions between many viral and bacterial pathogens have been studied. hRSV is not an exception since polymicrobial infections involving this virus are common, especially when illness has evolved into pneumonia. Here, we review the epidemiology and recent findings regarding the main polymicrobial infections involving hRSV and several prevalent bacterial and viral respiratory pathogens, such as Staphylococcus aureus, Pseudomonas aeruginosa, Streptococcus pneumoniae, Haemophilus influenzae, Moraxella catarrhalis, Klebsiella pneumoniae, human rhinoviruses, influenza A virus, human metapneumovirus, and human parainfluenza viruses. As reports of most polymicrobial infections involving hRSV lack a molecular basis explaining the interaction between hRSV and these pathogens, we believe this review article can serve as a starting point to interesting and very much needed research in this area.
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Affiliation(s)
- Gaspar A. Pacheco
- Departamento de Genética Molecular y Microbiología, Facultad de Ciencias Biológicas, Millennium Institute of Immunology and Immunotherapy, Pontificia Universidad Católica de Chile, Santiago 8320000, Chile; (G.A.P.); (N.M.S.G.); (J.A.S.); (C.A.A.)
| | - Nicolás M. S. Gálvez
- Departamento de Genética Molecular y Microbiología, Facultad de Ciencias Biológicas, Millennium Institute of Immunology and Immunotherapy, Pontificia Universidad Católica de Chile, Santiago 8320000, Chile; (G.A.P.); (N.M.S.G.); (J.A.S.); (C.A.A.)
| | - Jorge A. Soto
- Departamento de Genética Molecular y Microbiología, Facultad de Ciencias Biológicas, Millennium Institute of Immunology and Immunotherapy, Pontificia Universidad Católica de Chile, Santiago 8320000, Chile; (G.A.P.); (N.M.S.G.); (J.A.S.); (C.A.A.)
| | - Catalina A. Andrade
- Departamento de Genética Molecular y Microbiología, Facultad de Ciencias Biológicas, Millennium Institute of Immunology and Immunotherapy, Pontificia Universidad Católica de Chile, Santiago 8320000, Chile; (G.A.P.); (N.M.S.G.); (J.A.S.); (C.A.A.)
| | - Alexis M. Kalergis
- Departamento de Genética Molecular y Microbiología, Facultad de Ciencias Biológicas, Millennium Institute of Immunology and Immunotherapy, Pontificia Universidad Católica de Chile, Santiago 8320000, Chile; (G.A.P.); (N.M.S.G.); (J.A.S.); (C.A.A.)
- Departamento de Endocrinología, Facultad de Medicina, Pontificia Universidad Católica de Chile, Santiago 8320000, Chile
- Correspondence: ; Tel.: +56-2-686-2842; Fax: +56-2-222-5515
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Meron GT, Almog R, Kassis I, Ben Barak A, Shachor-Meyouhas Y. Viral respiratory infection among children treated in hemato-oncology department – Clinical and epidemiological characteristics. PEDIATRIC HEMATOLOGY ONCOLOGY JOURNAL 2021. [DOI: 10.1016/j.phoj.2021.01.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
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11
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Kosmeri C, Koumpis E, Tsabouri S, Siomou E, Makis A. Hematological manifestations of SARS-CoV-2 in children. Pediatr Blood Cancer 2020; 67:e28745. [PMID: 33009893 PMCID: PMC7646039 DOI: 10.1002/pbc.28745] [Citation(s) in RCA: 45] [Impact Index Per Article: 11.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/05/2020] [Revised: 09/11/2020] [Accepted: 09/18/2020] [Indexed: 12/18/2022]
Abstract
Infection from severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2), though mainly a respiratory disease, can impair many systems, including causing hematological complications. Lymphopenia and hypercoagulability have been reported in adults with coronavirus disease 2019 (COVID-19) and are considered markers of poor prognosis. This review summarizes the hematological findings in children with SARS-CoV-2 infection. The majority of infected children had a normal leukocyte count, while the most common white blood cell abnormality was leukopenia. Lymphopenia, which may be a marker of severe disease, was rarer in children than in adults, possibly due to their immature immune system or due to the less severe manifestation of COVID-19 in this age group. Age may have an impact, and in neonates and infants the most common abnormality was lymphocytosis. Abnormalities of red blood cells and platelets were uncommon. Anemia and hypercoagulability were reported mainly in children presenting the novel multisystem inflammatory syndrome (MIS) associated with SARS-CoV-2.
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Affiliation(s)
- Chrysoula Kosmeri
- Department of Pediatrics, Faculty of MedicineUniversity of IoanninaIoanninaGreece
| | - Epameinondas Koumpis
- Department of Internal Medicine, Faculty of MedicineUniversity of IoanninaIoanninaGreece
| | - Sophia Tsabouri
- Department of Pediatrics, Faculty of MedicineUniversity of IoanninaIoanninaGreece
| | - Ekaterini Siomou
- Department of Pediatrics, Faculty of MedicineUniversity of IoanninaIoanninaGreece
| | - Alexandros Makis
- Department of Pediatrics, Faculty of MedicineUniversity of IoanninaIoanninaGreece
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12
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Amicucci M, Canesi M, Rostagno E, Bergadano A, Badino C, Botta D, Fenicia D, Longo A, Macchi S, Ricciardi C, Partel MC. How we have protected our patients: The Italian pediatric onco-hematology units' response to the COVID-19 pandemic. Pediatr Blood Cancer 2020; 67:e28505. [PMID: 32588954 DOI: 10.1002/pbc.28505] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/19/2020] [Revised: 05/29/2020] [Accepted: 05/29/2020] [Indexed: 11/08/2022]
Affiliation(s)
- Matteo Amicucci
- Onco-Hematology and Cell and Gene Therapy Department, Ospedale Pediatrico Bambino Gesu, Rome, Italy
| | - Marta Canesi
- Pediatric Hematology and Oncology Unit, Fondazione Monza e Brianza per il Bambino e la sua Mamma, Monza, Italy
| | - Elena Rostagno
- Pediatric Onco-Hematology Unit, Università degli Studi di Bologna, Azienda Ospedaliera di Bologna Policlinico Sant'Orsola-Malpighi, Bologna, Italy
| | - Anna Bergadano
- Pediatric Hematology and Oncology Stem Cell Transplantation and Cellular Therapy Division, Regina Margherita Children's Hospital, Torino, Italy
| | - Clara Badino
- Pediatric Oncology Unit, IRCCS "Istituto Giannina Gaslini,", Genova, Italy
| | - Debora Botta
- Pediatric Unit, Ospedale Santissima Annunziata di Savigliano, Savigliano, Italy
| | - Diana Fenicia
- Pediatric Hematology and Oncology Unit A.O.R.N, Santobono Pausilipon, Azienda Ospedaliera Pediatrica, Napoli, Italy
| | - Antonella Longo
- Pediatric Hematology and Oncology Unit, IRCCS Materno Infantile "Burlo Garofolo,", Trieste, Italy
| | - Simone Macchi
- Pediatric Oncology Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, Milano, Italy
| | - Celeste Ricciardi
- Pediatric Hematology and Oncology Unit, IRCCS Ospedale "Casa Sollievo della Sofferenza,", San Giovanni Rotondo, Italy
| | - Moreno Crotti Partel
- Pediatric Hematology and Oncology Unit, Children's Hospital, ASST Spedali Civili di Brescia, Brescia, Italy
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13
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Amicucci M, Mastronuzzi A, Ciaralli I, Piccioni F, Schiopu AC, Tiozzo E, Gawronski O, Biagioli V, Dall’Oglio I. The Management of Children with Cancer during the COVID-19 Pandemic: A Rapid Review. J Clin Med 2020; 9:E3756. [PMID: 33233447 PMCID: PMC7700610 DOI: 10.3390/jcm9113756] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2020] [Revised: 11/18/2020] [Accepted: 11/19/2020] [Indexed: 12/11/2022] Open
Abstract
Despite the fact that cancer patients seem to be at a higher risk of being infected with SARS-CoV-2, limited data are available in the pediatric oncology setting. A systematic rapid review was conducted to analyze scientific literature regarding the management, interventions, and strategies adopted to prevent the spread of COVID-19 in the pediatric cancer population. Our search on PubMed, Scopus, Cochrane, and EMBASE databases yielded 505 articles. After removing duplicates, 21 articles were included. Articles focused on infection prevention (n = 19; 90.5%), management (n = 18; 85.7%), overall management of specific treatments for cancer (n = 13; 61.9%), and education (n = 7; 33.3%). The interventions adopted to prevent the spread of COVID-19 were similar across organizations and in line with general recommendations. Most of them reported interventions that could be used as valid strategies for similar emergencies. The strategies included limiting the risk of contagion by restricting access to the wards and implementing hygiene measures, the identification of separate pathways for the management of patients suspected or confirmed to be infected with COVID-19, the postponement of people accessing the hospital for non-urgent or unnecessary tests or medical examinations, and the preventive screening of patients before chemotherapy treatment or transplantation of hematopoietic stem cells. It is necessary to identify key indicators in order to better evaluate the effectiveness of the interventions implemented over time. A summary of the recommendations is provided.
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Affiliation(s)
- Matteo Amicucci
- Department of Onco Haematology and Cell and Gene Therapy, Bambino Gesù Children’s Hospital, IRCCS, 00165 Rome, Italy; (A.M.); (I.C.); (F.P.)
| | - Angela Mastronuzzi
- Department of Onco Haematology and Cell and Gene Therapy, Bambino Gesù Children’s Hospital, IRCCS, 00165 Rome, Italy; (A.M.); (I.C.); (F.P.)
| | - Italo Ciaralli
- Department of Onco Haematology and Cell and Gene Therapy, Bambino Gesù Children’s Hospital, IRCCS, 00165 Rome, Italy; (A.M.); (I.C.); (F.P.)
| | - Federico Piccioni
- Department of Onco Haematology and Cell and Gene Therapy, Bambino Gesù Children’s Hospital, IRCCS, 00165 Rome, Italy; (A.M.); (I.C.); (F.P.)
| | | | - Emanuela Tiozzo
- Professional Development, Continuing Education and Nursing Research Service, Bambino Gesù Children’s Hospital, IRCCS, 00165 Rome, Italy; (E.T.); (O.G.); (V.B.); (I.D.)
| | - Orsola Gawronski
- Professional Development, Continuing Education and Nursing Research Service, Bambino Gesù Children’s Hospital, IRCCS, 00165 Rome, Italy; (E.T.); (O.G.); (V.B.); (I.D.)
| | - Valentina Biagioli
- Professional Development, Continuing Education and Nursing Research Service, Bambino Gesù Children’s Hospital, IRCCS, 00165 Rome, Italy; (E.T.); (O.G.); (V.B.); (I.D.)
| | - Immacolata Dall’Oglio
- Professional Development, Continuing Education and Nursing Research Service, Bambino Gesù Children’s Hospital, IRCCS, 00165 Rome, Italy; (E.T.); (O.G.); (V.B.); (I.D.)
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14
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Cimolai N. Complicating Infections Associated with Common Endemic Human Respiratory Coronaviruses. Health Secur 2020; 19:195-208. [PMID: 33186086 DOI: 10.1089/hs.2020.0067] [Citation(s) in RCA: 25] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022] Open
Abstract
Coronaviruses OC43, 229E, NL63, and HKU1 are endemic human respiratory coronaviruses that typically cause mild to moderate upper respiratory infections, similar to the common cold. They also may cause simple and complicated lower respiratory infections, otitis media, asthma exacerbations, gastroenteritis, and a few systemic complications. These viruses are usually seasonal (with winter dominance) and affect nearly all age groups. The seasonal and annual variation in virus prevalence has implications for understanding the concept of acquired immunity and its persistence or diminution. Coronaviruses generally have outbreak potential in susceptible populations of any age, particularly in patients with comorbidities, who tend to have increased clinical disease. These 4 coronaviruses are often found in the context of what appears to be coinfection with other pathogens, but especially other viruses. If coronaviruses are not specifically tested for, the sole detection of a viral copathogen would suggest the pathogen is the causative agent, when a coronavirus may be culpable, or both. The detection of these viruses in circumstances where respiratory viruses are generally sought in clinical samples is, therefore, justified. These pathogens can be chronically shed from the respiratory tract, which is more likely to occur among immunocompromised and complicated patients. These viruses share the potential for genetic drift. The genome is among the largest of RNA viruses, and the capability of these viruses to further change is likely underestimated. Given the potential disease among humans, it is justified to search for effective antiviral chemotherapy for these viruses and to consider uses in niche situations should effective therapy be defined. Whereas SARS-CoV-2 may follow the epidemiological pattern of SARS-CoV and extinguish slowly over time, there is yet concern that SARS-CoV-2 may establish itself as an endemic human respiratory coronavirus similar to OC43, 2299E, NL63, and HKU1. Until sufficient data are acquired to better understand the potential of SARS-CoV-2, continued work on antiviral therapy and vaccination is imperative.
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Affiliation(s)
- Nevio Cimolai
- Nevio Cimolai, MD, FRCPC, is a Professor, Department of Pathology and Laboratory Medicine, Faculty of Medicine, University of British Columbia; he is also Medical Staff, Pathology and Laboratory Medicine, Children's and Women's Health Centre of British Columbia; both in Vancouver, Canada
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15
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Felsenstein S, Hedrich CM. SARS-CoV-2 infections in children and young people. Clin Immunol 2020; 220:108588. [PMID: 32905851 PMCID: PMC7474910 DOI: 10.1016/j.clim.2020.108588] [Citation(s) in RCA: 70] [Impact Index Per Article: 17.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2020] [Revised: 09/02/2020] [Accepted: 09/02/2020] [Indexed: 01/08/2023]
Abstract
Though recent reports link SARS-CoV-2 infections with hyper-inflammatory states in children, most children experience no/mild symptoms, and hospitalization and mortality rates are low in the age group. As symptoms are usually mild and seroconversion occurs at low frequencies, it remains unclear whether children significantly contribute to community transmission. Several hypotheses try to explain age-related differences in disease presentation and severity. Possible reasons for milder presentations in children as compared to adults include frequent contact to seasonal coronaviruses, presence of cross-reactive antibodies, and/or co-clearance with other viruses. Increased expression of ACE2 in young people may facilitate virus infection, while limiting inflammation and reducing the risk of severe disease. Further potential factors include recent vaccinations and a more diverse memory T cell repertoire. This manuscript reviews age-related host factors that may protect children from COVID-19 and complications associated, and addresses the confusion around seropositivity and immunity.
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Affiliation(s)
- Susanna Felsenstein
- Department of Infectious Diseases and Immunology, Alder Hey Children's NHS Foundation Trust Hospital, Liverpool, UK
| | - Christian M Hedrich
- Department of Women's & Children's Health, Institute of Live Course and Medical Sciences, University of Liverpool, Liverpool, UK; Department of Rheumatology, Alder Hey Children's NHS Foundation Trust Hospital, Liverpool, UK.
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16
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Chamseddine S, Chmaisse A, Akel I, Zein ZE, Khalil S, Raad SA, Khati A, Ghandour H, Khafaja S, Haj M, Abboud M, Mahfouz R, Araj G, Zaraket H, Hanna-Wakim R, Muwakkit S, Dbaibo G. Epidemiology and clinical characteristics of viral infections in hospitalized children and adolescents with cancer in Lebanon. PLoS One 2020; 15:e0239258. [PMID: 32961548 PMCID: PMC7508634 DOI: 10.1371/journal.pone.0239258] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2019] [Accepted: 09/02/2020] [Indexed: 11/30/2022] Open
Abstract
Background Viral infections in children and adolescents with malignancy are commonly encountered and have a significant impact on morbidity and mortality. Studies and epidemiological data regarding viral infections in children with cancer in developing countries are lacking. This retrospective cohort study aims to assess the burden of viral infections in children and adolescents with cancer, by assessing prevalence, risk factors, as well as morbidity and mortality of common viruses over a period of 8 years. Methods and findings Medical records of cancer patients treated at the Children Cancer Center of Lebanon were reviewed and 155 participants under the age of 21 were identified with at least one documented viral infection during the period from July 2009 to November 2017. This subset included 136 participants with active malignancy and 19 participants with a history of cancer who underwent hematopoietic stem cell transplantation [HSCT] and were in remission; the latter group was analyzed separately. Information regarding participant characteristics, hospital course, and complications were obtained. Associations between viral infections and certain factors were assessed. In the cohort, 64% were male, 81% were Lebanese. In participants with active malignancy, 90% received chemotherapy in the 6 months preceding the viral infection episode, 11% received radiotherapy. 51% of participants were neutropenic at the time of viral detection, and 77% were lymphopenic. 17% experienced a bacterial co-infection, and 3 experienced a viral co-infection. Among 162 viral infection episodes, clinically diagnosed skin infections, mainly herpes simplex virus type 1 and varicella-zoster virus, were the most common [44% of cases]. These were followed by laboratory-proven systemic herpes infections: cytomegalovirus [14%] and Epstein-Barr virus [6%]. Respiratory viruses: influenza and respiratory syncytial virus, accounted for 9% and 4%, respectively, whereas rotavirus represented 11% and BK virus represented 3% of cases. Acute lymphocytic leukemia was the most prevalent neoplasia [57%]. Fever was the most common presenting symptom [55%] and febrile neutropenia was the reason for admission in 24% of cases. The mean length of stay was significantly longer in participants with cytomegalovirus infections and significantly lower in rotavirus infection. Admission to the ICU occurred in 9%, complications in 8%, and mortality in 5%. Participants with viral infections post-HSCT were noted to have a significantly longer length of hospital stay compared to non-HSCT participants, with no other significant differences in clinical course and outcome. The study was limited by its retrospective nature and by the late introduction and underuse of multiplex PCR panels, which may have led to underdiagnosis of viral infections. Conclusions Viral infections were prevalent in our sample of cancer patients and may have contributed to morbidity and mortality. Newly available viral diagnostics are likely to vastly increase the number and scope of detectable viral infections in this population. Prospective studies using multiplex PCR technology with systematic testing of patients will be more helpful in defining the burden of viral infections. Furthermore, efforts at antimicrobial stewardship would benefit from the identification of viral causes of infection and limit the unnecessary use of antibiotics in the pediatric cancer population.
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Affiliation(s)
- Sarah Chamseddine
- Center for Infectious Diseases Research, American University of Beirut, Beirut, Lebanon
| | - Ahmad Chmaisse
- Center for Infectious Diseases Research, American University of Beirut, Beirut, Lebanon
| | - Imad Akel
- Center for Infectious Diseases Research, American University of Beirut, Beirut, Lebanon
| | - Zeinab El Zein
- Center for Infectious Diseases Research, American University of Beirut, Beirut, Lebanon
- Department of Pediatrics and Adolescent Medicine, American University of Beirut Medical Center, Beirut, Lebanon
| | - Suzan Khalil
- Center for Infectious Diseases Research, American University of Beirut, Beirut, Lebanon
| | - Sarah Abi Raad
- Center for Infectious Diseases Research, American University of Beirut, Beirut, Lebanon
| | - Antoine Khati
- Center for Infectious Diseases Research, American University of Beirut, Beirut, Lebanon
| | - Hiba Ghandour
- Center for Infectious Diseases Research, American University of Beirut, Beirut, Lebanon
| | - Sarah Khafaja
- Center for Infectious Diseases Research, American University of Beirut, Beirut, Lebanon
- Department of Pediatrics and Adolescent Medicine, American University of Beirut Medical Center, Beirut, Lebanon
| | - Magda Haj
- Center for Infectious Diseases Research, American University of Beirut, Beirut, Lebanon
| | - Miguel Abboud
- Department of Pediatrics and Adolescent Medicine, American University of Beirut Medical Center, Beirut, Lebanon
- Department of Pediatrics and Adolescent Medicine, Children’s Cancer Center of Lebanon, American University of Beirut Medical Center, Beirut, Lebanon
| | - Rami Mahfouz
- Center for Infectious Diseases Research, American University of Beirut, Beirut, Lebanon
- Department of Pathology and Laboratory Medicine, American University of Beirut Medical Center, Beirut, Lebanon
| | - George Araj
- Center for Infectious Diseases Research, American University of Beirut, Beirut, Lebanon
- Department of Pathology and Laboratory Medicine, American University of Beirut Medical Center, Beirut, Lebanon
| | - Hassan Zaraket
- Center for Infectious Diseases Research, American University of Beirut, Beirut, Lebanon
- Department of Experimental Pathology, Immunology and Microbiology, Faculty of Medicine, Beirut, Lebanon
| | - Rima Hanna-Wakim
- Center for Infectious Diseases Research, American University of Beirut, Beirut, Lebanon
- Department of Pediatrics and Adolescent Medicine, American University of Beirut Medical Center, Beirut, Lebanon
- Division of Pediatric Infectious Diseases, Department of Pediatrics and Adolescent Medicine, American University of Beirut Medical Center, Beirut, Lebanon
| | - Samar Muwakkit
- Department of Pediatrics and Adolescent Medicine, American University of Beirut Medical Center, Beirut, Lebanon
- Department of Pediatrics and Adolescent Medicine, Children’s Cancer Center of Lebanon, American University of Beirut Medical Center, Beirut, Lebanon
| | - Ghassan Dbaibo
- Center for Infectious Diseases Research, American University of Beirut, Beirut, Lebanon
- Department of Pediatrics and Adolescent Medicine, American University of Beirut Medical Center, Beirut, Lebanon
- Division of Pediatric Infectious Diseases, Department of Pediatrics and Adolescent Medicine, American University of Beirut Medical Center, Beirut, Lebanon
- * E-mail:
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17
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Terenziani M, Massimino M, Biassoni V, Casanova M, Chiaravalli S, Ferrari A, Luksch R, Meazza C, Podda M, Schiavello E, Spreafico F. SARS-CoV-2 disease and children under treatment for cancer. Pediatr Blood Cancer 2020; 67:e28346. [PMID: 32374054 PMCID: PMC7235501 DOI: 10.1002/pbc.28346] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/31/2020] [Revised: 04/02/2020] [Accepted: 04/03/2020] [Indexed: 12/24/2022]
Affiliation(s)
- Monica Terenziani
- Department of Medical Oncology and HematologyFondazione IRCCS Istituto Nazionale dei TumoriPediatric Oncology UnitMilanItaly
| | - Maura Massimino
- Department of Medical Oncology and HematologyFondazione IRCCS Istituto Nazionale dei TumoriPediatric Oncology UnitMilanItaly
| | - Veronica Biassoni
- Department of Medical Oncology and HematologyFondazione IRCCS Istituto Nazionale dei TumoriPediatric Oncology UnitMilanItaly
| | - Michela Casanova
- Department of Medical Oncology and HematologyFondazione IRCCS Istituto Nazionale dei TumoriPediatric Oncology UnitMilanItaly
| | - Stefano Chiaravalli
- Department of Medical Oncology and HematologyFondazione IRCCS Istituto Nazionale dei TumoriPediatric Oncology UnitMilanItaly
| | - Andrea Ferrari
- Department of Medical Oncology and HematologyFondazione IRCCS Istituto Nazionale dei TumoriPediatric Oncology UnitMilanItaly
| | - Roberto Luksch
- Department of Medical Oncology and HematologyFondazione IRCCS Istituto Nazionale dei TumoriPediatric Oncology UnitMilanItaly
| | - Cristina Meazza
- Department of Medical Oncology and HematologyFondazione IRCCS Istituto Nazionale dei TumoriPediatric Oncology UnitMilanItaly
| | - Marta Podda
- Department of Medical Oncology and HematologyFondazione IRCCS Istituto Nazionale dei TumoriPediatric Oncology UnitMilanItaly
| | - Elisabetta Schiavello
- Department of Medical Oncology and HematologyFondazione IRCCS Istituto Nazionale dei TumoriPediatric Oncology UnitMilanItaly
| | - Filippo Spreafico
- Department of Medical Oncology and HematologyFondazione IRCCS Istituto Nazionale dei TumoriPediatric Oncology UnitMilanItaly
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18
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Huang XB, Yuan L, Ye CX, Zhu X, Lin CJ, Zhang DM, He KS, Niu RX, Cao KY, Xu L. Epidemiological characteristics of respiratory viruses in patients with acute respiratory infections during 2009-2018 in southern China. Int J Infect Dis 2020; 98:21-32. [PMID: 32562851 DOI: 10.1016/j.ijid.2020.06.051] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2020] [Revised: 06/11/2020] [Accepted: 06/13/2020] [Indexed: 11/30/2022] Open
Abstract
BACKGROUND Acute respiratory infections (ARIs) remain a significant public threat with high morbidity and mortality worldwide; viruses are significant pathogens that cause ARIs. This study was conducted to better understand the epidemiological characteristics of respiratory viruses circulating in southern China. METHODS We collected 22,680 respiratory samples from ARI patients in 18 hospitals in southern China during 2009-2018; seven common respiratory viruses including Flu, RSV, PIV, hMPV, ADV, HCoV, and HBoV were screened using in-house real-time PCR. RESULTS Of all samples, 9760 ARI cases (9760/22680, 43.03%) tested positive for the seven common respiratory viruses. The most detected virus was Flu (14.15%), followed by RSV (10.33%) and PIV (5.43%); Flu-A, PIV3, and HCoV-OC43 were the predominant subtypes. Although most of the viruses were detected in male inpatients, Flu was more likely detected in female outpatients. Flu infection was more likely to cause URTI (upper respiratory tract infection), whereas RSV infection was more likely to cause pneumonia and bronchitis. The prevalence of Flu was particularly high in 2009. The epidemic level was found notably high in 2014-2018 for RSV, in 2016-2018 for PIV, in the summer of 2018 for ADV, in the summer of 2016 and winter of 2018 for HCoV, and in the summer of 2011 and autumn of 2018 for HBoV. The co-detection rate of the seven viruses was 4.70%; RSV, PIV, and Flu were the most commonly co-detected viruses. CONCLUSIONS This work demonstrates the epidemiological characteristics of seven common respiratory viruses in ARI patients in southern China.
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Affiliation(s)
- Xu-Bin Huang
- Department of Pulmonary and Critical Care Medicine, the First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
| | - Lei Yuan
- Clinical laboratory, First Affiliated Hospital of Nanchang University, Nanchang University, Jiangxi, China; Key Laboratory of Tropical Disease Control, Ministry of Education, Sun Yat-sen University, Guangzhou, China; Research Center for Clinical Laboratory Standard, Zhongshan School of Medicine, Sun Yat-sen University, Guangzhou, China; Department of Microbiology, Zhongshan School of Medicine, Sun Yat-sen University, Guangzhou, China
| | - Cong-Xiu Ye
- Department of Dermatovenereology, The Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, China
| | - Xun Zhu
- Key Laboratory of Tropical Disease Control, Ministry of Education, Sun Yat-sen University, Guangzhou, China; Research Center for Clinical Laboratory Standard, Zhongshan School of Medicine, Sun Yat-sen University, Guangzhou, China; Department of Microbiology, Zhongshan School of Medicine, Sun Yat-sen University, Guangzhou, China
| | - Cui-Ji Lin
- Key Laboratory of Tropical Disease Control, Ministry of Education, Sun Yat-sen University, Guangzhou, China; Research Center for Clinical Laboratory Standard, Zhongshan School of Medicine, Sun Yat-sen University, Guangzhou, China; Department of Microbiology, Zhongshan School of Medicine, Sun Yat-sen University, Guangzhou, China
| | - Ding-Mei Zhang
- Department of Medical Statistics and Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou, China
| | - Kai-Shu He
- Key Laboratory of Tropical Disease Control, Ministry of Education, Sun Yat-sen University, Guangzhou, China; Research Center for Clinical Laboratory Standard, Zhongshan School of Medicine, Sun Yat-sen University, Guangzhou, China; Department of Microbiology, Zhongshan School of Medicine, Sun Yat-sen University, Guangzhou, China
| | - Ruo-Xi Niu
- Key Laboratory of Tropical Disease Control, Ministry of Education, Sun Yat-sen University, Guangzhou, China; Research Center for Clinical Laboratory Standard, Zhongshan School of Medicine, Sun Yat-sen University, Guangzhou, China; Department of Microbiology, Zhongshan School of Medicine, Sun Yat-sen University, Guangzhou, China
| | - Kai-Yuan Cao
- Key Laboratory of Tropical Disease Control, Ministry of Education, Sun Yat-sen University, Guangzhou, China; Research Center for Clinical Laboratory Standard, Zhongshan School of Medicine, Sun Yat-sen University, Guangzhou, China; Department of Microbiology, Zhongshan School of Medicine, Sun Yat-sen University, Guangzhou, China.
| | - Lin Xu
- Key Laboratory of Tropical Disease Control, Ministry of Education, Sun Yat-sen University, Guangzhou, China; Research Center for Clinical Laboratory Standard, Zhongshan School of Medicine, Sun Yat-sen University, Guangzhou, China; Department of Microbiology, Zhongshan School of Medicine, Sun Yat-sen University, Guangzhou, China.
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19
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Ferrari A, Zecca M, Rizzari C, Porta F, Provenzi M, Marinoni M, Schumacher RF, Luksch R, Terenziani M, Casanova M, Spreafico F, Chiaravalli S, Compagno F, Bruni F, Piccolo C, Bettini L, D'Angiò M, Ferrari GM, Biondi A, Massimino M, Balduzzi A. Children with cancer in the time of COVID-19: An 8-week report from the six pediatric onco-hematology centers in Lombardia, Italy. Pediatr Blood Cancer 2020; 67:e28410. [PMID: 32452123 PMCID: PMC7267084 DOI: 10.1002/pbc.28410] [Citation(s) in RCA: 69] [Impact Index Per Article: 17.3] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/26/2020] [Accepted: 04/28/2020] [Indexed: 12/24/2022]
Affiliation(s)
- Andrea Ferrari
- Pediatric Oncology UnitFondazione IRCCS Istituto Nazionale dei TumoriMilanItaly
| | - Marco Zecca
- Department of Pediatric Hematology and OncologyFondazione IRCCS Policlinico San MatteoPaviaItaly
| | - Carmelo Rizzari
- Pediatric DepartmentUniversity of Milano BicoccaMBBM FoundationASST Monza Ospedale San GerardoMonzaItaly
| | - Fulvio Porta
- Oncology UnitOspedale dei BambiniASST–Spedali Civili of BresciaBresciaItaly
| | | | | | | | - Roberto Luksch
- Pediatric Oncology UnitFondazione IRCCS Istituto Nazionale dei TumoriMilanItaly
| | - Monica Terenziani
- Pediatric Oncology UnitFondazione IRCCS Istituto Nazionale dei TumoriMilanItaly
| | - Michela Casanova
- Pediatric Oncology UnitFondazione IRCCS Istituto Nazionale dei TumoriMilanItaly
| | - Filippo Spreafico
- Pediatric Oncology UnitFondazione IRCCS Istituto Nazionale dei TumoriMilanItaly
| | - Stefano Chiaravalli
- Pediatric Oncology UnitFondazione IRCCS Istituto Nazionale dei TumoriMilanItaly
| | - Francesca Compagno
- Department of Pediatric Hematology and OncologyFondazione IRCCS Policlinico San MatteoPaviaItaly
| | - Federica Bruni
- Pediatric Oncology UnitPapa Giovanni XXIII HospitalBergamoItaly
| | - Chiara Piccolo
- Pediatric DepartmentASST–Sette LaghiF. Del Ponte HospitalVareseItaly
| | - Laura Bettini
- Pediatric DepartmentUniversity of Milano BicoccaMBBM FoundationASST Monza Ospedale San GerardoMonzaItaly
| | - Mariella D'Angiò
- Pediatric DepartmentUniversity of Milano BicoccaMBBM FoundationASST Monza Ospedale San GerardoMonzaItaly
| | - Giulia Maria Ferrari
- Pediatric DepartmentUniversity of Milano BicoccaMBBM FoundationASST Monza Ospedale San GerardoMonzaItaly
| | - Andrea Biondi
- Pediatric DepartmentUniversity of Milano BicoccaMBBM FoundationASST Monza Ospedale San GerardoMonzaItaly
| | - Maura Massimino
- Pediatric Oncology UnitFondazione IRCCS Istituto Nazionale dei TumoriMilanItaly
| | - Adriana Balduzzi
- Pediatric DepartmentUniversity of Milano BicoccaMBBM FoundationASST Monza Ospedale San GerardoMonzaItaly
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20
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Assaf-Casals A, Saleh Z, Khafaja S, Fayad D, Ezzeddine H, Saleh M, Chamseddine S, Sayegh R, Sharara SL, Chmaisse A, Kanj SS, Kanafani Z, Hanna-Wakim R, Araj GF, Mahfouz R, Saito R, Suzuki H, Zaraket H, Dbaibo GS. The burden of laboratory-confirmed influenza infection in Lebanon between 2008 and 2016: a single tertiary care center experience. BMC Infect Dis 2020; 20:339. [PMID: 32397965 PMCID: PMC7216128 DOI: 10.1186/s12879-020-05013-7] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2020] [Accepted: 04/05/2020] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND Influenza is a major cause of morbidity and mortality worldwide. Following the 2009 pandemic, there was widened interest in studying influenza burden in all regions. However, since data from the World Health Organization (WHO) Middle East and North Africa (MENA) region remain limited, we aimed to contribute to the understanding of influenza burden in Lebanon. METHODS A retrospective chart review extending over a period of 8 seasons from Jan 1st, 2008 till June 30th, 2016 at a tertiary care center in Beirut was performed. All cases confirmed to have influenza based on rapid antigen detection or/and polymerase chain reaction on a respiratory sample were included for analysis. Data on epidemiology, clinical presentation, complications, antiviral use and mortality were collected for analysis. RESULTS A total of 1829 cases of laboratory-confirmed influenza were identified. Average annual positivity rate was 14% (positive tests over total requested). Both influenza A and B co-circulated in each season with predominance of influenza A. Influenza virus started circulating in December and peaked in January and February. The age group of 19-50 years accounted for the largest proportion of cases (22.5%) followed by the age group of 5-19 years (18%). Pneumonia was the most common complication reported in 33% of cases. Mortality reached 3.8%. The two extremes of age (< 2 years and ≥ 65 years) were associated with a more severe course of disease, hospitalization, intensive care unit (ICU) admission, complications, and mortality rate. Of all the identified cases, 26% were hospitalized. Moderate-to-severe disease was more likely in influenza B cases but no difference in mortality was reported between the two types. Antivirals were prescribed in 68.8% and antibiotics in 41% of cases. There seemed to be an increasing trend in the number of diagnosed and hospitalized cases over the years of the study. CONCLUSION Patients with laboratory-confirmed influenza at our center had a high rate of hospitalization and mortality. A population based prospective surveillance study is needed to better estimate the burden of Influenza in Lebanon that would help formulate a policy on influenza control.
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Affiliation(s)
- Aia Assaf-Casals
- Center for Infectious Diseases Research, Faculty of Medicine, American University of Beirut, PO Box: 11-0236, Riad El-Solh, Beirut, 1107 2020, Lebanon
- Division of Pediatric Infectious Diseases, Department of Pediatrics and Adolescent Medicine, Faculty of Medicine, American University of Beirut Medical Center, PO Box: 11-0236, Riad El-Solh, Beirut, 1107 2020, Lebanon
| | - Zeina Saleh
- Center for Infectious Diseases Research, Faculty of Medicine, American University of Beirut, PO Box: 11-0236, Riad El-Solh, Beirut, 1107 2020, Lebanon
| | - Sarah Khafaja
- Center for Infectious Diseases Research, Faculty of Medicine, American University of Beirut, PO Box: 11-0236, Riad El-Solh, Beirut, 1107 2020, Lebanon
- Division of Pediatric Infectious Diseases, Department of Pediatrics and Adolescent Medicine, Faculty of Medicine, American University of Beirut Medical Center, PO Box: 11-0236, Riad El-Solh, Beirut, 1107 2020, Lebanon
| | - Danielle Fayad
- Center for Infectious Diseases Research, Faculty of Medicine, American University of Beirut, PO Box: 11-0236, Riad El-Solh, Beirut, 1107 2020, Lebanon
| | - Hady Ezzeddine
- Center for Infectious Diseases Research, Faculty of Medicine, American University of Beirut, PO Box: 11-0236, Riad El-Solh, Beirut, 1107 2020, Lebanon
| | - Mohammad Saleh
- Center for Infectious Diseases Research, Faculty of Medicine, American University of Beirut, PO Box: 11-0236, Riad El-Solh, Beirut, 1107 2020, Lebanon
| | - Sarah Chamseddine
- Center for Infectious Diseases Research, Faculty of Medicine, American University of Beirut, PO Box: 11-0236, Riad El-Solh, Beirut, 1107 2020, Lebanon
| | - Rouba Sayegh
- Center for Infectious Diseases Research, Faculty of Medicine, American University of Beirut, PO Box: 11-0236, Riad El-Solh, Beirut, 1107 2020, Lebanon
| | - Sima L Sharara
- Center for Infectious Diseases Research, Faculty of Medicine, American University of Beirut, PO Box: 11-0236, Riad El-Solh, Beirut, 1107 2020, Lebanon
| | - Ahmad Chmaisse
- Center for Infectious Diseases Research, Faculty of Medicine, American University of Beirut, PO Box: 11-0236, Riad El-Solh, Beirut, 1107 2020, Lebanon
| | - Souha S Kanj
- Center for Infectious Diseases Research, Faculty of Medicine, American University of Beirut, PO Box: 11-0236, Riad El-Solh, Beirut, 1107 2020, Lebanon
- Division of Infectious Diseases, Department of Internal Medicine, Faculty of Medicine, American University of Beirut, PO Box: 11-0236, Riad El-Solh, Beirut, 1107 2020, Lebanon
| | - Zeina Kanafani
- Center for Infectious Diseases Research, Faculty of Medicine, American University of Beirut, PO Box: 11-0236, Riad El-Solh, Beirut, 1107 2020, Lebanon
- Division of Infectious Diseases, Department of Internal Medicine, Faculty of Medicine, American University of Beirut, PO Box: 11-0236, Riad El-Solh, Beirut, 1107 2020, Lebanon
| | - Rima Hanna-Wakim
- Center for Infectious Diseases Research, Faculty of Medicine, American University of Beirut, PO Box: 11-0236, Riad El-Solh, Beirut, 1107 2020, Lebanon
- Division of Pediatric Infectious Diseases, Department of Pediatrics and Adolescent Medicine, Faculty of Medicine, American University of Beirut Medical Center, PO Box: 11-0236, Riad El-Solh, Beirut, 1107 2020, Lebanon
| | - George F Araj
- Center for Infectious Diseases Research, Faculty of Medicine, American University of Beirut, PO Box: 11-0236, Riad El-Solh, Beirut, 1107 2020, Lebanon
- Department of Pathology and Laboratory Medicine, Faculty of Medicine, American University of Beirut, PO Box: 11-0236, Riad El-Solh, Beirut, 1107 2020, Lebanon
| | - Rami Mahfouz
- Center for Infectious Diseases Research, Faculty of Medicine, American University of Beirut, PO Box: 11-0236, Riad El-Solh, Beirut, 1107 2020, Lebanon
- Department of Pathology and Laboratory Medicine, Faculty of Medicine, American University of Beirut, PO Box: 11-0236, Riad El-Solh, Beirut, 1107 2020, Lebanon
| | - Reiko Saito
- Department of Public Health at Niigata University, Niigata, Japan
| | - Hiroshi Suzuki
- Department of Public Health at Niigata University, Niigata, Japan
| | - Hassan Zaraket
- Center for Infectious Diseases Research, Faculty of Medicine, American University of Beirut, PO Box: 11-0236, Riad El-Solh, Beirut, 1107 2020, Lebanon.
- Department of Experimental Pathology, Immunology & Microbiology, Faculty of Medicine, American University of Beirut, PO Box: 11-0236, Riad El-Solh, Beirut, 1107 2020, Lebanon.
| | - Ghassan S Dbaibo
- Center for Infectious Diseases Research, Faculty of Medicine, American University of Beirut, PO Box: 11-0236, Riad El-Solh, Beirut, 1107 2020, Lebanon.
- Division of Pediatric Infectious Diseases, Department of Pediatrics and Adolescent Medicine, Faculty of Medicine, American University of Beirut Medical Center, PO Box: 11-0236, Riad El-Solh, Beirut, 1107 2020, Lebanon.
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21
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Luo HJ, Huang XB, Zhong HL, Ye CX, Tan X, Zhou K, Yuan L, Zhang SF, Zhu X, Lin CJ, Wang WJ, Xu L, Cao KY. Epidemiological characteristics and phylogenic analysis of human respiratory syncytial virus in patients with respiratory infections during 2011-2016 in southern China. Int J Infect Dis 2019; 90:5-17. [PMID: 31634614 PMCID: PMC7110755 DOI: 10.1016/j.ijid.2019.10.009] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2019] [Revised: 10/06/2019] [Accepted: 10/11/2019] [Indexed: 12/25/2022] Open
Abstract
For respiratory syncytial virus (RSV), an annual distribution pattern of 2-year RSV-A dominance followed by a 1-year RSV-B dominance was found in Guangzhou. In 2011–2016 in south China, prevalent RSV-A genotypes were NA1 and ON1 and the prevalent RSV-B genotype was BA9. The prevalent RSV-A genotype changed from Chongqing NA1 in 2011 to Hong Kong ON1 in 2014. The highest RSV epidemic peak occurred in 2015, indicating a possible biennial peak. The ongoing evolution of RSV-A ON1 and NA1 genotypes indicated high selection pressure.
Background Human respiratory syncytial virus (RSV) is one of the most important pathogens that cause acute respiratory infections in children and immunocompromised adults. This work was conducted to understand the epidemiological and phylogenetic features of RSV in southern China during 2011–2016. Methods A total of 16 024 nasopharyngeal swabs were collected from patients with respiratory infections in 14 hospitals, and screened for RSV and seven other respiratory viruses using real-time PCR. Six hundred and twenty-three RSV-positive samples from 13 hospitals were further analyzed for subtypes. G gene sequencing and phylogenetic analysis were performed based on 46 RSV-A and 15 RSV-B strains. Results RSV was detected in 9.5% of the 16 024 specimens, the highest among the eight respiratory viruses screened. Most of these specimens came from inpatients and children under 3 years of age. The incidence of RSV-A (9.4%) was higher than that of RSV-B (4.4%) in children (<15 years), but not in adults (0.64% vs. 0.58%). A 2-year RSV-A dominance followed by a 1-year RSV-B dominance pattern was found. The co-detection rate of RSV was 25.1%. The main prevalent genotypes were NA1, ON1, and BA9. The prevalent RSV-A genotype in 2011–2012 was NA1, close to Chongqing and Brazil, but a new Hong Kong ON1 genotype was introduced and became the prevalent genotype in Guangzhou in 2014–2015. Deduced amino acid sequence analysis confirmed the ongoing evolution and a high selection pressure of RSV-A and B strains, especially in RSV-A ON1 and NA1 genotypes. Conclusions This study demonstrated the molecular epidemiological characteristics of RSV in patients with respiratory infections in southern China.
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Affiliation(s)
- Hong-Jiao Luo
- Department of Obstetrics and Gynecology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, 510120, China; Department of Microbiology, Zhongshan School of Medicine, Sun Yat-sen University, Guangzhou, 510080, China; Key Laboratory of Tropical Disease Control, Ministry of Education, Sun Yat-sen University, Guangzhou, 510080, China; Sun Yat-sen University - University of Hong Kong Joint Laboratory of Infectious Disease Surveillance, Sun Yat-sen University, Guangzhou, 510080, China.
| | - Xu-Bin Huang
- Department of Pulmonary and Critical Care Medicine, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, 510080, China.
| | - Hui-Ling Zhong
- Department of Obstetrics and Gynecology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, 510120, China; Department of Microbiology, Zhongshan School of Medicine, Sun Yat-sen University, Guangzhou, 510080, China; Key Laboratory of Tropical Disease Control, Ministry of Education, Sun Yat-sen University, Guangzhou, 510080, China; Sun Yat-sen University - University of Hong Kong Joint Laboratory of Infectious Disease Surveillance, Sun Yat-sen University, Guangzhou, 510080, China.
| | - Cong-Xiu Ye
- Department of Dermatovenereology, The Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, 510630, China.
| | - Xin Tan
- Department of Obstetrics and Gynecology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, 510120, China.
| | - Kai Zhou
- Department of Microbiology, Zhongshan School of Medicine, Sun Yat-sen University, Guangzhou, 510080, China; Key Laboratory of Tropical Disease Control, Ministry of Education, Sun Yat-sen University, Guangzhou, 510080, China; Sun Yat-sen University - University of Hong Kong Joint Laboratory of Infectious Disease Surveillance, Sun Yat-sen University, Guangzhou, 510080, China.
| | - Lei Yuan
- Department of Microbiology, Zhongshan School of Medicine, Sun Yat-sen University, Guangzhou, 510080, China; Key Laboratory of Tropical Disease Control, Ministry of Education, Sun Yat-sen University, Guangzhou, 510080, China; Sun Yat-sen University - University of Hong Kong Joint Laboratory of Infectious Disease Surveillance, Sun Yat-sen University, Guangzhou, 510080, China.
| | - Su-Fen Zhang
- Department of Microbiology, Zhongshan School of Medicine, Sun Yat-sen University, Guangzhou, 510080, China; Key Laboratory of Tropical Disease Control, Ministry of Education, Sun Yat-sen University, Guangzhou, 510080, China; Sun Yat-sen University - University of Hong Kong Joint Laboratory of Infectious Disease Surveillance, Sun Yat-sen University, Guangzhou, 510080, China.
| | - Xun Zhu
- Department of Microbiology, Zhongshan School of Medicine, Sun Yat-sen University, Guangzhou, 510080, China; Key Laboratory of Tropical Disease Control, Ministry of Education, Sun Yat-sen University, Guangzhou, 510080, China; Sun Yat-sen University - University of Hong Kong Joint Laboratory of Infectious Disease Surveillance, Sun Yat-sen University, Guangzhou, 510080, China.
| | - Cui-Ji Lin
- Department of Microbiology, Zhongshan School of Medicine, Sun Yat-sen University, Guangzhou, 510080, China; Key Laboratory of Tropical Disease Control, Ministry of Education, Sun Yat-sen University, Guangzhou, 510080, China; Sun Yat-sen University - University of Hong Kong Joint Laboratory of Infectious Disease Surveillance, Sun Yat-sen University, Guangzhou, 510080, China.
| | - Wen-Jun Wang
- Department of Obstetrics and Gynecology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, 510120, China.
| | - Lin Xu
- Department of Microbiology, Zhongshan School of Medicine, Sun Yat-sen University, Guangzhou, 510080, China; Key Laboratory of Tropical Disease Control, Ministry of Education, Sun Yat-sen University, Guangzhou, 510080, China; Sun Yat-sen University - University of Hong Kong Joint Laboratory of Infectious Disease Surveillance, Sun Yat-sen University, Guangzhou, 510080, China.
| | - Kai-Yuan Cao
- Department of Microbiology, Zhongshan School of Medicine, Sun Yat-sen University, Guangzhou, 510080, China; Key Laboratory of Tropical Disease Control, Ministry of Education, Sun Yat-sen University, Guangzhou, 510080, China; Sun Yat-sen University - University of Hong Kong Joint Laboratory of Infectious Disease Surveillance, Sun Yat-sen University, Guangzhou, 510080, China.
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22
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Guo Z, Lou Y, Kong M, Luo Q, Liu Z, Wu J. A Systematic Review of Phytochemistry, Pharmacology and Pharmacokinetics on Astragali Radix: Implications for Astragali Radix as a Personalized Medicine. Int J Mol Sci 2019; 20:E1463. [PMID: 30909474 PMCID: PMC6470777 DOI: 10.3390/ijms20061463] [Citation(s) in RCA: 72] [Impact Index Per Article: 14.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2019] [Accepted: 03/20/2019] [Indexed: 12/17/2022] Open
Abstract
Astragali radix (AR) is one of the most widely used traditional Chinese herbal medicines. Modern pharmacological studies and clinical practices indicate that AR possesses various biological functions, including potent immunomodulation, antioxidant, anti-inflammation and antitumor activities. To date, more than 200 chemical constituents have been isolated and identified from AR. Among them, isoflavonoids, saponins and polysaccharides are the three main types of beneficial compounds responsible for its pharmacological activities and therapeutic efficacy. After ingestion of AR, the metabolism and biotransformation of the bioactive compounds were extensive in vivo. The isoflavonoids and saponins and their metabolites are the major type of constituents absorbed in plasma. The bioavailability barrier (BB), which is mainly composed of efflux transporters and conjugating enzymes, is expected to have a significant impact on the bioavailability of AR. This review summarizes studies on the phytochemistry, pharmacology and pharmacokinetics on AR. Additionally, the use of AR as a personalized medicine based on the BB is also discussed, which may provide beneficial information to achieve a better and more accurate therapeutic response of AR in clinical practice.
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Affiliation(s)
- Zhenzhen Guo
- Joint Laboratory for Translational Cancer Research of Chinese Medicine of the Ministry of Education of the People's Republic of China, International Institute for Translational Chinese Medicine, Guangzhou University of Chinese Medicine, Guangzhou, Guangdong 510006, China.
| | - Yanmei Lou
- Joint Laboratory for Translational Cancer Research of Chinese Medicine of the Ministry of Education of the People's Republic of China, International Institute for Translational Chinese Medicine, Guangzhou University of Chinese Medicine, Guangzhou, Guangdong 510006, China.
| | - Muyan Kong
- Joint Laboratory for Translational Cancer Research of Chinese Medicine of the Ministry of Education of the People's Republic of China, International Institute for Translational Chinese Medicine, Guangzhou University of Chinese Medicine, Guangzhou, Guangdong 510006, China.
| | - Qing Luo
- Joint Laboratory for Translational Cancer Research of Chinese Medicine of the Ministry of Education of the People's Republic of China, International Institute for Translational Chinese Medicine, Guangzhou University of Chinese Medicine, Guangzhou, Guangdong 510006, China.
| | - Zhongqiu Liu
- Joint Laboratory for Translational Cancer Research of Chinese Medicine of the Ministry of Education of the People's Republic of China, International Institute for Translational Chinese Medicine, Guangzhou University of Chinese Medicine, Guangzhou, Guangdong 510006, China.
- State Key Laboratory of Quality Research in Chinese Medicine, Macau University of Science and Technology, Macau (SAR) 999078, China.
| | - Jinjun Wu
- Joint Laboratory for Translational Cancer Research of Chinese Medicine of the Ministry of Education of the People's Republic of China, International Institute for Translational Chinese Medicine, Guangzhou University of Chinese Medicine, Guangzhou, Guangdong 510006, China.
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23
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Soudani N, Caniza MA, Assaf-Casals A, Shaker R, Lteif M, Su Y, Tang L, Akel I, Muwakkit S, Chmaisse A, Homsi M, Dbaibo G, Zaraket H. Prevalence and characteristics of acute respiratory virus infections in pediatric cancer patients. J Med Virol 2019; 91:1191-1201. [PMID: 30763464 PMCID: PMC7166696 DOI: 10.1002/jmv.25432] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2018] [Revised: 01/30/2019] [Accepted: 02/12/2019] [Indexed: 01/09/2023]
Abstract
Background Patients with pediatric cancer have a higher risk of morbidity and mortality because of respiratory viral infections than other patient populations. Objectives To investigate the causative viruses of respiratory infections and their burden among patients with pediatric cancer in Lebanon. Study design Nasopharyngeal swabs along with clinical and demographic data were collected from patients with pediatric cancer presenting febrile episodes with upper respiratory tract symptoms. Total nucleic acid was extracted from specimens followed by the real‐time PCR analysis targeting 14 respiratory viruses to estimate the frequency of infections. Results We obtained 89 nasopharyngeal swabs from patients with pediatric cancer (mean age, 5.8 ± 4.2 years). Real‐time PCR confirmed viral infection in 77 swabs (86.5%). Among these, 151 respiratory viruses were detected. Several viruses cocirculated within the same period; respiratory syncytial virus (RSV) being the most common (45.45%), followed by parainfluenza virus (PIV; 26%), influenza type B (26%), human metapneumovirus (24.6%), and human coronavirus (HCoV; 24.6%). Coinfections were detected in 55% of the subjects, and most of them involved RSV with one or more other viruses. A strong correlation was found between PIV, Flu (influenza of any type), RSV, and HCoV with the incidence of coinfections. RSV was associated with lower respiratory tract infections, nasal congestion, bronchitis, and bacteremia. HCoV was associated with bronchiolitis; rhinovirus was associated with hospital admission. Conclusion Patients with pediatric cancer have a high burden of respiratory viral infections and a high incidence of coinfections. Molecular diagnostics can improve management of febrile episodes and reduce antibiotic use. Respiratory viruses are leading cause of ARTI in pediatric cancer patients. Coinfections are common among febrile pediatric cancer patients. RSV was the most common in mono‐ and coinfections among pediatric cancer patients. RSV, PIV, Flu, HCoV are associated with coinfections. Molecular diagnostics permit rapid and sensitive diagnostics and limit antibiotic abuse.
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Affiliation(s)
- Nadia Soudani
- Department of Experimental Pathology, Immunology and Microbiology, American University of Beirut Faculty of Medicine, Beirut, Lebanon.,Center for Infectious Diseases Research, American University of Beirut Faculty of Medicine, Beirut, Lebanon.,Department of Biology, Faculty of Sciences, EDST, Lebanese University, Lebanon
| | - Miguela A Caniza
- Department of Infectious Diseases, St Jude Children's Research Hospital, Memphis, Tennessee.,Department of Global Pediatric Medicine, St Jude Children's Research Hospital, Memphis, Tennessee
| | - Aia Assaf-Casals
- Center for Infectious Diseases Research, American University of Beirut Faculty of Medicine, Beirut, Lebanon.,Department of Pediatrics and Adolescent Medicine, American University of Beirut Faculty of Medicine, Beirut, Lebanon
| | - Rouba Shaker
- Center for Infectious Diseases Research, American University of Beirut Faculty of Medicine, Beirut, Lebanon.,Department of Pediatrics and Adolescent Medicine, American University of Beirut Faculty of Medicine, Beirut, Lebanon
| | - Mireille Lteif
- Center for Infectious Diseases Research, American University of Beirut Faculty of Medicine, Beirut, Lebanon.,Department of Pediatrics and Adolescent Medicine, American University of Beirut Faculty of Medicine, Beirut, Lebanon
| | - Yin Su
- Department of Biostatistics, St Jude Children's Research Hospital, Memphis, Tennessee
| | - Li Tang
- Department of Biostatistics, St Jude Children's Research Hospital, Memphis, Tennessee
| | - Imad Akel
- Center for Infectious Diseases Research, American University of Beirut Faculty of Medicine, Beirut, Lebanon.,Department of Pediatrics and Adolescent Medicine, American University of Beirut Faculty of Medicine, Beirut, Lebanon
| | - Samar Muwakkit
- Department of Pediatrics and Adolescent Medicine, American University of Beirut Faculty of Medicine, Beirut, Lebanon.,Children's Cancer Center of Lebanon, American University of Beirut, Beirut, Lebanon
| | - Ahmad Chmaisse
- Department of Experimental Pathology, Immunology and Microbiology, American University of Beirut Faculty of Medicine, Beirut, Lebanon.,Center for Infectious Diseases Research, American University of Beirut Faculty of Medicine, Beirut, Lebanon
| | - Maysam Homsi
- Department of Global Pediatric Medicine, St Jude Children's Research Hospital, Memphis, Tennessee
| | - Ghassan Dbaibo
- Center for Infectious Diseases Research, American University of Beirut Faculty of Medicine, Beirut, Lebanon.,Department of Pediatrics and Adolescent Medicine, American University of Beirut Faculty of Medicine, Beirut, Lebanon
| | - Hassan Zaraket
- Department of Experimental Pathology, Immunology and Microbiology, American University of Beirut Faculty of Medicine, Beirut, Lebanon.,Center for Infectious Diseases Research, American University of Beirut Faculty of Medicine, Beirut, Lebanon
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