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La EM, Bunniran S, Garbinsky D, Reynolds M, Schwab P, Poston S, Harrington L. Respiratory syncytial virus knowledge, attitudes, and perceptions among adults in the United States. Hum Vaccin Immunother 2024; 20:2303796. [PMID: 38297921 PMCID: PMC10841020 DOI: 10.1080/21645515.2024.2303796] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2023] [Accepted: 01/07/2024] [Indexed: 02/02/2024] Open
Abstract
Respiratory syncytial virus (RSV) is associated with considerable morbidity and mortality among older adults (aged ≥60 years) and adults with certain chronic conditions in the United States (US). Despite this burden, no previous studies have assessed the knowledge, attitudes, and perceptions (KAP) of RSV among these populations. This study evaluates RSV-related KAP among US adults at increased risk of severe RSV infection. A cross-sectional, web-based survey was administered from May to June 2022 to better understand respiratory infection- and RSV-related KAP among US adults who are at risk of severe RSV infection. The survey included ≥200 adults in each of 4 subgroups: adults aged 60-89 years, and adults aged 18-59 years with ≥1 chronic cardiovascular condition, chronic pulmonary condition, or diabetes mellitus. Survey responses were analyzed descriptively overall and by subgroup, with exploratory logistic regression modeling used to evaluate characteristics associated with RSV awareness and concern. Among the 827 survey respondents, only 43.3% had ever heard of RSV (n = 358/827). The study identified key knowledge gaps (e.g. bacterial vs. viral nature of respiratory infections, RSV seasonality, common RSV symptoms, extent to which RSV causes respiratory infections in specific patient populations). Although 33.7% of RSV-aware adults (n = 120/356) reported being worried/very worried about RSV, 67.3% (n = 241/358) rarely consider RSV as a potential cause of their cold/flu-like symptoms. Results from this study highlight important knowledge gaps related to RSV, perceived risk, and severity of RSV. Findings can be used to support the development of tailored education efforts to support RSV prevention.
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Affiliation(s)
| | - Su Bunniran
- RTI Health Solutions, Research Triangle Park, NC, USA
| | | | | | - Phil Schwab
- RTI Health Solutions, Research Triangle Park, NC, USA
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Tąpolska-Jóźwiak K, Gowin E, Pasieka A, Wasiak A, Stasik P, Łoś A, Sobkowiak P, Kycler Z, Jończyk-Potoczna K, Wojsyk-Banaszak I. Increasing incidence of severe complicated pneumonia in children caused by Streptococcus pyogenes. Pediatr Pulmonol 2024; 59:1836-1839. [PMID: 38558518 DOI: 10.1002/ppul.26991] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/18/2024] [Revised: 03/13/2024] [Accepted: 03/17/2024] [Indexed: 04/04/2024]
Affiliation(s)
- Katarzyna Tąpolska-Jóźwiak
- Department of Pediatric Pneumonology, Allergology and Clinical Immunology, Institute of Pediatrics, Poznan University of Medical Sciences, Poznan, Poland
| | - Ewelina Gowin
- Health Promotion Department, Poznan University of Medical Sciences, Greater Poland Pediatric Center, Poznan, Poland
| | - Anna Pasieka
- Department of Pediatric Pneumonology, Allergology and Clinical Immunology, Institute of Pediatrics, Poznan University of Medical Sciences, Poznan, Poland
| | - Agata Wasiak
- Department of Pediatric Pneumonology, Allergology and Clinical Immunology, Institute of Pediatrics, Poznan University of Medical Sciences, Poznan, Poland
| | | | - Agnieszka Łoś
- Central Laboratory, Karol Jonscher's Clinical Hospital, Poznan University of Medical Sciences, Poznan, Poland
| | - Paulina Sobkowiak
- Department of Pediatric Pneumonology, Allergology and Clinical Immunology, Institute of Pediatrics, Poznan University of Medical Sciences, Poznan, Poland
| | - Zdzisława Kycler
- Department of Pediatric Pneumonology, Allergology and Clinical Immunology, Institute of Pediatrics, Poznan University of Medical Sciences, Poznan, Poland
| | - Katarzyna Jończyk-Potoczna
- Department of Pediatric Radiology, Institute of Pediatrics, Poznan University of Medical Sciences, Poznan, Poland
| | - Irena Wojsyk-Banaszak
- Department of Pediatric Pneumonology, Allergology and Clinical Immunology, Institute of Pediatrics, Poznan University of Medical Sciences, Poznan, Poland
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Chen Q, Zheng X, Shi H, Zhou Q, Hu H, Sun M, Xu Y, Zhang X. Prediction of influenza outbreaks in Fuzhou, China: comparative analysis of forecasting models. BMC Public Health 2024; 24:1399. [PMID: 38796443 PMCID: PMC11127308 DOI: 10.1186/s12889-024-18583-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2023] [Accepted: 04/12/2024] [Indexed: 05/28/2024] Open
Abstract
BACKGROUND Influenza is a highly contagious respiratory disease that presents a significant challenge to public health globally. Therefore, effective influenza prediction and prevention are crucial for the timely allocation of resources, the development of vaccine strategies, and the implementation of targeted public health interventions. METHOD In this study, we utilized historical influenza case data from January 2013 to December 2021 in Fuzhou to develop four regression prediction models: SARIMA, Prophet, Holt-Winters, and XGBoost models. Their predicted performance was assessed by using influenza data from the period from January 2022 to December 2022 in Fuzhou. These models were used for fitting and prediction analysis. The evaluation metrics, including Mean Squared Error (MSE), Root Mean Squared Error (RMSE), and Mean Absolute Error (MAE), were employed to compare the performance of these models. RESULTS The results indicate that the epidemic of influenza in Fuzhou exhibits a distinct seasonal and cyclical pattern. The influenza cases data displayed a noticeable upward trend and significant fluctuations. In our study, we employed SARIMA, Prophet, Holt-Winters, and XGBoost models to predict influenza outbreaks in Fuzhou. Among these models, the XGBoost model demonstrated the best performance on both the training and test sets, yielding the lowest values for MSE, RMSE, and MAE among the four models. CONCLUSION The utilization of the XGBoost model significantly enhances the prediction accuracy of influenza in Fuzhou. This study makes a valuable contribution to the field of influenza prediction and provides substantial support for future influenza response efforts.
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Affiliation(s)
- Qingquan Chen
- The Affiliated Fuzhou Center for Disease Control and Prevention of Fujian Medical University, Fuzhou, 350005, China
- The School of Public Health, Fujian Medical University, Fuzhou, 350108, China
| | - Xiaoyan Zheng
- The Affiliated Fuzhou Center for Disease Control and Prevention of Fujian Medical University, Fuzhou, 350005, China
- The School of Public Health, Fujian Medical University, Fuzhou, 350108, China
| | - Huanhuan Shi
- The Affiliated Fuzhou Center for Disease Control and Prevention of Fujian Medical University, Fuzhou, 350005, China
- The School of Public Health, Fujian Medical University, Fuzhou, 350108, China
| | - Quan Zhou
- The Affiliated Fuzhou Center for Disease Control and Prevention of Fujian Medical University, Fuzhou, 350005, China
- The School of Public Health, Fujian Medical University, Fuzhou, 350108, China
| | - Haiping Hu
- The Affiliated Fuzhou Center for Disease Control and Prevention of Fujian Medical University, Fuzhou, 350005, China
- The School of Public Health, Fujian Medical University, Fuzhou, 350108, China
| | - Mengcai Sun
- The Affiliated Fuzhou Center for Disease Control and Prevention of Fujian Medical University, Fuzhou, 350005, China
- The School of Public Health, Fujian Medical University, Fuzhou, 350108, China
| | - Youqiong Xu
- The Affiliated Fuzhou Center for Disease Control and Prevention of Fujian Medical University, Fuzhou, 350005, China.
- The School of Public Health, Fujian Medical University, Fuzhou, 350108, China.
| | - Xiaoyang Zhang
- The Affiliated Fuzhou Center for Disease Control and Prevention of Fujian Medical University, Fuzhou, 350005, China.
- The School of Public Health, Fujian Medical University, Fuzhou, 350108, China.
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Wang CR. Epidemic characteristics and changing trend of enterovirus infections in the context of prevention and control of COVID-19 epidemic. WORLD CHINESE JOURNAL OF DIGESTOLOGY 2024; 32:254-260. [DOI: 10.11569/wcjd.v32.i4.254] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 04/28/2024]
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Shmueli M, Lendner I, Ben-Shimol S. Effect of the COVID-19 pandemic on the pediatric infectious disease landscape. Eur J Pediatr 2024; 183:1001-1009. [PMID: 37726566 DOI: 10.1007/s00431-023-05210-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/22/2023] [Revised: 09/11/2023] [Accepted: 09/15/2023] [Indexed: 09/21/2023]
Abstract
This narrative review aims to present an overview of the COVID-19 pandemic's effects on the landscape of pediatric infectious diseases. While COVID-19 generally results in mild symptoms and a favorable prognosis in children, the pandemic brought forth significant consequences. These included persistent symptoms among infected children ("long COVID"), a profound transformation in healthcare utilization (notably through the widespread adoption of telemedicine), and the implementation of optimization strategies within healthcare settings. Furthermore, the pandemic resulted in alterations in the circulation patterns of respiratory pathogens, including influenza, RSV, and Streptococcus pneumoniae. The possible reasons for those changes are discussed in this review. COVID-19 effect was not limited to respiratory infectious diseases, as other diseases, including urinary tract and gastrointestinal infections, have displayed decreased transmission rates, likely attributable to heightened hygiene measures and shifts in care-seeking behaviors. Finally, the disruption of routine childhood vaccination programs has resulted in reduced immunization coverage and an upsurge in vaccine hesitancy. In addition, the pandemic was associated with issues of antibiotic misuse and over-prescription. Conclusion: In conclusion, the COVID-19 pandemic has left a profound and multifaceted impact on the landscape of pediatric infectious diseases, ranging from the emergence of "long COVID" in children to significant changes in healthcare delivery, altered circulation patterns of various pathogens, and concerning disruptions in vaccination programs and antibiotic usage. What is Known: • COVID-19 usually presents with mild symptoms in children, although severe and late manifestations are possible. • The pandemic resulted in a dramatically increased use of health care services, as well as alterations in the circulation patterns of respiratory pathogens, decreased rates of other, non-respiratory, infections, disruption of routine childhood vaccination programs, and antibiotic misuse. What is New: • Possible strategies to tackle future outbreaks are presented, including changes in health care services utilization, implementation of updated vaccine programs and antibiotic stewardship protocols. • The decline in RSV and influenza circulation during COVID-19 was probably not primarily related to NPI measures, and rather related to other, non-NPI measures implementation, including specific pathogen-host interactions on the level of the biological niche (the nasopharynx).
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Affiliation(s)
- Moshe Shmueli
- Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer Sheva, Israel
| | - Idan Lendner
- Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer Sheva, Israel
- Pediatric Department B, Soroka University Medical Center, Beer-Sheva, Israel
| | - Shalom Ben-Shimol
- Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer Sheva, Israel.
- Pediatric Infectious Disease Unit, Soroka University Medical Center, Beer Sheva, Israel.
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Buonsenso D, Morello R, Mariani F, Mazzoli B, De Rose C, Lazzareschi I, Raffaelli F, Blandino R, Sanguinetti M, Valentini P. Utility of Rapid Nasopharyngeal Swab for Respiratory Pathogens in the Diagnosis of Viral Infections in Children Hospitalized with Fever: A Prospective Validation Study to Improve Antibiotic Use. CHILDREN (BASEL, SWITZERLAND) 2024; 11:225. [PMID: 38397338 PMCID: PMC10887280 DOI: 10.3390/children11020225] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/29/2023] [Revised: 01/31/2024] [Accepted: 02/07/2024] [Indexed: 02/25/2024]
Abstract
Introduction: Fever is among the most common reason for medical assessment and antibiotic prescription in practice. The aim of this study was to evaluate positive and negative predictive values of rapid nasopharyngeal swabs for respiratory pathogens to discriminate viral from bacterial infections. Methods: We prospectively tested children with signs and/or symptoms of infections (e.g., fever, cough, wheezing, suspected urinary tract infection) admitted to a paediatric department. Following discharge, clinical phenotypes were assigned defining a cohort of children having probable/certain viral infection, probable/certain bacterial infection, other inflammatory conditions or healthy controls. Results: In this study, 190 children were enrolled (50.5% females, median age 30.5 (8-86) months). In total, 102 patients (53.7%) were affected by respiratory viral infections, 16 (8.4%) by bacterial infections, 29 (15.3%) were healthy controls and 43 (22.6%) were affected by another pathological condition manifested with fever. In total, 84.3% of patients classified as viral infection tested positive for viruses, compared with 18.8% of patients with bacterial infection (p < 0.001), 18.6% of patients with other condition (p < 0.001) and 17.2% of control patients (p < 0.001). The positive predictive value of NPSs in the diagnosis of viral infection was 88.6% and the negative predictive value was 75.0%. Conclusion: Our findings suggest that rapid NPS tests for respiratory viruses are a useful tool to confirm viral infections in children with fever and improve antibiotic use.
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Affiliation(s)
- Danilo Buonsenso
- Department of Woman and Child Health and Public Health, Fondazione Policlinico Universitario A. Gemelli IRCCS, 00168 Rome, Italy; (R.M.); (F.M.); (C.D.R.); (I.L.); (P.V.)
- Centro di Salute Globale, Università Cattolica del Sacro Cuore, 00168 Roma, Italy
| | - Rosa Morello
- Department of Woman and Child Health and Public Health, Fondazione Policlinico Universitario A. Gemelli IRCCS, 00168 Rome, Italy; (R.M.); (F.M.); (C.D.R.); (I.L.); (P.V.)
| | - Francesco Mariani
- Department of Woman and Child Health and Public Health, Fondazione Policlinico Universitario A. Gemelli IRCCS, 00168 Rome, Italy; (R.M.); (F.M.); (C.D.R.); (I.L.); (P.V.)
| | - Bianca Mazzoli
- Department of Pediatrics, Catholic University of Rome, 00168 Rome, Italy; (B.M.); (R.B.)
| | - Cristina De Rose
- Department of Woman and Child Health and Public Health, Fondazione Policlinico Universitario A. Gemelli IRCCS, 00168 Rome, Italy; (R.M.); (F.M.); (C.D.R.); (I.L.); (P.V.)
| | - Ilaria Lazzareschi
- Department of Woman and Child Health and Public Health, Fondazione Policlinico Universitario A. Gemelli IRCCS, 00168 Rome, Italy; (R.M.); (F.M.); (C.D.R.); (I.L.); (P.V.)
| | - Francesca Raffaelli
- Dipartimento di Scienze di Laboratorio e Infettivologiche, Fondazione Policlinico Universitario A. Gemelli IRCCS, 00168 Rome, Italy; (F.R.); (M.S.)
| | - Rita Blandino
- Department of Pediatrics, Catholic University of Rome, 00168 Rome, Italy; (B.M.); (R.B.)
| | - Maurizio Sanguinetti
- Dipartimento di Scienze di Laboratorio e Infettivologiche, Fondazione Policlinico Universitario A. Gemelli IRCCS, 00168 Rome, Italy; (F.R.); (M.S.)
- Dipartimento di Scienze Biotecnologiche di Base, Cliniche Intensivologiche e Perioperatorie, Sezione di Microbiologia, Università Cattolica del Sacro Cuore, 00168 Rome, Italy
| | - Piero Valentini
- Department of Woman and Child Health and Public Health, Fondazione Policlinico Universitario A. Gemelli IRCCS, 00168 Rome, Italy; (R.M.); (F.M.); (C.D.R.); (I.L.); (P.V.)
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Chen D, Zhang T, Chen S, Ru X, Shao Q, Ye Q, Cheng D. The effect of nonpharmaceutical interventions on influenza virus transmission. Front Public Health 2024; 12:1336077. [PMID: 38389947 PMCID: PMC10881707 DOI: 10.3389/fpubh.2024.1336077] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2023] [Accepted: 01/23/2024] [Indexed: 02/24/2024] Open
Abstract
Background The use of nonpharmaceutical interventions (NPIs) during severe acute respiratory syndrome 2019 (COVID-19) outbreaks may influence the spread of influenza viruses. This study aimed to evaluate the impact of NPIs against SARS-CoV-2 on the epidemiological features of the influenza season in China. Methods We conducted a retrospective observational study analyzing influenza monitoring data obtained from the China National Influenza Center between 2011 and 2023. We compared the changes in influenza-positive patients in the pre-COVID-19 epidemic, during the COVID-19 epidemic, and post-COVID-19 epidemic phases to evaluate the effect of NPIs on influenza virus transmission. Results NPIs targeting COVID-19 significantly suppressed influenza activity in China from 2019 to 2022. In the seventh week after the implementation of the NPIs, the number of influenza-positive patients decreased by 97.46% in southern regions of China and 90.31% in northern regions of China. However, the lifting of these policies in December 2022 led to an unprecedented surge in influenza-positive cases in autumn and winter from 2022 to 2023. The percentage of positive influenza cases increased by 206.41% (p < 0.001), with high positivity rates reported in both the northern and southern regions of China. Conclusion Our findings suggest that NPIs against SARS-CoV-2 are effective at controlling influenza epidemics but may compromise individuals' immunity to the virus.
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Affiliation(s)
- Danlei Chen
- School of Medical Technology and Informatlon Engineering, Zhejiang Chinese Medical University, Hangzhou, China
- Department of Laboratory Medicine, Children's Hospital, Zhejiang University School of Medicine, National Clinical Research Center for Child Health, National Children's Regional Medical Center, Hangzhou, China
| | - Ting Zhang
- School of Medical Technology and Informatlon Engineering, Zhejiang Chinese Medical University, Hangzhou, China
| | - Simiao Chen
- Department of Laboratory Medicine, Children's Hospital, Zhejiang University School of Medicine, National Clinical Research Center for Child Health, National Children's Regional Medical Center, Hangzhou, China
| | - Xuanwen Ru
- Department of Laboratory Medicine, Children's Hospital, Zhejiang University School of Medicine, National Clinical Research Center for Child Health, National Children's Regional Medical Center, Hangzhou, China
| | - Qingyi Shao
- School of Medical Technology and Informatlon Engineering, Zhejiang Chinese Medical University, Hangzhou, China
- Department of Laboratory Medicine, Children's Hospital, Zhejiang University School of Medicine, National Clinical Research Center for Child Health, National Children's Regional Medical Center, Hangzhou, China
| | - Qing Ye
- Department of Laboratory Medicine, Children's Hospital, Zhejiang University School of Medicine, National Clinical Research Center for Child Health, National Children's Regional Medical Center, Hangzhou, China
| | - Dongqing Cheng
- School of Medical Technology and Informatlon Engineering, Zhejiang Chinese Medical University, Hangzhou, China
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Abushahin A, Toma H, Alnaimi A, Abu-Hasan M, Alneirab A, Alzoubi H, Belavendra A, Janahi I. Impact of COVID‑19 pandemic restrictions and subsequent relaxation on the prevalence of respiratory virus hospitalizations in children. BMC Pediatr 2024; 24:91. [PMID: 38302912 PMCID: PMC10835825 DOI: 10.1186/s12887-024-04566-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/13/2023] [Accepted: 01/15/2024] [Indexed: 02/03/2024] Open
Abstract
BACKGROUND The COVID-19 pandemic and the consequently adopted worldwide control measures have resulted in global changes in the epidemiology and severity of other respiratory viruses. We compared the number and severity of viral acute lower respiratory tract infection (ALRTI) hospitalizations and determined changes in causative respiratory pathogens before, during, and after the pandemic among young children in Qatar. METHODS In this single-center retrospective study, we reviewed data of children ≤ 36 months old who were admitted to Sidra Medicine in Qatar with a viral ALRTI during winter seasons (September-April) between 2019 and 2023. The study period was divided into three distinct seasons based on the pandemic-imposed restrictions as follows: (1) the period between September 2019 and April 2020 was considered the pre-COVID-19 pandemic season; (2) the periods between September 2020 and April 2021, and the period between January and April 2022 were considered the COVID-19 pandemic seasons; and (3) the periods between September 2022 and April 2023 was considered the post-COVID-19 pandemic season. RESULTS During the COVID-19 season, 77 patients were admitted, compared with 153 patients during the pre-COVID-19 season and 230 patients during the post-COVID-19 season. RSV was the dominant virus during the pre-COVID-19 season, with a detection rate of 50.9%. RSV infection rate dropped significantly during the COVID-19 season to 10.4% and then increased again during the post-COVID-19 season to 29.1% (P < 0.001). Rhinovirus was the dominant virus during the COVID-19 (39.1%) and post-COVID-19 seasons (61%) compared to the pre-COVID-19 season (31.4%) (P < 0.001). The average length of hospital stay was significantly longer in the post-COVID-19 season than in the pre-COVID-19 and COVID-19 seasons (P < 0.001). No significant differences in the pediatric intensive care unit (PICU) admission rate (P = 0.22), PICU length of stay (p = 0.479), or respiratory support requirements were detected between the three seasons. CONCLUSION Our study showed reduced viral ALRTI hospitalizations in Qatar during the COVID-19 pandemic with reduced RSV detection. An increase in viral ALRTI hospitalizations accompanied by a resurgence of RSV circulation following the relaxation of COVID-19 restrictions was observed without changes in disease severity.
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Affiliation(s)
- Ahmed Abushahin
- Department of Pediatric Medicine, Division of Pulmonology, Sidra Medicine, Doha, Qatar.
- Weill Cornel Medicine-Qatar (WCM-Q), Doha, Qatar.
| | - Haneen Toma
- Department of Pediatric Medicine, Division of Pulmonology, Sidra Medicine, Doha, Qatar
| | - Amal Alnaimi
- Department of Pediatric Medicine, Division of Pulmonology, Sidra Medicine, Doha, Qatar
- Weill Cornel Medicine-Qatar (WCM-Q), Doha, Qatar
| | - Mutasim Abu-Hasan
- Department of Pediatric Medicine, Division of Pulmonology, Sidra Medicine, Doha, Qatar
| | - Abdullah Alneirab
- Department of Pediatric Medicine, Division of Pulmonology, Sidra Medicine, Doha, Qatar
| | - Hadeel Alzoubi
- Department of Pediatric Medicine, Division of Pulmonology, Sidra Medicine, Doha, Qatar
| | - Antonisamy Belavendra
- Department of Pediatric Medicine, Division of Pulmonology, Sidra Medicine, Doha, Qatar
| | - Ibrahim Janahi
- Department of Pediatric Medicine, Division of Pulmonology, Sidra Medicine, Doha, Qatar
- Weill Cornel Medicine-Qatar (WCM-Q), Doha, Qatar
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Buonsenso D, Ferro V, Viozzi F, Morello R, Proli F, Bersani G, Lazzareschi I, Santangelo R, Sanguinetti M, Fiori B, Zampino G, Valentini P. Changes in clinical, demographic, and outcome patterns of children hospitalized with non-SARS-CoV-2 viral low respiratory tract infections before and during the COVID pandemic in Rome, Italy. Pediatr Pulmonol 2024; 59:362-370. [PMID: 37937896 DOI: 10.1002/ppul.26755] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/25/2023] [Revised: 10/24/2023] [Accepted: 11/01/2023] [Indexed: 11/09/2023]
Abstract
INTRODUCTION We performed this study aiming to evaluate changes in epidemiology, clinical presentation and outcomes of children hospitalized for viral lower respiratory tract infections (LRTI). METHODS We performed a retrospective study of children younger than 18 years of age hospitalized for LRTIs with a positive respiratory viral testing from 2018 to 2022. We compared need of pediatric intensive care unit (PICU), invasive ventilation, and other respiratory support, viral etiologies, clinical presentations, imaging, and laboratory results in the precovid (2018-2019) and covid (2020-2022) period. RESULTS A total of 523 were included in the analysis. In the pandemic period, the detection of influenza was 95% less likely to occur (odds ratio [OR]: 0.05; 95% confidence interval [95% CI]: 0.02-0.12; p < .001), likewise the detection of adenovirus was 77% less likely to occur (OR: 0.23; 95% CI: 0.10-0.51; p < .001). In the pandemic period, the number of codetections increased from 15.52% in 2018 to 57.25% in 2022, resulting in a significantly increasing trend (p < .001). The odds of transfer to PICU was more than five times greater during the pandemic period (OR: 5.31; 95% CI: 1.78-15.86; p = .003). CONCLUSIONS We found that the pattern of LRTI in children during COVID-19 pandemic significantly changed in terms of etiologies and increased severity.
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Affiliation(s)
- Danilo Buonsenso
- Department of Woman and Child Health, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
- Centro di Salute Globale, Università Cattolica del Sacro Cuore, Roma, Italia
| | - Valentina Ferro
- Department of Emergency, Acceptance and General Pediatrics, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy
| | - Francesca Viozzi
- Medicine and Surgery, Università Cattolica del Sacro Cuore, Roma, Italia
| | - Rosa Morello
- Department of Woman and Child Health, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
| | - Francesco Proli
- Department of Woman and Child Health, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
| | - Giulia Bersani
- Department of Woman and Child Health, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
| | - Ilaria Lazzareschi
- Department of Woman and Child Health, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
| | | | - Maurizio Sanguinetti
- Dipartimento di Scienze di Laboratorio e Infettivologiche, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
- Dipartimento di Scienze Biotecnologiche di Base, Cliniche Intensivologiche e Perioperatorie-Sezione di Microbiologia, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Barbara Fiori
- Dipartimento di Scienze di Laboratorio e Infettivologiche, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
| | - Giuseppe Zampino
- Department of Woman and Child Health, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
| | - Piero Valentini
- Department of Woman and Child Health, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
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Lai A, Bergna A, Fabiano V, Ventura CD, Fumagalli G, Mari A, Loiodice M, Zuccotti GV, Zehender G. Epidemiology and molecular analyses of respiratory syncytial virus in the 2021-2022 season in northern Italy. Front Microbiol 2024; 14:1327239. [PMID: 38239726 PMCID: PMC10794773 DOI: 10.3389/fmicb.2023.1327239] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2023] [Accepted: 11/28/2023] [Indexed: 01/22/2024] Open
Abstract
Background Human respiratory syncytial virus (RSV) is the leading cause of acute lower respiratory tract infection among infants and young children worldwide, with seasonal peaks in January and February. This study aimed to characterize the RSV samples from a pediatric cohort in the 2021-2022 season in Italy. Methods In total, 104 samples were collected from pediatric patients attending the "Vittore Buzzi" Children's Hospital in Milan, Italy in the 2021-2022 season. RT-PCR and next-generation sequencing were used to discriminate subgroups and obtain whole genomes. Maximum likelihood and Bayesian phylogenetic methods were used to analyze Italian sequences in the European contest and date Italian clusters. Results The median age was 78 days, and 76.9% of subjects required hospitalization, with a higher proportion of patients under 3 months of age. An equal proportion of subgroups A (GA2.3.5) and B (GB5.0.5a) was found, with significant differences in length of hospitalization, days of supplemental oxygen treatment, and intravenous hydration duration. Phylogeny highlighted 26 and 37 clusters containing quite the total of Italian sequences for RSV-A and -B, respectively. Clusters presented a tMRCA between December 2011-February 2017 and May 2014-December 2016 for A and B subgroups, respectively. Compared to European sequences, specific mutations were observed in Italian strains. Conclusion These data confirmed a more severe clinical course of RSV-A, particularly in young children. This study permitted the characterization of recent Italian RSV whole genomes, highlighting the peculiar pattern of mutations that needs to be investigated further and monitored.
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Affiliation(s)
- Alessia Lai
- Department of Biomedical and Clinical Sciences, University of Milan, Milan, Italy
| | - Annalisa Bergna
- Department of Biomedical and Clinical Sciences, University of Milan, Milan, Italy
| | - Valentina Fabiano
- Department of Biomedical and Clinical Sciences, University of Milan, Milan, Italy
- Pediatric Department, "Vittore Buzzi" Children's Hospital, Milan, Italy
| | - Carla della Ventura
- Department of Biomedical and Clinical Sciences, University of Milan, Milan, Italy
| | - Giulia Fumagalli
- Department of Biomedical and Clinical Sciences, University of Milan, Milan, Italy
| | - Alessandra Mari
- Pediatric Department, "Vittore Buzzi" Children's Hospital, Milan, Italy
| | - Martina Loiodice
- Pediatric Department, "Vittore Buzzi" Children's Hospital, Milan, Italy
| | - Gian Vincenzo Zuccotti
- Department of Biomedical and Clinical Sciences, University of Milan, Milan, Italy
- Pediatric Department, "Vittore Buzzi" Children's Hospital, Milan, Italy
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11
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Miron VD, Raianu RO, Filimon C, Craiu M. Clinical Differences between SARS-CoV-2 and RSV Infections in Infants: Findings from a Case-Control Study. Viruses 2023; 16:63. [PMID: 38257763 PMCID: PMC10819890 DOI: 10.3390/v16010063] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2023] [Revised: 12/27/2023] [Accepted: 12/29/2023] [Indexed: 01/24/2024] Open
Abstract
Infants are a unique pediatric group due to their high hospitalization rates and unfavorable outcomes from acute infectious diseases. Understanding the clinical differences and aftereffects of SARS-CoV-2 in comparison to other prevalent viruses in this age group, like RSV, is crucial for effective management. We conducted a retrospective case-control study of infants hospitalized with SARS-CoV-2 or respiratory syncytial virus (RSV) infection in one year, in a tertiary pediatric hospital in Bucharest, Romania. A total of 188 infants were included in the analysis in a 1:1 ratio (94 with SARS-CoV-2 infection and 94 with RSV infection). Infants with COVID-19 were 10.2 times more likely to have fever (p < 0.001) and 2.4 times more likely to have diarrhea (p = 0.016). Conversely, infants with RSV were 2.5 times more likely to have a cough (p < 0.001), 3.0 times more likely to have nasal congestion (p < 0.001), and 14.7 times more likely to present with dyspnea (p < 0.001). Increased lymphocyte count was more common in infants with RSV (p = 0.008), while lymphopenia was more frequent in infants with SARS-CoV-2 (p = 0.011). The median length of hospital stay was one day longer in infants with RSV infection (5 days vs. 4 days). Overall, infants with RSV infection had a 27.3-fold increased risk of developing respiratory failure (p < 0.001), while infants with COVID-19 had a 5.8-fold increased risk of laryngitis (p = 0.003). Our findings suggest that infants with SARS-CoV-2 infection may present with polymorphic symptoms, mostly dominated by fever, whereas infants with RSV often present with respiratory symptoms. Laboratory differentiation between the two infections is challenging; therefore, the use of rapid antigen or molecular diagnostic tests is crucial for accurate diagnosis, epidemiologically appropriate measures, and effective management. Continued surveillance of both viruses in infants, and beyond, and the implementation of specific control measures are needed to mitigate their impact on this vulnerable pediatric group.
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Affiliation(s)
| | - Raluca-Oana Raianu
- Carol Davila University of Medicine and Pharmacy, 050474 Bucharest, Romania
| | - Claudiu Filimon
- Carol Davila University of Medicine and Pharmacy, 050474 Bucharest, Romania
| | - Mihai Craiu
- Carol Davila University of Medicine and Pharmacy, 050474 Bucharest, Romania
- National Institute for Mother and Child Health “Alessandrescu-Rusescu”, 020395 Bucharest, Romania
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12
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Gnaba S, Sukhachev D, Pascreau T, Ackermann F, Delcominette F, Habarou F, Védrenne A, Jolly E, Sukhacheva E, Farfour E, Vasse M. Can Haematological Parameters Discriminate COVID-19 from Influenza? J Clin Med 2023; 13:186. [PMID: 38202193 PMCID: PMC10780240 DOI: 10.3390/jcm13010186] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2023] [Revised: 12/18/2023] [Accepted: 12/25/2023] [Indexed: 01/12/2024] Open
Abstract
Symptoms of COVID-19 are similar to the influenza virus, but because treatments and prognoses are different, it is important to accurately and rapidly differentiate these diseases. The aim of this study was to evaluate whether the analysis of complete blood count (CBC), including cellular population (CPD) data of leukocytes and automated flow cytometry analysis, could discriminate these pathologies. In total, 350 patients with COVID-19 and 102 patients with influenza were included between September 2021 and April 2022 in the tertiary hospital of Suresnes (France). Platelets were lower in patients with influenza than in patients with COVID-19, whereas the CD16pos monocyte count and the ratio of the CD16pos monocytes/total monocyte count were higher. Significant differences were observed for 9/56 CPD of COVID-19 and flu patients. A logistic regression model with 17 parameters, including among them 11 CPD, the haemoglobin level, the haematocrit, the red cell distribution width, and B-lymphocyte and CD16pos monocyte levels, discriminates COVID-19 patients from flu patients. The sensitivity and efficiency of the model were 96.2 and 86.6%, respectively, with an area under the curve of 0.862. Classical parameters of CBC are very similar among the three infections, but CPD, CD16pos monocytes, and B-lymphocyte levels can discriminate patients with COVID-19.
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Affiliation(s)
- Sahar Gnaba
- Biology Department, Foch Hospital, 92150 Suresnes, France; (S.G.); (T.P.); (F.D.); (F.H.); (A.V.); (E.J.); (E.F.)
| | | | - Tiffany Pascreau
- Biology Department, Foch Hospital, 92150 Suresnes, France; (S.G.); (T.P.); (F.D.); (F.H.); (A.V.); (E.J.); (E.F.)
- INSERM Hémostase Inflammation Thrombose HITh U1176, Université Paris-Saclay, 94276 Le Kremlin-Bicêtre, France
| | - Félix Ackermann
- Department of Internal Medicine, Foch Hospital, 92150 Suresnes, France;
| | - Frédérique Delcominette
- Biology Department, Foch Hospital, 92150 Suresnes, France; (S.G.); (T.P.); (F.D.); (F.H.); (A.V.); (E.J.); (E.F.)
| | - Florence Habarou
- Biology Department, Foch Hospital, 92150 Suresnes, France; (S.G.); (T.P.); (F.D.); (F.H.); (A.V.); (E.J.); (E.F.)
| | - Aurélie Védrenne
- Biology Department, Foch Hospital, 92150 Suresnes, France; (S.G.); (T.P.); (F.D.); (F.H.); (A.V.); (E.J.); (E.F.)
| | - Emilie Jolly
- Biology Department, Foch Hospital, 92150 Suresnes, France; (S.G.); (T.P.); (F.D.); (F.H.); (A.V.); (E.J.); (E.F.)
| | | | - Eric Farfour
- Biology Department, Foch Hospital, 92150 Suresnes, France; (S.G.); (T.P.); (F.D.); (F.H.); (A.V.); (E.J.); (E.F.)
| | - Marc Vasse
- Biology Department, Foch Hospital, 92150 Suresnes, France; (S.G.); (T.P.); (F.D.); (F.H.); (A.V.); (E.J.); (E.F.)
- INSERM Hémostase Inflammation Thrombose HITh U1176, Université Paris-Saclay, 94276 Le Kremlin-Bicêtre, France
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13
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Rice E, Oakes DB, Holland C, Moore HC, Blyth CC. Respiratory syncytial virus in children: epidemiology and clinical impact post-COVID-19. Curr Opin Infect Dis 2023; 36:522-528. [PMID: 37830952 DOI: 10.1097/qco.0000000000000967] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/14/2023]
Abstract
PURPOSE OF REVIEW Respiratory syncytial virus (RSV) remains a leading cause of mortality and morbidity worldwide. RSV seasonality was disrupted by COVID-19-associated nonpharmaceutical interventions (NPIs). We review RSV seasonality, molecular epidemiology, clinical manifestations, and community awareness to inform future prevention strategies. RECENT FINDINGS An initial reduction of RSV disease observed with NPIs, and subsequent global resurgence was associated with a collapse in genetic diversity. A lack of immunity is suggested to have contributed to the resurgence of RSV cases experienced post COVID-19. The median age of children admitted with RSV increased during the resurgence, likely secondary to the expanded cohort of RSV-immune naive children. The pandemic also played a role in increased community awareness, which can be utilized as part of a coordinated public health effort to introduce prevention strategies. Further education on signs and symptoms of RSV is still required. SUMMARY mAbs and maternal vaccines targeting RSV have the potential to reduce paediatric morbidity, however this new era of RSV prevention will require ongoing research to facilitate community awareness and engagement, and better respiratory surveillance. Tackling the global burden of RSV will require a coordinated effort and measures to ensure access and affordability of new prevention strategies.
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Affiliation(s)
- Emily Rice
- Department of General Paediatrics, Perth Children's Hospital, Hospital Avenue
- Wesfarmers Centre of Vaccines and Infectious Diseases, Telethon Kids Institute, University of Western Australia
| | - Daniel B Oakes
- Wesfarmers Centre of Vaccines and Infectious Diseases, Telethon Kids Institute, University of Western Australia
| | - Charlie Holland
- Wesfarmers Centre of Vaccines and Infectious Diseases, Telethon Kids Institute, University of Western Australia
- School of Population Health, Curtin University
| | - Hannah C Moore
- Wesfarmers Centre of Vaccines and Infectious Diseases, Telethon Kids Institute, University of Western Australia
- School of Population Health, Curtin University
| | - Christopher C Blyth
- Wesfarmers Centre of Vaccines and Infectious Diseases, Telethon Kids Institute, University of Western Australia
- Department of Infectious Diseases, Perth Children's Hospital, Hospital Avenue
- School of Medicine, University of Western Australia
- Department of Microbiology, PathWest Laboratory Medicine, QEII Medical Centre, Perth, Western Australia
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14
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Meslé MMI, Sinnathamby M, Mook P, Pebody R. Seasonal and inter-seasonal RSV activity in the European Region during the COVID-19 pandemic from autumn 2020 to summer 2022. Influenza Other Respir Viruses 2023; 17:e13219. [PMID: 38025589 PMCID: PMC10661829 DOI: 10.1111/irv.13219] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2023] [Revised: 10/10/2023] [Accepted: 10/11/2023] [Indexed: 12/01/2023] Open
Abstract
Background The emergence of the Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) in early 2020 and subsequent implementation of public health and social measures (PHSM) disrupted the epidemiology of respiratory viruses. This work describes the epidemiology of respiratory syncytial virus (RSV) observed during two winter seasons (weeks 40-20) and inter-seasonal periods (weeks 21-39) during the pandemic between October 2020 and September 2022. Methods Using data submitted to The European Surveillance System (TESSy) by countries or territories in the World Health Organization (WHO) European Region between weeks 40/2020 and 39/2022, we aggregated country-specific weekly RSV counts of sentinel, non-sentinel and Severe Acute Respiratory Infection (SARI) surveillance specimens and calculated percentage positivity. Results for both 2020/21 and 2021/22 seasons and inter-seasons were compared with pre-pandemic 2016/17 to 2019/20 seasons and inter-seasons. Results Although more specimens were tested than in pre-COVID-19 pandemic seasons, very few RSV detections were reported during the 2020/21 season in all surveillance systems. During the 2021 inter-season, a gradual increase in detections was observed in all systems. In 2021/22, all systems saw early peaks of RSV infection, and during the 2022 inter-seasonal period, patterns of detections were closer to those seen before the COVID-19 pandemic. Conclusion RSV surveillance continued throughout the COVID-19 pandemic, with an initial reduction in transmission, followed by very high and out-of-season RSV circulation (summer 2021) and then an early start of the 2021/22 season. As of the 2022/23 season, RSV circulation had not yet normalised.
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Affiliation(s)
| | - Mary Sinnathamby
- World Health Organization (WHO) Regional Office for EuropeCopenhagenDenmark
| | - Piers Mook
- World Health Organization (WHO) Regional Office for EuropeCopenhagenDenmark
| | | | - Richard Pebody
- World Health Organization (WHO) Regional Office for EuropeCopenhagenDenmark
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15
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Meister TL, Friesland M, Frericks N, Wetzke M, Haid S, Steinmann J, Todt D, Pietschmann T, Steinmann E. Virucidal activity of oral, hand, and surface disinfectants against respiratory syncytial virus. J Hosp Infect 2023; 141:25-32. [PMID: 37625461 DOI: 10.1016/j.jhin.2023.08.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2023] [Revised: 08/11/2023] [Accepted: 08/20/2023] [Indexed: 08/27/2023]
Abstract
BACKGROUND Respiratory syncytial virus (RSV) is known as a major cause of respiratory tract infection in adults and children. Human-to-human transmission occurs via droplets as well as direct and indirect contact (e.g. contaminated surfaces or hands of medical staff). Therefore, applicable hygiene measures and knowledge about viral inactivation are of utmost importance. AIM To elucidate the disinfection profile of RSV. METHODS The study evaluated the virucidal efficacy of oral rinses specifically designed for children, World Health Organization (WHO)-recommended hand-rub formulations, and ethanol, as well as 2-propanol against RSV in a quantitative suspension test (EN14476). The stability of RSV on stainless steel discs was assessed and its inactivation by different surface disinfectants (EN16777) investigated. FINDINGS All tested oral rinses except one reduced infectious viral titres to the lower limit of quantification. The two WHO-recommended hand-rub formulations as well as 30% ethanol and 2-propanol completely abolished the detection of infectious virus. Infectious RSV was recovered after several days on stainless steel discs. However, RSV was efficiently inactivated by all tested surface disinfectants based on alcohol, aldehyde, or hydrogen peroxide. CONCLUSION Oral rinses, all tested hand-rub formulations as well as surface inactivation reagents were sufficient for RSV inactivation in vitro.
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Affiliation(s)
- T L Meister
- Department for Molecular & Medical Virology, Ruhr University Bochum, Bochum, Germany
| | - M Friesland
- Institute for Experimental Virology, TWINCORE, Centre for Experimental and Clinical Infection Research, Hannover, Germany
| | - N Frericks
- Department for Molecular & Medical Virology, Ruhr University Bochum, Bochum, Germany
| | - M Wetzke
- Clinic for Paediatric Pneumology, Allergology, and Neonatology, Hannover Medical School, German Center for Lung Research, Hannover, Germany
| | - S Haid
- Institute for Experimental Virology, TWINCORE, Centre for Experimental and Clinical Infection Research, Hannover, Germany
| | - J Steinmann
- Institute of Clinical Hygiene, Medical Microbiology and Infectiology, General Hospital Nürnberg, Paracelsus Medical University, Nuremberg, Germany; Institute of Medical Microbiology, University Hospital of Essen, Essen, Germany
| | - D Todt
- Department for Molecular & Medical Virology, Ruhr University Bochum, Bochum, Germany; European Virus Bioinformatics Center (EVBC), Jena, Germany
| | - T Pietschmann
- Institute for Experimental Virology, TWINCORE, Centre for Experimental and Clinical Infection Research, Hannover, Germany; German Center for Infection Research (DZIF), Partner Site Hannover-Braunschweig, Hannover, Germany; Cluster of Excellence RESIST (EXC 2155), Hannover Medical School, Hannover, Germany
| | - E Steinmann
- Department for Molecular & Medical Virology, Ruhr University Bochum, Bochum, Germany; German Centre for Infection Research (DZIF), External Partner Site, Bochum, Germany.
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16
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Ramirez MM, Zarate MN, Rodriguez LA, Aquino VH. Performance evaluation of Biofire Film Array Respiratory Panel 2.1 for SARS-CoV-2 detection in a pediatric hospital setting. PLoS One 2023; 18:e0292314. [PMID: 37797063 PMCID: PMC10553804 DOI: 10.1371/journal.pone.0292314] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2023] [Accepted: 09/18/2023] [Indexed: 10/07/2023] Open
Abstract
The highly contagious nature of the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), the causative agent of Coronavirus Disease 2019 (COVID-19), requires rapid diagnostic tests to prevent the virus from spreading within hospitals and communities. Reverse transcription followed by the polymerase chain reaction (RT-PCR) test is the gold standard for detecting SARS-CoV-2 infections but is time-consuming, labor-intensive, and restricted to centralized laboratories. There is a growing need to develop and implement point-of-care and rapid tests for SARS-CoV-2 detection to address these limitations. We aimed to evaluate the performance of BioFire Film Array Respiratory Panel 2.1 (BioFire FA-RP2.1) for SARS-CoV-2 detection in a pediatric hospital setting. The BioFire FA-RP2.1 test provides rapid results and can identify several viral and bacterial infections in a single test. This prospective, cross-sectional, diagnostic accuracy study enrolled participants ranging from 0 to 18 years of age, seeking medical consultation for any reason, who had been in contact with individuals confirmed to have COVID-19 or managed at the hospital for medical or surgical reasons. We employed a systematic sampling technique to ensure a representative sample. The study included 339 participants with a median age of 5 years. The BioFire FA-RP2.1 test detected SARS-CoV-2 in 18.6% of cases, while the reference RT-PCR test in 14% of cases. The BioFire FA-RP2.1 sensitivity and specificity for SARS CoV-2 detection were 98% and 94%, respectively. The positive probability coefficient (LR+) was 18. The agreement between the two tests was 0.80. In addition, the BioFire FA-RP2.1 test detected coinfection with two viruses in 7,6% of cases. The BioFire FA-RP2.1 is a reliable solution to meet pediatric healthcare needs and improve prognosis in the post-pandemic era thanks to its friendly interface and rapid testing process.
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Affiliation(s)
| | - Miria Noemi Zarate
- General Pediatric Hospital “Children of Acosta Ñu,” San Lorenzo, Central, Paraguay
| | | | - Victor Hugo Aquino
- Immunology Department, Research Institute for Health Sciences, National University of Asuncion, San Lorenzo, Central, Paraguay
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17
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Cozzi G, Sovtic A, Garelli D, Krivec U, Silvagni D, Corsini I, Colombo M, Giangreco M, Giannattasio A, Milani GP, Minute M, Marchetti F, Gatto A, Debbia C, Gortan AJ, Massaro M, Hatziagorou E, Ravidà D, Diamand R, Jones E, Visekruna J, Zago A, Barbi E, Amaddeo A, Cortellazzo Wiel L. SARS-CoV-2-related bronchiolitis: a multicentre international study. Arch Dis Child 2023; 108:e15. [PMID: 37130726 DOI: 10.1136/archdischild-2023-325448] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/09/2023] [Accepted: 04/17/2023] [Indexed: 05/04/2023]
Abstract
BACKGROUND Bronchiolitis is the main acute lower respiratory tract infection in infants. Data regarding SARS-CoV-2-related bronchiolitis are limited. OBJECTIVE To describe the main clinical characteristics of infants with SARS-CoV-2-related bronchiolitis in comparison with infants with bronchiolitis associated with other viruses. SETTING, PATIENTS, INTERVENTIONS A multicentre retrospective study was conducted in 22 paediatric emergency departments (PED) in Europe and Israel. Infants diagnosed with bronchiolitis, who had a test for SARS-CoV-2 and were kept in clinical observation in the PED or admitted to hospital from 1 May 2021 to 28 February 2022 were considered eligible for participation. Demographic and clinical data, diagnostic tests, treatments and outcomes were collected. MAIN OUTCOME MEASURES The main outcome was the need for respiratory support in infants testing positive for SARS-CoV-2 compared with infants testing negative. RESULTS 2004 infants with bronchiolitis were enrolled. Of these, 95 (4.7%) tested positive for SARS-CoV-2. Median age, gender, weight, history of prematurity and presence of comorbidities did not differ between the SARS-CoV-2-positive and SARS-CoV-2-negative infants. Human metapneumovirus and respiratory syncytial virus were the viruses most frequently detected in the group of infants negative for SARS-CoV-2.Infants testing positive for SARS-CoV-2 received oxygen supplementation less frequently compared with SARS-CoV-2-negative patients, 37 (39%) vs 1076 (56.4%), p=0.001, OR 0.49 (95% CI 0.32 to 0.75). They received less ventilatory support: 12 (12.6%) high flow nasal cannulae vs 468 (24.5%), p=0.01; 1 (1.0%) continuous positive airway pressure vs 125 (6.6%), p=0.03, OR 0.48 (95% CI 0.27 to 0.85). CONCLUSIONS SARS-CoV-2 rarely causes bronchiolitis in infants. SARS-CoV-2-related bronchiolitis mostly has a mild clinical course.
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Affiliation(s)
- Giorgio Cozzi
- Institute for Maternal and Child Health IRCCS "Burlo Garofolo", Trieste, Italy
| | - Aleksandar Sovtic
- Institute for Health Protection of Mother and Child of Serbia 'Dr Vukan Cupic', Beograd, Serbia
- University of Belgrade Faculty of Medicine, Beograd, Serbia
| | | | - Uros Krivec
- Department of Pediatric Pulmology, University Children's Hospital Ljubljana, Ljubljana, Slovenia
- Department of Pediatrics, Faculty of Medicine, University of Ljubljana, Ljubljana, Slovenia
| | - Davide Silvagni
- Azienda Ospedaliera Universitaria Integrata Verona, Verona, Italy
| | - Ilaria Corsini
- IRCCS Policlinico Ospedaliero Universitario di Bologna, Bologna, Italy
| | - Marco Colombo
- Pediatric Emergency Deparment, Ospedale Filippo del Ponte, ASST Sette Laghi, Varese, Italy
| | - Manuela Giangreco
- Clinical Epidemiology and Public Health Research Unit, Institute for Maternal and Child Health, IRCCS "Burlo Garofolo", Trieste, Italy
| | | | - Gregorio Paolo Milani
- Paediatric Emergency Department, Foundation IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
- Department of Clinical Science and Community Health, University of Milan, Milan, Italy
| | - Marta Minute
- Ospedale Regionale Ca Foncello Treviso, Treviso, Italy
| | | | - Antonio Gatto
- Department of Pediatrics, Fondazione Policlinico Universitario "A. Gemelli" IRCCS, Rome, Italy
| | - Carla Debbia
- Emergency Departement, IRCCS Istituto Giannina Gaslini, Genova, Italy
| | | | - Marta Massaro
- Ospedale Santa Maria degli Angeli di Pordenone, Pordenone, Italy
| | - Elpis Hatziagorou
- Pediatric Pulmonology Unit, 3rd Pediatric Dept, Hippokration Hospital of Thessaloniki, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Domenico Ravidà
- Institute of Pediatrics of Southern Switzerland, EOC, Bellinzona, Switzerland
| | - Raz Diamand
- Ruth Rappaport Children's Hospital, Haifa, Israel
| | | | - Jelena Visekruna
- Institute for Health Protection of Mother and Child of Serbia 'Dr Vukan Cupic', Beograd, Serbia
| | | | - Egidio Barbi
- Institute for Maternal and Child Health IRCCS "Burlo Garofolo", Trieste, Italy
- University of Trieste, Trieste, Italy
| | - Alessandro Amaddeo
- Institute for Maternal and Child Health IRCCS "Burlo Garofolo", Trieste, Italy
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18
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Numata M, Kandasamy P, Voelker DR. The anti-inflammatory and antiviral properties of anionic pulmonary surfactant phospholipids. Immunol Rev 2023; 317:166-186. [PMID: 37144896 PMCID: PMC10524216 DOI: 10.1111/imr.13207] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2023] [Revised: 04/06/2023] [Accepted: 04/10/2023] [Indexed: 05/06/2023]
Abstract
The pulmonary surfactant system of the lung is a lipid and protein complex, which regulates the biophysical properties of the alveoli to prevent lung collapse and the innate immune system in the lung. Pulmonary surfactant is a lipoprotein complex consisting of 90% phospholipids and 10% protein, by weight. Two minor components of pulmonary surfactant phospholipids, phosphatidylglycerol (PG) and phosphatidylinositol (PI), exist at very high concentrations in the extracellular alveolar compartments. We have reported that one of the most dominant molecular species of PG, palmitoyl-oleoyl-phosphatidylglycerol (POPG) and PI inhibit inflammatory responses induced by multiple toll-like receptors (TLR2/1, TLR3, TLR4, and TLR2/6) by interacting with subsets of multiprotein receptor components. These lipids also exert potent antiviral effects against RSV and influenza A, in vitro, by inhibiting virus binding to host cells. POPG and PI inhibit these viral infections in vivo, in multiple animal models. Especially noteworthy, these lipids markedly attenuate SARS-CoV-2 infection including its variants. These lipids are natural compounds that already exist in the lung and, thus, are less likely to cause adverse immune responses by hosts. Collectively, these data demonstrate that POPG and PI have strong potential as novel therapeutics for applications as anti-inflammatory compounds and preventatives, as treatments for broad ranges of RNA respiratory viruses.
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Affiliation(s)
- Mari Numata
- Department of Medicine, National Jewish Health, Denver, CO 80206
- Division of Pulmonary, Critical Care and Sleep Medicine, National Jewish Health, Denver, CO 80206
| | - Pitchaimani Kandasamy
- Department of Medicine, National Jewish Health, Denver, CO 80206
- Division of Pulmonary, Critical Care and Sleep Medicine, National Jewish Health, Denver, CO 80206
| | - Dennis R. Voelker
- Department of Medicine, National Jewish Health, Denver, CO 80206
- Division of Pulmonary, Critical Care and Sleep Medicine, National Jewish Health, Denver, CO 80206
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19
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Sobczak M, Pawliczak R. Which Factors Were Related to the Number of COVID-19 Cases in the 2022/2023 Season Compared to the 2021/2022 Season in Europe? J Clin Med 2023; 12:4517. [PMID: 37445552 DOI: 10.3390/jcm12134517] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2023] [Revised: 07/03/2023] [Accepted: 07/04/2023] [Indexed: 07/15/2023] Open
Abstract
The number of COVID-19 cases was greater in early autumn 2022 in contrast to in autumn 2021. Therefore, we decided to examine the factors that may have affected differences in the number of COVID-19 cases between the time periods 2021/2022 and 2022/2023 with consideration of the occurrence of influenza. In this cross-sectional study, we conducted a multiple factor analysis using data from publicly available databases for weeks 35-14 in 2022/2023 and 2021/2022 for Austria, Germany, Greece, Italy, and Slovenia. In the 2021/2022 season, the analyzed countries had similar profiles and were characterized by restrictions, health system policies, and SARS-CoV-2 variants, such as Alpha, Beta, Delta, Kappa, Eta, as well as Omicron sublineages (BA.1, BA.2), which were positively correlated with the number of new cases of COVID-19 per million people. However, in the 2022/2023 season, the analyzed countries were described by groups of variables corresponding to vaccination, influenza, the number of flights, and the Omicron SARS-CoV-2 subvariant. In summary, crucial factors correlated with the increasing of number of COVID-19 cases in the 2021/2022 season were the presence of dominant SARS-CoV-2 variants as well as the lifting of restrictions and strict health system policies.
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Affiliation(s)
- Marharyta Sobczak
- Department of Immunopathology, Division of Biomedical Science, Faculty of Medicine, Medical University of Lodz, 90-752 Lodz, Poland
| | - Rafał Pawliczak
- Department of Immunopathology, Division of Biomedical Science, Faculty of Medicine, Medical University of Lodz, 90-752 Lodz, Poland
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20
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Mellou K, Tryfinopoulou K, Emmanouil M, Gkolfinopoulou K, Sapounas S, Evangelidou M, Moulopoulou P, Miaoulis E, Angelakis E, Sourvinos G, Zaoutis T, Paraskevis D. Influenza transmission during COVID-19 measures downscaling in Greece, August 2022: evidence for the need of continuous integrated surveillance of respiratory viruses. Euro Surveill 2023; 28:2200754. [PMID: 37440348 PMCID: PMC10347892 DOI: 10.2807/1560-7917.es.2023.28.28.2200754] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2022] [Accepted: 04/05/2023] [Indexed: 07/15/2023] Open
Abstract
After the near absence of influenza and other respiratory viruses during the first 2 years of the COVID-19 pandemic, an increased activity of mainly influenza A(H3N2) was detected at the beginning of August 2022 in Greece on three islands. Of 33 cases with respiratory symptoms testing negative for SARS-CoV-2 with rapid antigen tests, 24 were positive for influenza: 20 as A(H3N2) subtype and four as A(H1N1)pdm09 subtype. Phylogenetic analysis of selected samples from both subtypes was performed and they fell into clusters within subclades that included the 2022/23 vaccine strains. Our data suggest that influenza can be transmitted even in the presence of another highly infectious pathogen, such as SARS-CoV-2, with a similar transmission mode. We highlight the need for implementing changes in the current influenza surveillance and suggest a move from seasonal to continuous surveillance, especially in areas with a high number of tourists. Year-round surveillance would allow for a timelier start of vaccination campaigns and antiviral drugs procurement processes.
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Affiliation(s)
| | | | - Mary Emmanouil
- Diagnostic Department and Public Health Laboratories, Hellenic Pasteur Institute, Athens, Greece
| | | | | | - Maria Evangelidou
- Diagnostic Department and Public Health Laboratories, Hellenic Pasteur Institute, Athens, Greece
| | | | | | - Emmanouil Angelakis
- Diagnostic Department and Public Health Laboratories, Hellenic Pasteur Institute, Athens, Greece
| | - George Sourvinos
- Laboratory of Clinical Virology, School of Medicine, University of Crete, Heraklion, Greece
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21
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Yang MC, Su YT, Chen PH, Tsai CC, Lin TI, Wu JR. Changing patterns of infectious diseases in children during the COVID-19 pandemic. Front Cell Infect Microbiol 2023; 13:1200617. [PMID: 37457965 PMCID: PMC10339349 DOI: 10.3389/fcimb.2023.1200617] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2023] [Accepted: 06/19/2023] [Indexed: 07/18/2023] Open
Abstract
Each infectious disease has had its own epidemic pattern and seasonality for decades. However, public health mitigation measures during the coronavirus disease 2019 (COVID-19) pandemic have resulted in changing epidemic patterns of infectious diseases. Stringent measures resulted in low incidences of various infectious diseases during the outbreak of COVID-19, including influenza, respiratory syncytial virus, pneumococcus, enterovirus, and parainfluenza. Owing to the prevalence of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infections and subsequent immunity development, decreasing virulence of SARS-CoV-2, and worldwide immunization against SARS-CoV-2 in children beyond 6 months of age, mitigation measures are lifted country by country. Consequently, the immunity debt to infectious respiratory viruses other than SARS-CoV-2 contributed to the "off-season," "see-saw," and "upsurge" patterns of various infectious diseases in children. Moreover, apart from the persistence of SARS-CoV-2, the coexistence of other circulating viruses or bacterial outbreaks may lead to twindemics or tripledemics during the following years. Therefore, it is necessary to maintain hand hygiene and immunization policies against various pathogens to alleviate the ongoing impact of infectious diseases on children.
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Affiliation(s)
- Ming-Chun Yang
- Department of Pediatrics, E-DA Hospital, I-Shou University, Kaohsiung, Taiwan
- School of Medicine, College of Medicine, I-Shou University, Kaohsiung, Taiwan
| | - Yu-Tsun Su
- Department of Pediatrics, E-DA Hospital, I-Shou University, Kaohsiung, Taiwan
- School of Medicine for International Students, College of Medicine, I-Shou University, Kaohsiung, Taiwan
| | - Ping-Hong Chen
- Department of Pediatrics, E-DA Hospital, I-Shou University, Kaohsiung, Taiwan
| | - Ching-Chung Tsai
- Department of Pediatrics, E-DA Hospital, I-Shou University, Kaohsiung, Taiwan
- School of Medicine for International Students, College of Medicine, I-Shou University, Kaohsiung, Taiwan
| | - Ting-I Lin
- Department of Pediatrics, E-DA Hospital, I-Shou University, Kaohsiung, Taiwan
| | - Jiunn-Ren Wu
- Department of Pediatrics, E-DA Hospital, I-Shou University, Kaohsiung, Taiwan
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22
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Kandeel A, Fahim M, Deghedy O, Roshdy WH, Khalifa MK, Shesheny RE, Kandeil A, Naguib A, Afifi S, Mohsen A, Abdelghaffar K. Resurgence of influenza and respiratory syncytial virus in Egypt following two years of decline during the COVID-19 pandemic: outpatient clinic survey of infants and children, October 2022. BMC Public Health 2023; 23:1067. [PMID: 37277781 DOI: 10.1186/s12889-023-15880-9] [Citation(s) in RCA: 16] [Impact Index Per Article: 16.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2023] [Accepted: 05/11/2023] [Indexed: 06/07/2023] Open
Abstract
INTRODUCTION Two years after unprecedented low rates of circulation of most common respiratory viruses (SARS-CoV-2), the Egyptian ARI surveillance system detected an increase in acute respiratory infections (ARIs) with a reduced circulation of the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), especially among school children. A national survey was conducted to estimate the burden and identify the viral causes of ARIs among children < 16 years of age. METHODS A one-day survey was carried out in 98 governmental outpatient clinics distributed all over Egypt 26 governorates. The four largest referral hospitals in each governorate where most influenza-like illness (ILI) patients seek care were selected. Using the WHO case definition, the first five patients < 16 years of age with ILI symptoms visiting the selected outpatient clinics on the survey day were enrolled. Basic demographic and clinical data of patients were collected using a linelist. Patients were swabbed and tested for SARS-CoV-2, influenza, and Respiratory Syncytial virus (RSV) by RT-PCR at the Central Laboratory in Cairo. RESULTS Overall, 530 patients enrolled, their mean age was 5.8 ± 4.2, 57.1% were males, and 70.2% reside in rural or semi-rural areas. Of all patients, 134 (25.3%) had influenza, 111 (20.9%) RSV, and 14 (2.8%) coinfections. Influenza-positive children were older compared to RSV, (7.2 ± 4.1, 4.3 ± 4.1, p < 0.001), with more than half of them (53.0%) being school students. Dyspnea was reported in RSV more than in influenza (62.2% vs. 49.3%, p < 0.05). Among RSV patients, children < 2 years had a higher rate of dyspnea than others (86.7% vs. 53.1%, < 0.001). CONCLUSIONS A resurgence of influenza and RSV was detected in Egypt in the 2022-2023 winter season. Influenza caused a higher rate of infection than RSV, while RSV caused more severe symptoms than influenza. Monitoring a broader range of respiratory pathogens is recommended to estimate the ARI burden and risky groups for severe disease in Egypt.
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Affiliation(s)
- Amr Kandeel
- Ministry of Health and Population, Cairo, Egypt
| | - Manal Fahim
- Ministry of Health and Population, Cairo, Egypt
| | - Ola Deghedy
- Ministry of Health and Population, Cairo, Egypt
| | - Wael H Roshdy
- Central Public Health Laboratory, Ministry of Health and Population, Cairo, Egypt
| | - Mohamed K Khalifa
- Centre of Scientific Excellence for Influenza Viruses, National Research Centre, 12622, Dokki, Giza, Egypt
| | - Rabeh El Shesheny
- Centre of Scientific Excellence for Influenza Viruses, National Research Centre, 12622, Dokki, Giza, Egypt
| | - Ahmed Kandeil
- Centre of Scientific Excellence for Influenza Viruses, National Research Centre, 12622, Dokki, Giza, Egypt
| | - Amel Naguib
- Central Public Health Laboratory, Ministry of Health and Population, Cairo, Egypt
| | - Salma Afifi
- Consultant Ministry of Health and Population, Cairo, Egypt
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23
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Fyles F, Hill H, Duncan G, Carter E, Solórzano C, Davies K, McLellan L, Lesosky M, Dodd J, Finn A, McNamara PS, Lewis D, Bangert M, Vassilouthis N, Taylor M, Ferreira D, Collins AM. Surveillance towards preventing paediatric incidence of respiratory syncytial virus attributable respiratory tract infection in primary and secondary/tertiary healthcare settings in Merseyside, Cheshire and Bristol, UK. BMJ Open Respir Res 2023; 10:10/1/e001457. [PMID: 37277188 DOI: 10.1136/bmjresp-2022-001457] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2022] [Accepted: 04/28/2023] [Indexed: 06/07/2023] Open
Abstract
INTRODUCTION Respiratory syncytial virus (RSV) is a common respiratory virus, particularly affecting children, and can cause respiratory infections such as croup and bronchiolitis. The latter is a leading cause of paediatric hospitalisation within the UK. Children <3 years of age and/or with underlying health conditions are more vulnerable to severe RSV infection.There are currently limited data on the incidence of laboratory-confirmed RSV, particularly within primary care settings and outside the typical 'RSV season', which in the Northern hemisphere tends to coincide with winter months. There is also a lack of data on the health economic impact of RSV infection on families and healthcare systems.This observational surveillance study aims to collect data on the incidence of laboratory-confirmed RSV-attributable respiratory tract infection (RTI) in children aged <3 years presenting to primary, secondary or tertiary care; it also aims to estimate the health economic and quality of life impact of RSV-attributable infection in this cohort. Such data will contribute to informing public health strategies to prevent RSV-associated infection, including use of preventative medications. METHODS AND ANALYSIS Parents/carers of children <3 years of age with RTI symptoms will consent for a respiratory sample (nasal swab) to be taken. Laboratory PCR testing will assess for the presence of RSV and/or other pathogens. Data will be obtained from medical records on demographics, comorbidities, severity of infection and hospitalisation outcomes. Parents will complete questionnaires on the impact of ongoing infection symptoms at day 14 and 28 following enrolment. The primary outcome is incidence of laboratory-confirmed RSV in children <3 years presenting to primary, secondary or tertiary care with RTI symptoms leading to health-seeking behaviours. Recruitment will be carried out from December 2021 to March 2023, encompassing two UK winter seasons and intervening months. ETHICS AND DISSEMINATION Ethical approval has been granted (21/WS/0142), and study findings will be published as per International Committee of Medical Journal Editors' guidelines.
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Affiliation(s)
- Fred Fyles
- Department of Clinical Sciences, Liverpool School of Tropical Medicine, Liverpool, UK
| | - Helen Hill
- Department of Clinical Sciences, Liverpool School of Tropical Medicine, Liverpool, UK
| | - Gregory Duncan
- Department of Clinical Sciences, Liverpool School of Tropical Medicine, Liverpool, UK
| | - Emma Carter
- Department of Clinical Sciences, Liverpool School of Tropical Medicine, Liverpool, UK
| | - Carla Solórzano
- Department of Clinical Sciences, Liverpool School of Tropical Medicine, Liverpool, UK
| | - Kelly Davies
- Department of Clinical Sciences, Liverpool School of Tropical Medicine, Liverpool, UK
| | - Lauren McLellan
- Department of Clinical Sciences, Liverpool School of Tropical Medicine, Liverpool, UK
| | - Maia Lesosky
- Department of Clinical Sciences, Liverpool School of Tropical Medicine, Liverpool, UK
| | - James Dodd
- Department of Clinical Sciences, Liverpool School of Tropical Medicine, Liverpool, UK
| | - Adam Finn
- University of Bristol Medical School, Bristol, UK
| | - Paul Stephen McNamara
- Department of Child Health, University of Liverpool, Liverpool, UK
- Alder Hey Children's Hospital, Liverpool, UK
| | | | | | | | | | - Daniela Ferreira
- Department of Clinical Sciences, Liverpool School of Tropical Medicine, Liverpool, UK
- Oxford Vaccine Group, University of Oxford, Oxford, UK
| | - Andrea M Collins
- Department of Clinical Sciences, Liverpool School of Tropical Medicine, Liverpool, UK
- Liverpool University Hospitals NHS Foundation Trust, Liverpool, UK
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24
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Buonsenso D, Valentini P, Mariani F, Di Noi S, Mazza S, Palucci I, Sanguinetti M, Sali M. Comparison between Nasopharyngeal and Saliva Samples for the Detection of Respiratory Viruses in Children with Acute Lower Respiratory Tract Infections: A Pilot Study. CHILDREN (BASEL, SWITZERLAND) 2023; 10:children10050899. [PMID: 37238447 DOI: 10.3390/children10050899] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/25/2023] [Revised: 05/15/2023] [Accepted: 05/17/2023] [Indexed: 05/28/2023]
Abstract
PURPOSE During the COVID-19 pandemic, the use of salivary swabs (SS) to detect the SARS-CoV-2 virus has been implemented and widely studied in adults and children. However, the role of SS in detecting other common respiratory viruses in children is poorly investigated. METHODS Children younger than 18 years of age admitted with respiratory signs and symptoms underwent both nasopharyngeal and SS procedures. Sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) of SS were calculated, considering the nasopharyngeal swab result as the gold standard. RESULTS A total of 83 patients (44 females, 53%) underwent both nasopharyngeal and SS procedures. Overall, the sensitivity of SS was 49.4%. Sensitivity according to different respiratory viruses ranged from 0% to 71.43%, while the specificity ranged from 96% to 100%. Negative predictive value ranged from 68.06% to 98.8%, while positive predictive value ranged from 0 to 100%. SS sensitivity in patients younger than 12 months of age was 39.47%, while in patients older than or equal to 12 months of age it was 57.78%. Patients with negative SS had a significantly lower median age (8.5 months (15.25) vs. 23 months (34), p = 0.001) and a significantly lower quantity of median saliva collected for salivary analysis (0 μL (213) vs. 300 μL (100), p < 0.001). CONCLUSIONS SS has a relatively low sensitivity in detecting common respiratory viruses in children with LRTI, with a lower probability in younger children (and in particular those younger than 6 months of age) or those from whom we have collected lesser amounts of saliva. New strategies to improve saliva collection are needed for testing on a larger study population.
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Affiliation(s)
- Danilo Buonsenso
- Department of Woman and Child Health and Public Health, Fondazione Policlinico Universitario A Gemelli IRCCS, 00168 Rome, Italy
- Global Health Research Institute, Istituto di Igiene, Università Cattolica del Sacro Cuore, 00168 Rome, Italy
| | - Piero Valentini
- Department of Woman and Child Health and Public Health, Fondazione Policlinico Universitario A Gemelli IRCCS, 00168 Rome, Italy
| | - Francesco Mariani
- Department of Woman and Child Health and Public Health, Fondazione Policlinico Universitario A Gemelli IRCCS, 00168 Rome, Italy
| | - Silvia Di Noi
- Department of Woman and Child Health and Public Health, Fondazione Policlinico Universitario A Gemelli IRCCS, 00168 Rome, Italy
| | - Sofia Mazza
- Medicine and Surgery, Università Cattolica del Sacro Cuore, 00168 Rome, Italy
| | - Ivana Palucci
- Dipartimento di Scienze Biotecnologiche di Base, Cliniche Intensivologiche e Perioperatorie, Sezione di Microbiologia, Università Cattolica del Sacro Cuore, 00168 Rome, Italy
- Dipartimento di Scienze di Laboratorio e Infettivologiche, Fondazione Policlinico Universitario A Gemelli IRCCS, 00168 Rome, Italy
| | - Maurizio Sanguinetti
- Dipartimento di Scienze Biotecnologiche di Base, Cliniche Intensivologiche e Perioperatorie, Sezione di Microbiologia, Università Cattolica del Sacro Cuore, 00168 Rome, Italy
- Dipartimento di Scienze di Laboratorio e Infettivologiche, Fondazione Policlinico Universitario A Gemelli IRCCS, 00168 Rome, Italy
| | - Michela Sali
- Dipartimento di Scienze Biotecnologiche di Base, Cliniche Intensivologiche e Perioperatorie, Sezione di Microbiologia, Università Cattolica del Sacro Cuore, 00168 Rome, Italy
- Dipartimento di Scienze di Laboratorio e Infettivologiche, Fondazione Policlinico Universitario A Gemelli IRCCS, 00168 Rome, Italy
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25
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Bravo-Queipo-de-Llano B, Sánchez García L, Casas I, Pozo F, La Banda L, Alcolea S, Atucha J, Sánchez-León R, Pellicer A, Calvo C. Surveillance of Viral Respiratory Infections in the Neonatal Intensive Care Unit-Evolution in the Last 5 Years. Pathogens 2023; 12:pathogens12050644. [PMID: 37242314 DOI: 10.3390/pathogens12050644] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2023] [Revised: 04/22/2023] [Accepted: 04/25/2023] [Indexed: 05/28/2023] Open
Abstract
Viral respiratory infections (VRIs) in very low birthweight infants can be associated with high rates of morbidity. The COVID-19 pandemic has exerted a strong impact on viral circulation. The purpose of this study is to report on VRIs during NICU admission in infants below 32 weeks' gestation and compare data collected between the pre-and post-COVID-19 pandemic periods. A prospective surveillance study was conducted at a tertiary NICU between April 2016 and June 2022. The COVID-19 post-pandemic period was established as being from March 2020 onwards. Respiratory virus detection was performed by real-time multiplex PCR assays in nasopharyngeal aspirates (NPAs). A total of 366 infants were enrolled. There were no statistical differences between periods regarding infants' birth weight, gestational age, gender distribution, or rates of bronchopulmonary dysplasia. Among the 1589 NPA collected during the pre-COVID-19 period, 8.9% were positive, and among the 1147 NPA collected during the post-pandemic period, only 3% were positive (p < 0.005). The type of viruses detected did not differ according to the study period (pre-COVID19 vs. post-COVID-19): rhinovirus (49.5% vs. 37.5%), adenovirus (22.6% vs. 25%), and human coronavirus (12.9% vs. 16.7%). SARS-CoV-2 was only detected in one patient. In conclusion, the viral profile causing VRI during the pre-COVID-19 and post-COVID-19 era was similar. However, the total number of VRI dropped significantly, most probably due to the global increase in infection prevention measures.
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Affiliation(s)
- Blanca Bravo-Queipo-de-Llano
- Paediatric Infectious and Tropical Diseases Department, Hospital Universitario La Paz, Hospital La Paz Institute for Health Research (IdiPAZ Foundation), 28046 Madrid, Spain
| | - Laura Sánchez García
- Department of Neonatology, Hospital Universitario La Paz, Hospital La Paz Institute for Health Research (IdiPAZ Foundation), 28046 Madrid, Spain
| | - Inmaculada Casas
- Respiratory Viruses and Influenza Unit, National Centre of Microbiology, 28222 Madrid, Spain
- Centro de Investigación Biomédica en Red en Epidemiología y Salud Pública (CIBERESP), Instituto de Salud Carlos III, 28222 Madrid, Spain
| | - Francisco Pozo
- Respiratory Viruses and Influenza Unit, National Centre of Microbiology, 28222 Madrid, Spain
- Centro de Investigación Biomédica en Red en Epidemiología y Salud Pública (CIBERESP), Instituto de Salud Carlos III, 28222 Madrid, Spain
| | - Leticia La Banda
- Department of Neonatology, Hospital Universitario La Paz, Hospital La Paz Institute for Health Research (IdiPAZ Foundation), 28046 Madrid, Spain
| | - Sonia Alcolea
- Paediatric Infectious and Tropical Diseases Department, Hospital Universitario La Paz, Hospital La Paz Institute for Health Research (IdiPAZ Foundation), 28046 Madrid, Spain
- Centro de Investigación Biomédica en Red en Enfermedades Infecciosas (CIBERINFEC), Instituto de Salud Carlos III, 28222 Madrid, Spain
| | - Jorge Atucha
- Paediatric Infectious and Tropical Diseases Department, Hospital Universitario La Paz, Hospital La Paz Institute for Health Research (IdiPAZ Foundation), 28046 Madrid, Spain
- Centro de Investigación Biomédica en Red en Enfermedades Infecciosas (CIBERINFEC), Instituto de Salud Carlos III, 28222 Madrid, Spain
| | - Rocío Sánchez-León
- Paediatric Infectious and Tropical Diseases Department, Hospital Universitario La Paz, Hospital La Paz Institute for Health Research (IdiPAZ Foundation), 28046 Madrid, Spain
| | - Adelina Pellicer
- Department of Neonatology, Hospital Universitario La Paz, Hospital La Paz Institute for Health Research (IdiPAZ Foundation), 28046 Madrid, Spain
| | - Cristina Calvo
- Paediatric Infectious and Tropical Diseases Department, Hospital Universitario La Paz, Hospital La Paz Institute for Health Research (IdiPAZ Foundation), 28046 Madrid, Spain
- Centro de Investigación Biomédica en Red en Enfermedades Infecciosas (CIBERINFEC), Instituto de Salud Carlos III, 28222 Madrid, Spain
- Traslational Research Network in Pediatric Infectious Diseases (RITIP), Universidad Autónoma de Madrid, 28049 Madrid, Spain
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26
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Brisca G, Mariani M, Buratti S, Ferretti M, Pirlo D, Buffoni I, Mallamaci M, Salvati P, Tagliarini G, Piccotti E, Sacco O, Castagnola E, Moscatelli A. How has the SARS-CoV-2 pandemic changed the epidemiology and management of acute bronchiolitis? Pediatr Pulmonol 2023; 58:1169-1177. [PMID: 36636959 DOI: 10.1002/ppul.26315] [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: 10/19/2022] [Revised: 12/27/2022] [Accepted: 01/12/2023] [Indexed: 01/14/2023]
Abstract
OBJECTIVE SARS-COV-2 pandemic profoundly impacted acute bronchiolitis epidemiology worldwide, especially respiratory syncytial virus (RSV) diffusion and the burden of disease, with remarkable implications on the management of health resources. We aimed to study the epidemiology and clinical course of bronchiolitis in the past 5 years in our region and to assess the trends that occurred during and after the SARS-COV-2 pandemic. METHODS We conducted an observational study including all children aged 0-2 years with bronchiolitis admitted to a tertiary children's hospital during the last 5 years. Demographic, clinical, and microbiological data were collected. Comparisons between patient subgroups were carried out. RESULTS A total of 647 patients admitted for bronchiolitis were included (median age 78 days). Molecular diagnostic tests were performed in 617 patients (95.4%) with RSV detected in 51.5% of patients in prepandemic years and 74.5% in pandemic years. Through the study period, we observed a progressive increase in the number of children requiring respiratory support, RSV infections, and children with a history of prematurity. Conversely, this was not true for mechanical ventilation, duration of respiratory support, intensive care unit admission, and length of stay. CONCLUSIONS Clinical course and epidemiology of bronchiolitis showed a significant change through the study years with a heavy impact during the 2021-2022 season. The increase in the number of patients requiring respiratory support, although not associated with an increase in mechanical ventilation, may be explained by the higher prevalence of RSV. The change in epidemiology highlights the importance of surveillance systems to monitor RSV circulation, to plan prophylactic strategies, and prepare healthcare systems.
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Affiliation(s)
- Giacomo Brisca
- Terapia Semintensiva, Dipartimento di Emergenza, IRCCS Istituto Giannina Gaslini, Genoa, Italy
| | - Marcello Mariani
- Unità di Malattie Infettive e COVID Hospital, Dipartimento di Scienze Pediatriche, IRCCS Istituto Giannina Gaslini, Genoa, Italy
| | - Silvia Buratti
- Terapia Intensiva, Dipartimento di Emergenza, IRCCS Istituto Giannina Gaslini, Genoa, Italy
| | - Marta Ferretti
- Pediatria d'Urgenza e Pronto Soccorso, IRCCS Istituto Giannina Gaslini, Genoa, Italy
| | - Daniela Pirlo
- Terapia Semintensiva, Dipartimento di Emergenza, IRCCS Istituto Giannina Gaslini, Genoa, Italy
| | - Isabella Buffoni
- Terapia Semintensiva, Dipartimento di Emergenza, IRCCS Istituto Giannina Gaslini, Genoa, Italy
| | - Marisa Mallamaci
- Terapia Semintensiva, Dipartimento di Emergenza, IRCCS Istituto Giannina Gaslini, Genoa, Italy
| | - Pietro Salvati
- Pronto Soccorso e Medicina d'Urgenza, Dipartimento di Emergenza, IRCCS Istituto Giannina Gaslini, Genoa, Italy
| | - Giulia Tagliarini
- Unità di Pneumologia Pediatrica e Endoscopica Respiratoria, Dipartimento di Scienze Pediatriche, IRCCS Istituto Giannina Gaslini, Genoa, Italy
| | - Emanuela Piccotti
- Pediatria d'Urgenza e Pronto Soccorso, IRCCS Istituto Giannina Gaslini, Genoa, Italy
| | - Oliviero Sacco
- Pronto Soccorso e Medicina d'Urgenza, Dipartimento di Emergenza, IRCCS Istituto Giannina Gaslini, Genoa, Italy
| | - Elio Castagnola
- Unità di Malattie Infettive e COVID Hospital, Dipartimento di Scienze Pediatriche, IRCCS Istituto Giannina Gaslini, Genoa, Italy
| | - Andrea Moscatelli
- Terapia Semintensiva, Dipartimento di Emergenza, IRCCS Istituto Giannina Gaslini, Genoa, Italy.,Terapia Intensiva, Dipartimento di Emergenza, IRCCS Istituto Giannina Gaslini, Genoa, Italy
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27
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Fotovat L, Chiappelli F. Colliding Pandemics and CoViD-19. Bioinformation 2023; 19:251-254. [PMID: 37808373 PMCID: PMC10557438 DOI: 10.6026/97320630019251] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2023] [Revised: 03/31/2023] [Accepted: 03/31/2023] [Indexed: 10/10/2023] Open
Abstract
Cases of the respiratory syncytial virus (RSV), monkeypox virus (MPXV), and avian influenza A Virus (IAV) have increased during our current prolonged Corona Virus Disease 2019 (CoViD-19) pandemic. The rise of these viral infectious diseases may be associated or even inter-dependent with acute, latent or recurrent infection with Systemic Acute Respiratory Syndrome Corona virus-2 (SARS-CoV2). The nonsensical neologism 'tripledemic' was tentatively introduced to describe the confluent nature of these trends (epidemic comes from two Greek words: epi=on, about, demos=people; pandemic is also derived from Ancient Greek: pan=all, demos=people; but 'tripledemic' would derive from Latin triplus=three, Greek demos=people, and would at best signify 'three countries, three peoples', but certainly not the current threat of confluence of three, or perhaps more pandemics). Emerging evidence suggests that monkey pox and CoViD-19, among several other viral diseases, produce significant observable manifestations in the oral cavity. From a clinical standpoint, dentists and dental personnel may be among the first health professionals to encounter and diagnose clinical signs of converging infections. From the immune surveillance viewpoint, viral recombination and viral interference among these infectious diseases must be examined to determine the potential threat of these colliding pandemics.
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Affiliation(s)
- Lily Fotovat
- Dental Group of Sherman Oaks, CA 91403, USA (www.oliviacajulisdds.com)
| | - Francesco Chiappelli
- Dental Group of Sherman Oaks, CA 91403, USA (www.oliviacajulisdds.com)
- Center for the Health Sciences, UCLA, Los Angeles, CA; Dental Group of Sherman Oaks, CA 91403
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28
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Uwak I, Johnson N, Mustapha T, Rahman M, Tonpay T, Regan AK, Mendoza-Sanchez I. Quantifying changes in respiratory syncytial virus-associated hospitalizations among children in Texas during COVID-19 pandemic using records from 2006 to 2021. Front Pediatr 2023; 11:1124316. [PMID: 36994433 PMCID: PMC10040829 DOI: 10.3389/fped.2023.1124316] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/15/2022] [Accepted: 02/24/2023] [Indexed: 03/31/2023] Open
Abstract
Aim To quantify changes on RSV- associated hospitalizations during COVID-19 pandemic, among children four years of age or younger at the state and county levels of Texas using routinely acquired hospital admission records. Methods We used the Texas Public Use Data Files (PUDF) of the Department of State Human Services (DSHS) to obtain hospital admissions and healthcare outcomes from 2006 to 2021. We used the 2006-2019 period to estimate a long-term temporal trend and predict expected values for 2020-2021. Actual and predicted values were used to quantify changes in seasonal trends of the number of hospital admissions and mean length of hospital stay. Additionally, we calculated hospitalization rates and assessed their similarity to rates reported in the RSV Hospitalization Surveillance Network (RSV-NET). Results An unusually low number of hospitalizations in 2020 was followed by an unusual peak in the third quarter of 2021. Hospital admissions in 2021 were approximately twice those in a typical year. The mean length of hospital stay typically followed a seasonal trend before COVID-19, but increased by a factor of ∼6.5 during the pandemic. Spatial distribution of hospitalization rates revealed localized healthcare infrastructure overburdens during COVID-19. RSV associated hospitalization rates were, on average, two times higher than those of RSV-NET. Conclusion Hospital admission data can be used to estimate long-term temporal and spatial trends and quantify changes during events that exacerbate healthcare systems, such as pandemics. Using the mean difference between hospital rates calculated with hospital admissions and hospital rates obtained from RSV-NET, we speculate that state-level hospitalization rates for 2022 could be at least twice those observed in the two previous years, and the highest in the last 17 years.
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Affiliation(s)
- Inyang Uwak
- Department of Environmental & Occupational Health, Texas A&M University School of Public Health, College Station, TX, United States
| | - Natalie Johnson
- Department of Environmental & Occupational Health, Texas A&M University School of Public Health, College Station, TX, United States
| | - Toriq Mustapha
- Department of Environmental & Occupational Health, Texas A&M University School of Public Health, College Station, TX, United States
| | - Mariya Rahman
- Department of Environmental & Occupational Health, Texas A&M University School of Public Health, College Station, TX, United States
| | - Tanaya Tonpay
- Department of Environmental & Occupational Health, Texas A&M University School of Public Health, College Station, TX, United States
| | - Annette K. Regan
- School of Nursing and Health Professions, University of San Francisco, San Francisco, CA, United States
| | - Itza Mendoza-Sanchez
- Department of Environmental & Occupational Health, Texas A&M University School of Public Health, College Station, TX, United States
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29
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De Rose C, Sopo SM, Buonsenso D. Preventive therapy for childhood asthma and wheezing: Should we change our approach due to disrupted seasonality in viral circulation? Pediatr Pulmonol 2023; 58:959-962. [PMID: 36478418 DOI: 10.1002/ppul.26250] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/10/2022] [Revised: 11/04/2022] [Accepted: 11/13/2022] [Indexed: 12/12/2022]
Affiliation(s)
- Cristina De Rose
- Department of Woman and Child Health and Public Health, Fondazione Policlinico Universitario A. Gemelli, Rome, Italy
| | - Stefano Miceli Sopo
- Department of Woman and Child Health and Public Health, Fondazione Policlinico Universitario A. Gemelli, Rome, Italy.,Department of Life Sciences and Public Health, Pediatric Allergy Unit, Pediatrics Section, Policlinico Gemelli Universitary Foundation IRCCS, Catholic University of Sacre Hearth, Rome, Italy
| | - Danilo Buonsenso
- Department of Woman and Child Health and Public Health, Fondazione Policlinico Universitario A. Gemelli, Rome, Italy.,Dipartimento di Scienze Biotecnologiche di Base, Cliniche Intensivologiche e Perioperatorie, Università Cattolica del Sacro Cuore, Rome, Italy.,Global Health Research Institute, Istituto di Igiene, Università Cattolica del Sacro Cuore, Roma, Italy
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30
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Stein RT, Zar HJ. RSV through the COVID-19 pandemic: Burden, shifting epidemiology, and implications for the future. Pediatr Pulmonol 2023; 58:1631-1639. [PMID: 36811330 DOI: 10.1002/ppul.26370] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/02/2022] [Revised: 01/20/2023] [Accepted: 02/17/2023] [Indexed: 02/24/2023]
Abstract
Respiratory syncytial virus (RSV) represents a major global healthcare burden, particularly in those under 5 years of age. There is no available vaccine, with treatment limited to supportive care or palivizumab for high-risk children. Additionally, although a causal relationship has not been established, RSV has been associated with the development of asthma or wheezing in some children. The COVID-19 pandemic and the introduction of nonpharmaceutical interventions (NPIs) have caused substantial changes to RSV seasonality and epidemiology. Many countries have experienced an absence of RSV during the time of a typical season, followed by an out-of-season surge upon relaxation of NPI use. These dynamics have disrupted traditional RSV disease patterns and assumptions, but also provide a unique opportunity to learn more about the transmission of RSV and other respiratory viruses, as well as inform future approaches to RSV preventive strategies. Here, we review the RSV burden and epidemiology through the COVID-19 pandemic and discuss how new data may affect future decisions regarding RSV prevention.
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Affiliation(s)
- Renato T Stein
- Infant Center, Department of Pediatrics, School of Medicine, Pontifícia Universidade Católica do Rio Grande do Sul, Porto Alegre, Brazil
| | - Heather J Zar
- Department of Paediatrics and Child Health, University of Cape Town, Cape Town, South Africa.,SA-MRC Unit for Child and Adolescent Health, University of Cape Town, Cape Town, South Africa
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31
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Scarponi D, Bedetti L, Zini T, Di Martino M, Cingolani GM, Spaggiari E, Rossi K, Miselli F, Lugli L, Bergamini BM, Iughetti L, Berardi A. COVID-19 restrictions and hygiene measures reduce the rates of respiratory infections and wheezing among preterm infants. ACTA BIO-MEDICA : ATENEI PARMENSIS 2023; 94:e2023032. [PMID: 36786261 PMCID: PMC9987504 DOI: 10.23750/abm.v94i1.13596] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Received: 08/19/2022] [Accepted: 08/21/2022] [Indexed: 02/15/2023]
Abstract
BACKGROUND AND AIM During the 2020 and 2021 Italian COVID-19 pandemic social restrictions and strict hygiene measures were recommended to limit the spread of SARS-CoV-2. We aimed to assess whether rates of respiratory infections and wheezing in preterm infants have changed during the pandemic. METHODS Single center, retrospective study. Preterm infants in the first 6 months of life discharged home prior to (Period 1, January 2017 - December 2019) or during the pandemic (Period 2, January 2020 - March 2021) were compared. Rates of respiratory infection and wheezing in preterm infants with or without bronchopulmonary dysplasia (BDP) were assessed. RESULTS During period 2 premature infants had lower rates of respiratory infections (36 out of 55 in Period 1 vs 11 out of 28 in Period 2, P=0.023) and wheezing (20 out of 55 in Period 1 vs 1 out of 28 in Period 2, P=0.001). This difference remained significant when infants with BPD (all grades) were analyzed separately (respiratory infections 26 out of 40 in Period 1 vs 7 out of 24 in Period 2, P=0.005; wheezing 16 out of 40 in Period 1 vs 1 out of 24 in Period 2, P=0.001). In contrast, respiratory infections and wheezing in preterm infants without BPD did not change after pandemic. CONCLUSIONS Episodes of respiratory infections and wheezing among preterm infants were reduced during pandemic. We highlight the importance of proper family education for preventing respiratory tract infections in preterm infants with BPD, beyond the extraordinary conditions of the COVID-19 pandemic.
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Affiliation(s)
- Davide Scarponi
- "Post-graduate School of Pediatrics, Department of Medical and Surgical Sciences of Mothers, Children and Adults, University of Modena and Reggio Emilia, Modena (Italy)"..
| | - Luca Bedetti
- "PhD Program in Clinical and Experimental Medicine, University of Modena and Reggio Emilia, Modena (Italy)"..
| | - Tommaso Zini
- "Post-graduate School of Pediatrics, Department of Medical and Surgical Sciences of Mothers, Children and Adults, University of Modena and Reggio Emilia, Modena (Italy)"..
| | - Marianna Di Martino
- "Post-graduate School of Pediatrics, Department of Medical and Surgical Sciences of Mothers, Children and Adults, University of Modena and Reggio Emilia, Modena (Italy)"..
| | - Greta Miriam Cingolani
- "Post-graduate School of Pediatrics, Department of Medical and Surgical Sciences of Mothers, Children and Adults, University of Modena and Reggio Emilia, Modena (Italy)"..
| | - Eugenio Spaggiari
- "Neonatal Intensive Care Unit, Department of Medical and Surgical Sciences of Mothers, Children and Adults, University of Modena and Reggio Emilia, Modena (Italy)"..
| | - Katia Rossi
- "Neonatal Intensive Care Unit, Department of Medical and Surgical Sciences of Mothers, Children and Adults, University of Modena and Reggio Emilia, Modena (Italy)"..
| | - Francesca Miselli
- "Neonatal Intensive Care Unit, Department of Medical and Surgical Sciences of Mothers, Children and Adults, University of Modena and Reggio Emilia, Modena (Italy)"..
| | - Licia Lugli
- "Neonatal Intensive Care Unit, Department of Medical and Surgical Sciences of Mothers, Children and Adults, University of Modena and Reggio Emilia, Modena (Italy)"..
| | - Barbara Maria Bergamini
- "Pediatric Unit, Department of Medical and Surgical Sciences of the Mother, Children and Adults. University of Modena and Reggio Emilia, Modena (Italy)"..
| | - Lorenzo Iughetti
- "Pediatric Unit, Department of Medical and Surgical Sciences of the Mother, Children and Adults. University of Modena and Reggio Emilia, Modena (Italy)"..
| | - Alberto Berardi
- "Neonatal Intensive Care Unit, Department of Medical and Surgical Sciences of Mothers, Children and Adults, University of Modena and Reggio Emilia, Modena (Italy)"..
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32
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Chuang YC, Lin KP, Wang LA, Yeh TK, Liu PY. The Impact of the COVID-19 Pandemic on Respiratory Syncytial Virus Infection: A Narrative Review. Infect Drug Resist 2023; 16:661-675. [PMID: 36743336 PMCID: PMC9897071 DOI: 10.2147/idr.s396434] [Citation(s) in RCA: 36] [Impact Index Per Article: 36.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2022] [Accepted: 01/12/2023] [Indexed: 02/01/2023] Open
Abstract
Respiratory syncytial virus (RSV) is one of the most common respiratory viruses. It not only affects young children but also the elderly and immunocompromised patients. After the emergence of SARS-CoV-2 and the corona virus disease 2019 (COVID-19) era, a dramatic reduction in RSV activity was found, which coincided with the implementation of public health and social measures (PHSMs). However, the correlation is more complicated than we initially thought. After PHSMs were gradually lifted, a seasonality shift and a delayed RSV outbreak with greater number of infected patients were found in numerous countries, such as Israel, Australia, South Africa, New Zealand, France, United States, and Japan. Several hypotheses and possible reasons explaining the interaction between SARS-CoV-2 and RSV were mentioned. Since RSV vaccinations are still under investigation, administration of palivizumab should be considered in high-risk patients. In the post-COVID-19 era, greater attention should be paid to a further resurgence of RSV. In this narrative review, we conducted a thorough review of the current knowledge on the epidemiology of RSV during the COVID-19 era, the out-of-season outbreak of RSV, and the data on co-infection with RSV and SARS-CoV-2.
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Affiliation(s)
- Yu-Chuan Chuang
- Department of Internal Medicine, Taichung Veterans General Hospital, Taichung, Taiwan
| | - Kuan-Pei Lin
- Department of Internal Medicine, Taichung Veterans General Hospital, Taichung, Taiwan
| | - Li-An Wang
- Department of Internal Medicine, Taichung Veterans General Hospital, Taichung, Taiwan
| | - Ting-Kuang Yeh
- Division of Infectious Disease, Department of Internal Medicine, Taichung Veterans General Hospital, Taichung, Taiwan,Genomic Center for Infectious Diseases, Taichung Veterans General Hospital, Taichung, Taiwan
| | - Po-Yu Liu
- Division of Infectious Disease, Department of Internal Medicine, Taichung Veterans General Hospital, Taichung, Taiwan,Genomic Center for Infectious Diseases, Taichung Veterans General Hospital, Taichung, Taiwan,Ph.D. in Translational Medicine, National Chung Hsing University, Taichung, Taiwan,Rong Hsing Research Center for Translational Medicine, National Chung Hsing University, Taichung, Taiwan,Department of Post-Baccalaureate Medicine, College of Medicine, National Chung Hsing University, Taichung, Taiwan,Correspondence: Po-Yu Liu, Division of Infectious Disease, Department of Internal Medicine, Taichung Veterans General Hospital, No. 1650, Sec. 4, Taiwan Blvd., Xitun Dist, Taichung City, 407219, Taiwan, Tel +886 4 2359 2525, Email
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33
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Steponavičienė A, Burokienė S, Ivaškevičienė I, Stacevičienė I, Vaičiūnienė D, Jankauskienė A. Influenza and Respiratory Syncytial Virus Infections in Pediatric Patients during the COVID-19 Pandemic: A Single-Center Experience. CHILDREN (BASEL, SWITZERLAND) 2023; 10:children10010126. [PMID: 36670676 PMCID: PMC9856748 DOI: 10.3390/children10010126] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/05/2022] [Revised: 01/02/2023] [Accepted: 01/04/2023] [Indexed: 01/11/2023]
Abstract
The overlap of coronavirus disease 2019 (COVID-19) with other common respiratory pathogens may complicate the course of the disease and prognosis. The aim of the study was to evaluate the rates, characteristics, and outcomes of pediatric patients with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), respiratory syncytial virus (RSV), influenza A/B infections, and their coinfections. A single-center prospective cross-sectional study was performed at the pediatric emergency department in Vilnius from 1 October 2021 to 30 April 2022. In total, 5127 children were screened for SARS-CoV-2, RSV, and influenza A/B. SARS-CoV-2 PCR tests were positive for 21.0% of children (1074/5127). The coinfection rate of respiratory viruses (RSV, influenza A) in patients with COVID-19 was 7.2% (77/1074). Among the 4053 SARS-CoV-2 negative patients, RSV was diagnosed in 405 (10.0%) patients and influenza A/B in 827 (20.4%) patients. Patients with COVID-19 and coinfection did not have a more severe clinical course than those with RSV or influenza infection alone. RSV and SARS-CoV-2 primarily affected younger patients (up to 2 years), while the influenza was more common in older children (4-10 years). Patients infected with RSV were more severely ill, reflected by higher hospitalization proportion and need for respiratory support.
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34
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Jiang M, Xu Y, Wu H, Zhu R, Sun Y, Chen D, Wang F, Zhou Y, Guo Q, Wu A, Qian Y, Zhou H, Zhao L. Changes in endemic patterns of respiratory syncytial virus infection in pediatric patients under the pressure of nonpharmaceutical interventions for COVID-19 in Beijing, China. J Med Virol 2023; 95:e28411. [PMID: 36524893 PMCID: PMC9878212 DOI: 10.1002/jmv.28411] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2022] [Revised: 11/16/2022] [Accepted: 12/14/2022] [Indexed: 12/23/2022]
Abstract
A series of nonpharmaceutical interventions (NPIs) was launched in Beijing, China, on January 24, 2020, to control coronavirus disease 2019. To reveal the roles of NPIs on the respiratory syncytial virus (RSV), respiratory specimens collected from children with acute respiratory tract infection between July 2017 and Dec 2021 in Beijing were screened by capillary electrophoresis-based multiplex PCR (CEMP) assay. Specimens positive for RSV were subjected to a polymerase chain reaction (PCR) and genotyped by G gene sequencing and phylogenetic analysis using iqtree v1.6.12. The parallel and fixed (paraFix) mutations were analyzed with the R package sitePath. Clinical data were compared using SPSS 22.0 software. Before NPIs launched, each RSV endemic season started from October/November to February/March of the next year in Beijing. After that, the RSV positive rate abruptly dropped from 31.93% in January to 4.39% in February 2020; then, a dormant state with RSV positive rates ≤1% from March to September, a nearly dormant state in October (2.85%) and November (2.98%) and a delayed endemic season in 2020, and abnormal RSV positive rates remaining at approximately 10% in summer until September 2021 were detected. Finally, an endemic RSV season returned in October 2021. There was a game between Subtypes A and B, and RSV-A replaced RSV-B in July 2021 to become the dominant subtype. Six RSV-A and eight RSV-B paraFix mutations were identified on G. The percentage of severe pneumonia patients decreased to 40.51% after NPIs launched. NPIs launched in Beijing seriously interfered with the endemic season of RSV.
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Affiliation(s)
- Ming‐Li Jiang
- Laboratory of Virology, Beijing Key Laboratory of Etiology of Viral Diseases in ChildrenCapital Institute of PediatricsBeijingChina,Graduate School of Peking Union Medical CollegeBeijingChina
| | - Yan‐Peng Xu
- Laboratory of Virology, Beijing Key Laboratory of Etiology of Viral Diseases in ChildrenCapital Institute of PediatricsBeijingChina
| | - Hui Wu
- Institute of Systems MedicineChinese Academy of Medical Sciences and Peking Union Medical CollegeBeijingChina,Suzhou Institute of Systems MedicineSuzhouChina
| | - Ru‐Nan Zhu
- Laboratory of Virology, Beijing Key Laboratory of Etiology of Viral Diseases in ChildrenCapital Institute of PediatricsBeijingChina
| | - Yu Sun
- Laboratory of Virology, Beijing Key Laboratory of Etiology of Viral Diseases in ChildrenCapital Institute of PediatricsBeijingChina
| | - Dong‐Mei Chen
- Laboratory of Virology, Beijing Key Laboratory of Etiology of Viral Diseases in ChildrenCapital Institute of PediatricsBeijingChina
| | - Fang Wang
- Laboratory of Virology, Beijing Key Laboratory of Etiology of Viral Diseases in ChildrenCapital Institute of PediatricsBeijingChina
| | - Yu‐Tong Zhou
- Laboratory of Virology, Beijing Key Laboratory of Etiology of Viral Diseases in ChildrenCapital Institute of PediatricsBeijingChina
| | - Qi Guo
- Laboratory of Virology, Beijing Key Laboratory of Etiology of Viral Diseases in ChildrenCapital Institute of PediatricsBeijingChina
| | - Aiping Wu
- Institute of Systems MedicineChinese Academy of Medical Sciences and Peking Union Medical CollegeBeijingChina,Suzhou Institute of Systems MedicineSuzhouChina
| | - Yuan Qian
- Laboratory of Virology, Beijing Key Laboratory of Etiology of Viral Diseases in ChildrenCapital Institute of PediatricsBeijingChina
| | - Hang‐Yu Zhou
- Institute of Systems MedicineChinese Academy of Medical Sciences and Peking Union Medical CollegeBeijingChina,Suzhou Institute of Systems MedicineSuzhouChina
| | - Lin‐Qing Zhao
- Laboratory of Virology, Beijing Key Laboratory of Etiology of Viral Diseases in ChildrenCapital Institute of PediatricsBeijingChina,Graduate School of Peking Union Medical CollegeBeijingChina
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35
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Changes in the Epidemiology of Respiratory Pathogens in Children during the COVID-19 Pandemic. Pathogens 2022; 11:pathogens11121542. [PMID: 36558876 PMCID: PMC9781834 DOI: 10.3390/pathogens11121542] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2022] [Revised: 12/04/2022] [Accepted: 12/06/2022] [Indexed: 12/23/2022] Open
Abstract
Since the outbreak of the COVID-19 pandemic, a significant decrease in non-COVID-19 respiratory illnesses were observed, suggesting that the implementation of measures against COVID-19 affected the transmission of other respiratory pathogens. The aim of this study was to highlight the changes in the epidemiology of respiratory pathogens in children during the COVID-19 pandemic. All children with Severe Acute respiratory illness admitted to the pediatric departments between January 2018 and December 2021 with negative COVID-19 PCR, were enrolled. The detection of respiratory pathogens was made by the Film Array Respiratory Panel. A total of 902 respiratory specimens were tested. A significantly lower positivity rate during the COVID-19 period was found (p = 0.006), especially in infants under 6 months (p = 0.008). There was a substantial absence of detection of Respiratory Syncytial Virus and Influenza A during the winter season following the outbreak of the pandemic (p < 0.05; p = 0.002 respectively). An inter-seasonal resurgence of Respiratory Syncytial Virus was noted. Human Rhinovirus was detected throughout the year, and more prevalent in winter during COVID-19 (p = 0.0002). These changes could be explained by the impact of the implementation of preventive measures related to the COVID-19 pandemic on the transmission of respiratory pathogens in children.
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36
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Impact of COVID-19 Pandemic and Lockdown on the Epidemiology of RSV-Mediated Bronchiolitis: Experience from Our Centre. CHILDREN (BASEL, SWITZERLAND) 2022; 9:children9111723. [PMID: 36360451 PMCID: PMC9688686 DOI: 10.3390/children9111723] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/10/2022] [Revised: 10/26/2022] [Accepted: 11/08/2022] [Indexed: 11/12/2022]
Abstract
Background: The COVID-19 pandemic has dramatically affected the global epidemiology of other infectious respiratory diseases, leading to a significant decrease in their incidence. Hence, we aimed to characterize the epidemiology of RSV-bronchiolitis in children. Methods: children aged ≤2 years diagnosed with RSV-mediated bronchiolitis admitted to our Unit from October 2018 to December 2021, were retrospectively enrolled. Results: We included 95 patients (M/F = 46/49; mean age 7.56 ± 6.6 months). Specifically, 17 infants in 2018, 34 in 2019, 0 during 2020 lockdown, 1 during 2020 post-lockdown, and 43 in 2021. Incidence was significantly lower in 2020 compared with 2018, 2019 and 2021 (p < 0.05). No differences were found concerning need for respiratory support. Discussion: Several factors related to SARS-CoV-2 pandemic, especially restrictive measures, may have contributed to a significant reduction in hospitalizations due to RSV. The new outbreak in RSV infection-related hospitalizations reported between October and December 2021 has been suggested it may be due to an increased number of susceptible individuals to RSV infection. Conclusion: The experience of the SARS-CoV-2 outbreak has led to a marked decrease in other viral respiratory infections, such as RSV. This may pave the way for new approaches in preventing respiratory infections, highlighting the role of preventive measures.
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37
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Kuitunen I, Renko M, Tapiainen T. Unusual late epidemic peak during influenza season 2021-2022: A nationwide register-based analysis in Finland. Influenza Other Respir Viruses 2022; 16:1199-1201. [PMID: 36047516 DOI: 10.1111/irv.13036] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2022] [Accepted: 08/04/2022] [Indexed: 11/26/2022] Open
Affiliation(s)
- Ilari Kuitunen
- Institute of Clinical Medicine and Department of Pediatrics, University of Eastern Finland, Kuopio, Finland.,Department of Pediatrics, Mikkeli Central Hospital, Mikkeli, Finland
| | - Marjo Renko
- Institute of Clinical Medicine and Department of Pediatrics, University of Eastern Finland, Kuopio, Finland.,Department of Pediatrics, Kuopio University Hospital, Kuopio, Finland
| | - Terhi Tapiainen
- Medical Research Unit, University of Oulu, Oulu, Finland.,Department of Pediatrics and Adolescent Medicine, Oulu University Hospital, Oulu, Finland
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38
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Prazuck T, Gravier A, Pires‐Roteira D, Theillay A, Pallay S, Colin M, Serreau R, Hocqueloux L, Cassuto NG. Evaluation of a new "all in one" SARS-CoV-2 antigen-detecting rapid diagnostic test and self-test: Diagnostic performance and usability in child and adult populations. J Med Virol 2022; 94:4097-4106. [PMID: 35474460 PMCID: PMC9088384 DOI: 10.1002/jmv.27812] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2022] [Revised: 04/15/2022] [Accepted: 04/22/2022] [Indexed: 11/09/2022]
Abstract
The control of the COVID-19 epidemics has been one global health priorities for the last 2 years. To that end, more reliable and easy-to-use, regardless of age, diagnostic tests are necessary. Considering that, we evaluated an innovative two-step self-test, the AAZ COVID-VIRO ALL IN®, switching from the classic nasal swab to a nasal sponge. We performed a multicenter study, on 124 adults and children, in a point-of-care setting. Sensitivity, specificity and overall acceptance of the COVID-VIRO ALL IN® self-test compared to reverse transcriptase polymerase chain reaction (RT-PCR) on nasopharyngeal samples were of 93.0%, 100%, and 97.5%, respectively. We then performed a multicenter, usability study to evaluate the ease of use of COVID-VIRO ALL IN® on 68 laypersons adults. A vast majority of participants correctly executed and interpreted the test. The usability was then specifically investigated on 40 children and teenagers, comparing COVID-VIRO® first generation to the new COVID-VIRO ALL IN®. They all found COVID-VIRO ALL IN® more comfortable and easier to use. For young children, the new self-test seems safer (less risk of trauma and no liquid exposure), and faster than saliva-based RT-PCR. Moreover, the COVID-VIRO ALL IN® can easily be adapted as a multiplex self-test for other respiratory viruses, opening new perspectives of simultaneous, rapid and massive detection of respiratory infections, especially among vulnerable populations like children and elderly people.
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Affiliation(s)
- Thierry Prazuck
- Centre gratuit d'information, de dépistage et de diagnostic (CeGIDD) Orléans, Centre Hospitalier Régional d'OrléansOrléansFrance
- Centre hospitalier régional d'Orléans, service des maladies infectieuses et tropicalesOrléansFrance
| | - Anne Gravier
- Centre gratuit d'information, de dépistage et de diagnostic (CeGIDD) Orléans, Centre Hospitalier Régional d'OrléansOrléansFrance
| | - Daniela Pires‐Roteira
- Centre hospitalier régional d'Orléans, service des maladies infectieuses et tropicalesOrléansFrance
| | - Aurelie Theillay
- Centre hospitalier régional d'Orléans, service des maladies infectieuses et tropicalesOrléansFrance
| | - Sandra Pallay
- Centre hospitalier régional d'Orléans, service des maladies infectieuses et tropicalesOrléansFrance
| | - Mathilda Colin
- Centre hospitalier régional d'Orléans, service des maladies infectieuses et tropicalesOrléansFrance
| | | | - Laurent Hocqueloux
- Centre hospitalier régional d'Orléans, service des maladies infectieuses et tropicalesOrléansFrance
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39
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Zama D, Leardini D, Biscardi L, Corsini I, Pierantoni L, Andreozzi L, Lanari M. Activity of a Pediatric Emergency Department of a Tertiary Center in Bologna, Italy, during SARS-CoV-2 Pandemic. Pediatr Rep 2022; 14:366-374. [PMID: 36136082 PMCID: PMC9505070 DOI: 10.3390/pediatric14030043] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/16/2022] [Revised: 08/18/2022] [Accepted: 08/19/2022] [Indexed: 11/16/2022] Open
Abstract
During the SARS-CoV-2 pandemic, the pediatric emergency department (ED) of Bologna, Emilia-Romagna, Italy faced a reorganization to better deal with the new clinical needs. We herein describe the main changes in the organization and in the attendances to our pediatric ED. From the 1 March 2020 to the 31 January 2022, 796 children positive for SARS-CoV-2 presented to our pediatric ED, but only 26 required hospitalizations, of which only 9 for COVID-19 related reasons. During this period, we also registered a temporal correlation between multisystem inflammatory syndrome in children (MIS-C) admissions and the peaks of SARS-CoV-2 infection in the Italian population. Respiratory syncytial virus (RSV) remained during last year the viral infection with the highest hospitalization rate. The analysis and description of the changes in the activity of the pediatric ED during the SARS-CoV-2 pandemic may help to better understand the routinary activity and be prepared for any possible new challenge.
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Affiliation(s)
- Daniele Zama
- Unit of Pediatrics Emergency, IRCCS Azienda Ospedaliero-Universitaria di Bologna, 40138 Bologna, Italy
- Department of Medical and Surgical Sciences (DIMEC), University of Bologna, 40138 Bologna, Italy
| | - Davide Leardini
- Specialty School of Pediatrics, University of Bologna, 40138 Bologna, Italy
| | - Lorenzo Biscardi
- Specialty School of Pediatrics, University of Bologna, 40138 Bologna, Italy
- Correspondence: ; Tel.: +39-051-214-4231
| | - Ilaria Corsini
- Unit of Pediatrics Emergency, IRCCS Azienda Ospedaliero-Universitaria di Bologna, 40138 Bologna, Italy
| | - Luca Pierantoni
- Unit of Pediatrics Emergency, IRCCS Azienda Ospedaliero-Universitaria di Bologna, 40138 Bologna, Italy
| | - Laura Andreozzi
- Department of Medical and Surgical Sciences (DIMEC), University of Bologna, 40138 Bologna, Italy
| | - Marcello Lanari
- Unit of Pediatrics Emergency, IRCCS Azienda Ospedaliero-Universitaria di Bologna, 40138 Bologna, Italy
- Department of Medical and Surgical Sciences (DIMEC), University of Bologna, 40138 Bologna, Italy
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40
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Abdullahi M, Uzairu A, Shallangwa GA, Mamza PA, Ibrahim MT. Computational modelling studies of some 1,3-thiazine derivatives as anti-influenza inhibitors targeting H1N1 neuraminidase via 2D-QSAR, 3D-QSAR, molecular docking, and ADMET predictions. BENI-SUEF UNIVERSITY JOURNAL OF BASIC AND APPLIED SCIENCES 2022; 11:104. [PMID: 36000144 PMCID: PMC9389500 DOI: 10.1186/s43088-022-00280-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2022] [Accepted: 07/27/2022] [Indexed: 12/19/2022] Open
Abstract
Abstract
Background
Influenza virus disease remains one of the most contagious diseases that aided the deaths of many patients, especially in this COVID-19 pandemic era. Recent discoveries have shown that the high prevalence of influenza and SARS-CoV-2 coinfection can rapidly increase the death rate of patients. Hence, it became necessary to search for more potent inhibitors for influenza disease therapy. The present study utilized some computational modeling concepts such as 2D-QSAR, 3D-QSAR, molecular docking simulation, and ADMET predictions of some 1,3-thiazine derivatives as inhibitors of influenza neuraminidase (NA).
Results
The 2D-QSAR modeling results showed GFA-MLR ($$R_{{\text{train }}}^{2}$$
R
train
2
= 0.9192, Q2 = 0.8767, R2adj = 0.8991, RMSE = 0.0959, $$R_{{{\text{test}}}}^{2}$$
R
test
2
= 0.8943, $$R_{{{\text{pred}}}}^{2}$$
R
pred
2
= 0.7745) and GFA-ANN ($$R_{{\text{train }}}^{2}$$
R
train
2
= 0.9227, Q2 = 0.9212, RMSE = 0.0940, $$R_{{{\text{test}}}}^{2}$$
R
test
2
= 0.8831, $$R_{{{\text{pred}}}}^{2}$$
R
pred
2
= 0.7763) models with the computed descriptors as ATS7s, SpMax5_Bhv, nHBint6, and TDB9m for predicting the NA inhibitory activities of compounds which have passed the global criteria of accepting QSAR model. The 3D-QSAR modeling was carried out based on the comparative molecular field analysis (CoMFA) and comparative similarity indices analysis (CoMSIA). The CoMFA_ES ($$R_{{\text{train }}}^{2}$$
R
train
2
= 0.9620, Q2 = 0.643) and CoMSIA_SED ($$R_{{\text{train }}}^{2}$$
R
train
2
= 0.8770, Q2 = 0.702) models were found to also have good and reliable predicting ability. The compounds were also virtually screened based on their binding scores via molecular docking simulations with the active site of the NA (H1N1) target receptor which also confirms their resilient potency. Four potential lead compounds (4, 7, 14, and 15) with the relatively high inhibitory rate (> 50%) and docking (> − 6.3 kcal/mol) scores were identified as the possible lead candidates for in silico exploration of improved anti-influenza agents.
Conclusion
The drug-likeness and ADMET predictions of the lead compounds revealed non-violation of Lipinski’s rule and good pharmacokinetic profiles as important guidelines for rational drug design. Hence, the outcome of this research set a course for the in silico design and exploration of novel NA inhibitors with improved potency.
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41
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Impact of COVID-19 on the Changing Patterns of Respiratory Syncytial Virus Infections. Infect Dis Rep 2022; 14:558-568. [PMID: 35893478 PMCID: PMC9394296 DOI: 10.3390/idr14040059] [Citation(s) in RCA: 32] [Impact Index Per Article: 16.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/18/2022] [Revised: 07/20/2022] [Accepted: 07/21/2022] [Indexed: 12/04/2022] Open
Abstract
Seasonal epidemics of respiratory syncytial virus (RSV) is one of the leading causes of hospitalization and mortality among children. Preventive measures implemented to reduce the spread of SARS-CoV-2, including facemasks, stay-at-home orders, closure of schools and local-national borders, and hand hygiene, may have also prevented the transmission of RSV and influenza. However, with the easing of COVID-19 imposed restrictions, many regions are noticing a delayed RSV outbreak. Some of these regions have also noted an increase in severity of these delayed RSV outbreaks partly due to a lack of protective immunity in the community following a lack of exposure from the previous season. Lessons learned from the COVID-19 pandemic can be implemented for controlling RSV outbreaks, including: (1) measures to reduce the spread, (2) effective vaccine development, and (3) genomic surveillance tools and computational modeling to predict the timing and severity of RSV outbreaks. These measures can help reduce the severity and prepare the health care system to deal with future RSV outbreaks by appropriate and timely allocation of health care resources.
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42
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Kuitunen I, Artama M, Haapanen M, Renko M. Record high parainfluenza season in children after relaxation of COVID-19 restrictions in fall 2021-A nationwide register study in Finland. Influenza Other Respir Viruses 2022; 16:613-616. [PMID: 35315214 PMCID: PMC9111305 DOI: 10.1111/irv.12983] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2022] [Accepted: 03/13/2022] [Indexed: 01/24/2023] Open
Abstract
Social restrictions interrupted the circulation of common respiratory viruses among children in spring 2020. In the winter season 2020-2021, only rhinovirus spread in Finland. As the restrictions were ended in September 2021, we saw record high epidemic peak of parainfluenza. Typically, the epidemic peak is in springtime, but now, it started in the early fall 2021. The monthly incidence among children aged 0-4 years (120 per 100,000 children) was six times higher than the second highest reported monthly incidence (21 per 100,000 children) during the last 10 years. Our finding highlights the importance of active surveillance of viral respiratory pathogens during the pandemic.
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Affiliation(s)
- Ilari Kuitunen
- Institute of Clinical Medicine and Department of Pediatrics, University of Eastern Finland, Kuopio, Finland
- Department of Pediatrics, Mikkeli Central Hospital, Mikkeli, Finland
| | - Miia Artama
- Faculty of Social Sciences, Tampere University, Tampere, Finland
- Department of Health Security, Finnish Institute for Health and Welfare, Helsinki, Finland
| | - Marjut Haapanen
- Institute of Clinical Medicine and Department of Pediatrics, University of Eastern Finland, Kuopio, Finland
| | - Marjo Renko
- Institute of Clinical Medicine and Department of Pediatrics, University of Eastern Finland, Kuopio, Finland
- Department of Pediatrics, Kuopio University Hospital, Kuopio, Finland
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43
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Bellizzi S, Panu Napodano CM, Pinto S, Pichierri G. COVID-19 and seasonal influenza: The potential 2021–22 “Twindemic”. Vaccine 2022; 40:3286-3287. [PMID: 35527058 PMCID: PMC9069306 DOI: 10.1016/j.vaccine.2022.04.074] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2021] [Revised: 01/14/2022] [Accepted: 04/25/2022] [Indexed: 11/30/2022]
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44
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Camporesi A, Morello R, Ferro V, Pierantoni L, Rocca A, Lanari M, Trobia GL, Sciacca T, Bellinvia AG, De Ferrari A, Valentini P, Roland D, Buonsenso D. Epidemiology, Microbiology and Severity of Bronchiolitis in the First Post-Lockdown Cold Season in Three Different Geographical Areas in Italy: A Prospective, Observational Study. CHILDREN (BASEL, SWITZERLAND) 2022; 9:children9040491. [PMID: 35455535 PMCID: PMC9024462 DOI: 10.3390/children9040491] [Citation(s) in RCA: 19] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/06/2022] [Revised: 03/19/2022] [Accepted: 03/21/2022] [Indexed: 11/16/2022]
Abstract
The aim of this study was to understand the epidemiology, disease severity, and microbiology of bronchiolitis in Italy during the 2021–2022 cold season, outside of lockdowns. Before COVID-19, the usual bronchiolitis season in Italy would begin in November and end in April, peaking in February. We performed a prospective observational study in four referral pediatric centers located in different geographical areas in Italy (two in the north, one in the center and one in the south). From 1 July 2021 to 31 January 2022, we collected all new clinical diagnoses of bronchiolitis in children younger than two years of age recording demographic, clinical and microbiological data. A total of 657 children with a clinical diagnosis of bronchiolitis were enrolled; 56% children were admitted and 5.9% required PICU admission. The first cases were detected during the summer, peaking in November 2021 and declining into December 2021 with only a few cases detected in January 2022. RSV was the commonest etiological agent, while SARS-CoV-2 was rarely detected and only since the end of December 2021. Disease severity was similar in children with RSV vs. non-RSV bronchiolitis, and in those with a single infectious agent detected compared with children with co-infections. The 2021–2022 bronchiolitis season in Italy started and peaked earlier than the usual pre-pandemic seasons, but had a shorter duration. Importantly, the current bronchiolitis season was not more severe when data were compared with Italian published data, and SARS-CoV-2 was rarely a cause of bronchiolitis in children younger than 24 months of age.
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Affiliation(s)
- Anna Camporesi
- Anesthesia and Intensive Care Unit, “Vittore Buzzi” Children’s Hospital, 20154 Milan, Italy; (A.C.); (A.D.F.)
| | - Rosa Morello
- Department of Woman and Child Health, Fondazione Policlinico Universitario A. Gemelli IRCCS, 00168 Rome, Italy; (R.M.); (P.V.)
| | - Valentina Ferro
- Department of Pediatric Emergency, Bambin Gesù Children’s Hospital IRCCS, 00168 Rome, Italy;
| | - Luca Pierantoni
- Pediatric Emergency Unit, IRCCS Azienda Ospedaliero-Universitaria di Bologna, 40138 Bologna, Italy; (L.P.); (A.R.); (M.L.)
| | - Alessandro Rocca
- Pediatric Emergency Unit, IRCCS Azienda Ospedaliero-Universitaria di Bologna, 40138 Bologna, Italy; (L.P.); (A.R.); (M.L.)
| | - Marcello Lanari
- Pediatric Emergency Unit, IRCCS Azienda Ospedaliero-Universitaria di Bologna, 40138 Bologna, Italy; (L.P.); (A.R.); (M.L.)
| | - Gian Luca Trobia
- Pediatric and Pediatric Emergency Room Unit, Cannizzaro Emergency Hospital-Catania, 95126 Catania, Italy; (G.L.T.); (T.S.); (A.G.B.)
| | - Tiziana Sciacca
- Pediatric and Pediatric Emergency Room Unit, Cannizzaro Emergency Hospital-Catania, 95126 Catania, Italy; (G.L.T.); (T.S.); (A.G.B.)
| | - Agata Giuseppina Bellinvia
- Pediatric and Pediatric Emergency Room Unit, Cannizzaro Emergency Hospital-Catania, 95126 Catania, Italy; (G.L.T.); (T.S.); (A.G.B.)
| | - Alessandra De Ferrari
- Anesthesia and Intensive Care Unit, “Vittore Buzzi” Children’s Hospital, 20154 Milan, Italy; (A.C.); (A.D.F.)
| | - Piero Valentini
- Department of Woman and Child Health, Fondazione Policlinico Universitario A. Gemelli IRCCS, 00168 Rome, Italy; (R.M.); (P.V.)
| | - Damian Roland
- Paediatric Emergency Medicine Leicester Academic (PEMLA) Group, Leicester Hospital, Leicester LE1 5WW, UK;
- Social science APPlied to Healthcare Improvement REsearch, SAPPHIRE Group, Health Sciences, Leicester University, Leicester LE1 7RH, UK
| | - Danilo Buonsenso
- Department of Woman and Child Health, Fondazione Policlinico Universitario A. Gemelli IRCCS, 00168 Rome, Italy; (R.M.); (P.V.)
- Center for Global Health Research Studies, Università Cattolica del Sacro Cuore, 00168 Rome, Italy
- Correspondence: ; Tel.: +39-06-30154390
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45
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Riccò M, Ferraro P, Peruzzi S, Zaniboni A, Ranzieri S. Respiratory Syncytial Virus: Knowledge, Attitudes and Beliefs of General Practitioners from North-Eastern Italy (2021). Pediatr Rep 2022; 14:147-165. [PMID: 35466200 PMCID: PMC9036244 DOI: 10.3390/pediatric14020021] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/14/2022] [Revised: 03/16/2022] [Accepted: 03/23/2022] [Indexed: 02/05/2023] Open
Abstract
Respiratory syncytial virus (RSV) is a lead cause of morbidity and hospitalizations in infants. RSV vaccines are currently under development, and preventive options are limited to monoclonal antibodies (mAb). We assessed the knowledge, attitudes and practices for RSV in a sample of general practitioners (GPs) from north-eastern Italy (2021), focusing on the risk perception for infants (age < 8 years) and its potential effectors. We administered an internet survey to 543 GPs, with a response rate of 28.9%. Knowledge status was unsatisfactory, with substantial knowledge gaps found on the epidemiology of RSV and its prevention through mAb. The main effectors of risk perception were identified as having a background in pediatrics (adjusted odds ratio (aOR): 55.398 and 95% confidence interval (95% CI): 6.796−451.604), being favorable towards RSV vaccines when available (aOR: 4.728, 95% CI: 1.999−11.187), while having previously managed an RSV case (aOR: 0.114, 95% CI: 0.024−0.552) and previously recommended hospitalization for cases (aOR: 0.240, 95% CI: 0.066−0.869) were identified as negative effectors. In summary, the significant extent of knowledge gaps and the erratic risk perception, associated with the increasing occurrence in RSV infections, collectively stress the importance of appropriate information campaigns among primary care providers.
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Affiliation(s)
- Matteo Riccò
- AUSL–IRCCS di Reggio Emilia, Servizio di Prevenzione e Sicurezza Negli Ambienti di Lavoro (SPSAL), Local Health Unit of Reggio Emilia, I-42122 Reggio Emilia, Italy
- Correspondence: or ; Tel.: +39-339-2994343 or +39-522-837587
| | - Pietro Ferraro
- Occupational Medicine Unit, Direzione Sanità, Italian Railways’ Infrastructure Division, RFI SpA, I-00161 Rome, Italy;
| | - Simona Peruzzi
- AUSL–IRCCS di Reggio Emilia, Laboratorio Analisi Chimico Cliniche e Microbiologiche, Ospedale Civile di Guastalla, I-42016 Guastalla, Italy;
| | - Alessandro Zaniboni
- Department of Medicine and Surgery, University of Parma, I-43126 Parma, Italy; (A.Z.); (S.R.)
| | - Silvia Ranzieri
- Department of Medicine and Surgery, University of Parma, I-43126 Parma, Italy; (A.Z.); (S.R.)
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46
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Afshari A, Disma N, von Ungern-Sternberg BS, Matava C. COVID-19 implications for pediatric anesthesia: Lessons learnt and how to prepare for the next pandemic. Paediatr Anaesth 2022; 32:385-390. [PMID: 34850493 DOI: 10.1111/pan.14347] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/19/2021] [Revised: 11/25/2021] [Accepted: 11/28/2021] [Indexed: 11/29/2022]
Abstract
COVID-19 is mainly considered an "adult pandemic," but it also has strong implications for children and consequently for pediatric anesthesia. Despite the lethality of SARS-CoV-2 infection being directly correlated with age, children have equally experienced the negative impacts of this pandemic. In fact, the spectrum of COVID-19 symptoms among children ranges from very mild to those resembling adults, but may also present as a multisystemic inflammatory syndrome. Moreover, the vast majority of children might be affected by asymptomatic or pauci-symptomatic infection making them the "perfect" carriers for spreading the disease in the community. Beyond the clinical manifestations of SARS-CoV-2 infection, the COVID-19 pandemic may ultimately have catastrophic health and socioeconomic consequences for children and adolescents, which are yet to be defined. The aim of this narrative review is to highlight how COVID-19 pandemic has affected and changed the pediatric anesthesia practice and which lessons are to be learned in case of a future "pandemic." In particular, the rapid evolution and dissemination of research and clinical findings have forced the scientific community to adapt and alter clinical practice on an unseen and pragmatic manner. Equally, implementation of new platforms, techniques, and devices together with artificial intelligence and large-scale collaborative efforts may present a giant step for mankind. The valuable lessons of this pandemic will ultimately translate into new treatments modalities for various diseases but will also have the potential for safety improvement and better quality of care. However, this pandemic has revealed the vulnerability and deficiencies of our health-care system. If not addressed properly, we may end up with a tsunami of burnout and compassionate fatigue among health-care professionals. Pediatric anesthesia and critical care staff are no exceptions.
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Affiliation(s)
- Arash Afshari
- Department of Paediatric and Obstetric Anaesthesia, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark
| | - Nicola Disma
- Unit for Research & Innovation, Department of Paediatric Anaesthesia, Istituto Giannina Gaslini, Genoa, Italy
| | - Britta S von Ungern-Sternberg
- Department of Anaesthesia and Pain Management, Perth Children's Hospital, Perth, WA, Australia.,Division of Emergency Medicine, Anaesthesia and Pain Medicine, Medical School, The University of Western Australia, Perth, WA, Australia
| | - Clyde Matava
- Department of Anaesthesia and Pain Medicine, Perioperative Medicine Team, Telethon Kids Institute, Hospital for Sick Children, Toronto, Ontario, Canada.,Department of Anaesthesiology and Pain Medicine, Termerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
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47
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Terliesner N, Unterwalder N, Edelmann A, Corman V, Knaust A, Rosenfeld L, Gratopp A, Ringe H, Martin L, von Bernuth H, Mall MA, Kallinich T. Viral infections in hospitalized children in Germany during the COVID-19 pandemic: Association with non-pharmaceutical interventions. Front Pediatr 2022; 10:935483. [PMID: 36034546 PMCID: PMC9403271 DOI: 10.3389/fped.2022.935483] [Citation(s) in RCA: 16] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/04/2022] [Accepted: 07/25/2022] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Non-pharmaceutical interventions (NPI) during the COVID-19 pandemic aimed at prevention of SARS-CoV-2 transmission also influenced transmission of viruses other than SARS-CoV-2. The aim of this study was to describe and compare the burden of common viral respiratory and gastrointestinal infections in children admitted to Berlin University Children's Hospital (BCH) before and during the COVID-19 pandemic at different levels of public NPI measures. METHODS In this retrospective study, we analyzed the frequency of detection of common human respiratory and gastrointestinal viruses from January 2016 through January 2022 in all patients admitted to BCH. We compared virus detection before and during the COVID-19 pandemic at different levels of public NPI measures. RESULTS The frequency of detection of seasonal enveloped and non-enveloped viruses [Boca-, Corona-, Influenza-, Metapneumo-, Parainfluenza-, Rota-, and Respiratory Syncytial Viruses (RSV)] was diminished during the COVID-19 pandemic, whereas detection rates of non-seasonal viruses (Rhino-/Entero-, and Adenoviruses) were stable during the pandemic. After withdrawal of major NPI measures, we observed an out of season surge of the detection rates of Boca-, Corona-, Parainfluenzaviruses, and RSV. In contrast, no increased detection frequency was observed for Influenza-, Metapneumo-, and Rotaviruses as of January 2022. CONCLUSION Corona-, Boca-, Parainfluenzaviruses, and RSV returned as frequently detected pathogens after withdrawal of major NPI measures. The out of season rise might be attributed to an "immune-debt" due to missing contact to viral antigens resulting in waning of population immunity during the COVID-19 pandemic.
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Affiliation(s)
- Nicolas Terliesner
- Department of Pediatric Respiratory Medicine, Immunology and Critical Care Medicine, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Berlin Institute of Health, Humboldt-Universität zu Berlin, Berlin, Germany
| | | | | | - Victor Corman
- Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Berlin Institute of Health, Institute of Virology, Humboldt-Universität zu Berlin, Berlin, Germany.,Berlin Institute of Health at Charité-Universitätsmedizin Berlin, Berlin, Germany
| | | | - Leonard Rosenfeld
- Department of Pediatric Respiratory Medicine, Immunology and Critical Care Medicine, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Berlin Institute of Health, Humboldt-Universität zu Berlin, Berlin, Germany
| | - Alexander Gratopp
- Department of Pediatric Respiratory Medicine, Immunology and Critical Care Medicine, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Berlin Institute of Health, Humboldt-Universität zu Berlin, Berlin, Germany
| | - Hannelore Ringe
- Department of Pediatric Respiratory Medicine, Immunology and Critical Care Medicine, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Berlin Institute of Health, Humboldt-Universität zu Berlin, Berlin, Germany
| | - Luise Martin
- Department of Pediatric Respiratory Medicine, Immunology and Critical Care Medicine, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Berlin Institute of Health, Humboldt-Universität zu Berlin, Berlin, Germany
| | - Horst von Bernuth
- Department of Pediatric Respiratory Medicine, Immunology and Critical Care Medicine, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Berlin Institute of Health, Humboldt-Universität zu Berlin, Berlin, Germany.,Labor Berlin GmbH, Berlin, Germany.,Berlin Institute of Health at Charité-Universitätsmedizin Berlin, Berlin, Germany.,Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Berlin Institute of Health, Berlin-Brandenburg Center for Regenerative Therapies, Humboldt-Universität zu Berlin, Berlin, Germany
| | - Marcus A Mall
- Department of Pediatric Respiratory Medicine, Immunology and Critical Care Medicine, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Berlin Institute of Health, Humboldt-Universität zu Berlin, Berlin, Germany.,Berlin Institute of Health at Charité-Universitätsmedizin Berlin, Berlin, Germany
| | - Tilmann Kallinich
- Department of Pediatric Respiratory Medicine, Immunology and Critical Care Medicine, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Berlin Institute of Health, Humboldt-Universität zu Berlin, Berlin, Germany.,Berlin Institute of Health at Charité-Universitätsmedizin Berlin, Berlin, Germany.,Deutsches Rheumaforschungszentrum, An Institute of the Leibniz Association, Berlin, Germany
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