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Yang Y, Zheng Q, Yang L, Wu L. Comparison of inflammatory markers, coagulation indicators and outcomes between influenza and COVID-19 infection amongst children: A systematic review and meta-analysis. Heliyon 2024; 10:e30391. [PMID: 38765052 PMCID: PMC11096948 DOI: 10.1016/j.heliyon.2024.e30391] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2023] [Revised: 04/25/2024] [Accepted: 04/25/2024] [Indexed: 05/21/2024] Open
Abstract
Background Influenza and COVID-19 patients share similar features and outcomes amongst adults. However, the difference between these diseases is not explored in paediatric age group especially in terms of inflammatory markers, coagulation profile and outcomes. Hence, we did this review to compare the inflammatory, coagulation features and outcomes between influenza and COVID-19 infected children. Methods Literature search was done in PubMed Central, Scopus, EMBASE, CINAHL, Cochrane library, Google Scholar & ScienceDirect from November 2019 to May 2022. Risk of bias assessment was done through Newcastle Ottawa scale. Meta-analysis was done using random-effects model and the final pooled estimate was reported as pooled odds ratio (OR) or standardized mean difference (SMD) along with 95 % confidence interval (CI) depending on the type of outcome. Results About 16 studies were included with most studies having higher risk of bias. Influenza paediatric patients had significantly higher erythrocyte sedimentation rate (ESR) (pooled SMD = 0.60; 95%CI: 0.30-0.91; I2 = 0 %), lactate dehydrogenase (LDH) (pooled SMD = 2.01; 95%CI: 0.37-3.66; I2 = 98.4 %) and prothrombin time (PT) (pooled SMD = 2.12; 95%CI: 0.44-3.80; I2 = 98.3 %) when compared to paediatric COVID-19 patients. There was no significant difference in terms of features like CRP, procalcitonin, serum albumin, aPTT, mortality and need for mechanical ventilation. Conclusion Inflammatory markers like ESR, LDH and PT was significantly higher in influenza patients when compared to COVID-19 in children, while rest of the markers and adverse clinical outcomes were similar between both the groups. Identification of these biomarkers has helped in understanding the distinctness of COVID-19 and influenza virus and develop better management strategies.
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Affiliation(s)
- Yutang Yang
- Department of Pediatrics, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, Shandong Province, 250021, China
| | - Qi Zheng
- Department of Gynecology, Central Hospital Affiliated to Shandong First Medical University, Jinan, Shandong Province, 250013, China
| | - Linlin Yang
- Department of Hematology and Rheumatology, Central Hospital Affiliated to Shandong First Medical University, Jinan, Shandong Province, 250013, China
| | - Lei Wu
- Department of Pediatrics, Central Hospital Affiliated to Shandong First Medical University, Jinan, Shandong Province, 250013, China
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Guo M, Chen D, Zhao M, Xu T, Zhang Y, Xiao M, Li Y, Zhu B. 5-Nitrobenzo[c][1, 2, 5]selenadiazole as therapeutic agents in the regulation of oxidative stress and inflammation induced by influenza A(H1N1)pdm09 in vitro and in vivo. J Med Virol 2023; 95:e28920. [PMID: 37386905 DOI: 10.1002/jmv.28920] [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: 12/26/2022] [Revised: 05/23/2023] [Accepted: 06/11/2023] [Indexed: 07/01/2023]
Abstract
Currently, various problems are being faced in the treatment of influenza, so the development of new safe and effective drugs is crucial. Selenadiazole, an important component of selenium heterocyclic compounds, has received wide attention for its biological activity. This study aimed to verify the antiviral activity of 5-nitrobenzo[c][1,2,5]selenadiazole (SeD-3) in vivo and in vitro. The cell counting kit-8 assay and observation of cytopathic effect verified that SeD-3 could improve the survival of influenza A(H1N1)pdm09-infected Madin-Darby canine kidney cells. Polymerase chain reaction quantification and neuraminidase assay showed that SeD-3 could inhibit the proliferation of H1N1 virus. The time of addition assay demonstrated that SeD-3 may have a direct effect on virus particles and block some stages of H1N1 life cycle after virus adsorption. Cell cycle, JC-1, Annexin V, and terminal deoxynucleotidyl transferase (TdT) dUTP nick-end labeling-4',6-diamidino-2-phenylindole (TUNEL-DAPI) assays showed that SeD-3 inhibited H1N1 infection-induced apoptosis. Cytokine detection demonstrated SeD-3 inhibited the production of proinflammatory factors after infection, including tumor necrosis factor-α (TNF-α), TNF-β, interferon-γ, interleukin 12 (IL-12), and IL-17F. In vivo experiments suggested that the pathological damage in the lungs was significantly alleviated after treatment with SeD-3 by hematoxylin and eosin staining. The TUNEL assay of lung tissues indicated that SeD-3 inhibited DNA damage during H1N1 infection. Immunohistochemical assays were performed to further explore the mechanism that SeD-3 inhibited H1N1-induced apoptosis via reactive oxygen species-mediated MAPK, AKT, and P53 signaling pathways. In conclusion, SeD-3 may become a new potential anti-H1N1 influenza virus drug due to its antiviral and anti-inflammatory activity.
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Affiliation(s)
- Min Guo
- Center Laboratory, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, Guangzhou, China
| | - Danyang Chen
- Center Laboratory, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, Guangzhou, China
| | - Mingqi Zhao
- Center Laboratory, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, Guangzhou, China
| | - Tiantian Xu
- Center Laboratory, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, Guangzhou, China
| | - Yingying Zhang
- Center Laboratory, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, Guangzhou, China
| | - Misi Xiao
- Center Laboratory, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, Guangzhou, China
| | - Yinghua Li
- Center Laboratory, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, Guangzhou, China
| | - Bing Zhu
- Center Laboratory, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, Guangzhou, China
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Yu B, Chen HH, Hu XF, Mai RZ, He HY. Comparison of laboratory parameters, clinical symptoms and clinical outcomes of COVID-19 and influenza in pediatric patients: A systematic review and meta-analysis. World J Clin Cases 2022; 10:10516-10528. [PMID: 36312478 PMCID: PMC9602229 DOI: 10.12998/wjcc.v10.i29.10516] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/16/2022] [Revised: 07/26/2022] [Accepted: 08/30/2022] [Indexed: 02/05/2023] Open
Abstract
BACKGROUND New and more severe clinical manifestations associated with the coronavirus disease 2019 (COVID-19) are emerging constantly in the pediatric age group. Patients in this age group are also primary carriers of the influenza virus and are at a higher risk of developing severe infection. However, studies comparing influenza and COVID-19 to show which condition causes a more severe form of disease amongst the pediatric age group are scarce. AIM To compare the laboratory results, clinical symptoms and clinical outcomes in pediatric patients with COVID-19 and influenza. METHODS A systematic and comprehensive search was carried out in databases and search engines, including EMBASE, Cochrane, MEDLINE, ScienceDirect and Google Scholar from 1964 until January 2022. A meta-analysis was carried out using a random-effects model and pooled odds ratio (OR) or standardized mean difference (SMD) and 95%CI. RESULTS A total of 16 studies satisfied the inclusion criteria. Pediatric COVID-19 patients had a significantly reduced risk of cough (pooled OR = 0.16; 95%CI: 0.09 to 0.27), fever (pooled OR = 0.23; 95%CI: 0.12 to 0.43), and dyspnea (pooled OR = 0.54; 95%CI: 0.33 to 0.88) compared to influenza patients. Furthermore, total hemoglobin levels (pooled SMD = 1.22; 95%CI: 0.29 to 2.14) in COVID-19 patients were significantly higher as compared to pediatric influenza patients. There was no significant difference in symptoms such as sore throat, white blood cell count, platelets, neutrophil and lymphocytes levels, and outcomes like mortality, intensive care unit admission, mechanical ventilation or length of hospital stay. CONCLUSION COVID-19 is associated with a significantly lower rate of clinical symptoms and abnormal laboratory indexes compared to influenza in the pediatric age group. However, further longitudinal studies of the outcomes between influenza and COVID-19 pediatric patients are needed.
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Affiliation(s)
- Bang Yu
- Emergency and Critical Care Center, Beijing Jingdu Children’s Hospital, Beijing 102200, China
| | - Hai-Hua Chen
- Emergency and Critical Care Center, Beijing Jingdu Children’s Hospital, Beijing 102200, China
| | - Xiao-Fei Hu
- Emergency and Critical Care Center, Beijing Jingdu Children’s Hospital, Beijing 102200, China
| | - Rui-Zhi Mai
- Emergency and Critical Care Center, Beijing Jingdu Children’s Hospital, Beijing 102200, China
| | - Hai-Yan He
- Emergency and Critical Care Center, Beijing Jingdu Children’s Hospital, Beijing 102200, China
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Tasar S, Karadag-Oncel E, Yilmaz-Ciftdogan D, Kara-Aksay A, Ekemen-Keles Y, Elvan-Tuz A, Ustundag G, Sahin A, Kanık MA, Yılmaz N. Influenza is More Severe than Our Newest Enemy (COVID-19) in Hospitalized Children: Experience from a Tertiary Center. J Med Virol 2022; 94:4107-4114. [PMID: 35477866 PMCID: PMC9088615 DOI: 10.1002/jmv.27817] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2021] [Revised: 04/04/2022] [Accepted: 04/26/2022] [Indexed: 12/15/2022]
Abstract
Understanding differences in terms of clinical phenotypes and outcomes of coronavirus disease 2019 (COVID‐19) compared with influenza is vital to optimizing the management of patients and planning healthcare. Herein, we aimed to investigate the clinical differences and outcomes in hospitalized patients with severe acute respiratory syndrome coronavirus 2 (SARS‐CoV‐2) and influenza. We performed a retrospective study of hospitalized children who were positive for SARS‐CoV‐2 between March 2020 and March 2021 and for influenza between January 2016 and February 2020 in respiratory samples. The primary outcome of this study was pediatric intensive care unit (PICU) admission, and the secondary outcome was the need for respiratory support. A total of 74 patients with influenza and 71 who were positive for SARS‐CoV‐2 were included. The distribution among the sexes was similar, but patients with COVID‐19 were older than patients with influenza (96 vs. 12, p < 0.001). In terms of underlying chronic diseases, the frequency was 26.7% in the COVID‐19 group and 54% in the influenza group (p = 0.001). The comparison of symptoms revealed that fatigue, headache, nausea, vomiting, and abdominal pain occurred more frequently with COVID‐19 (for all p < 0.05) and runny nose with influenza (p = 0.002). The frequency of admission to the PICU was relatively higher (18.9%) in the influenza group than with COVID‐19 (2.8%) with a significant ratio (p = 0.001), secondary bacterial infections were observed more frequently in the influenza group (20.2% vs. 4.2%, p = 0.003). Some 88.7% of patients with COVID‐19 did not need respiratory support, whereas 59.4% of patients with influenza did require respiratory support (p < 0.001). This study noted that influenza caused more frequent admissions to the PICU and a greater need for respiratory support in hospitalized pediatric patients than COVID‐19.
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Affiliation(s)
- Selin Tasar
- Department of Pediatric Infectious Diseases, University of Health Sciences, Izmir Tepecik Training and Research Hospital, Izmir, Turkey
| | - Eda Karadag-Oncel
- Department of Pediatric Infectious Diseases, University of Health Sciences, Izmir Tepecik Training and Research Hospital, Izmir, Turkey
| | - Dilek Yilmaz-Ciftdogan
- Department of Pediatric Infectious Diseases, University of Health Sciences, Izmir Tepecik Training and Research Hospital, Izmir, Turkey.,Department of Pediatric Infectious Diseases, Izmir Kâtip Celebi University, Izmir, Turkey
| | - Ahu Kara-Aksay
- Department of Pediatric Infectious Diseases, University of Health Sciences, Izmir Tepecik Training and Research Hospital, Izmir, Turkey
| | - Yildiz Ekemen-Keles
- Department of Pediatric Infectious Diseases, University of Health Sciences, Izmir Tepecik Training and Research Hospital, Izmir, Turkey
| | - Aysegul Elvan-Tuz
- Department of Pediatric Infectious Diseases, University of Health Sciences, Izmir Tepecik Training and Research Hospital, Izmir, Turkey
| | - Gulnihan Ustundag
- Department of Pediatric Infectious Diseases, University of Health Sciences, Izmir Tepecik Training and Research Hospital, Izmir, Turkey
| | - Aslihan Sahin
- Department of Pediatric Infectious Diseases, University of Health Sciences, Izmir Tepecik Training and Research Hospital, Izmir, Turkey
| | - Muhammet Ali Kanık
- Department of Pediatrics, University of Health Sciences, Izmir Tepecik Training and Research Hospital, Izmir, Turkey
| | - Nisel Yılmaz
- Department of Microbiology, Izmir Tepecik Training and Research Hospital, Izmir, Turkey
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Qin J, Lin J, Zhang X, Yuan S, Zhang C, Yin Y. Evaluation of the Clinical Effectiveness of Oseltamivir for Influenza Treatment in Children. Front Pharmacol 2022; 13:849545. [PMID: 35462914 PMCID: PMC9020783 DOI: 10.3389/fphar.2022.849545] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2022] [Accepted: 03/17/2022] [Indexed: 11/25/2022] Open
Abstract
Objective: To estimate the clinical effectiveness of oseltamivir in children with different subtypes of influenza virus infection. Methods: A total of 998 children with acute respiratory infection were enrolled from January to March 2018, and were divided into influenza A, influenza B, influenza A + B, and non-influenza infection (IV-negative) groups. Influenza-like symptoms and duration of fever were evaluated and compared between oseltamivir-treated and non-treated groups. Results: There were no significant differences in the reduction in total febrile period and duration of fever from the onset of therapy between the oseltamivir treated and non-treated children infected with influenza A (p = 0.6885 for total febrile period and 0.7904 for the duration of fever from the onset of treatment), influenza B (p = 0.1462 and 0.1966), influenza A + B (p = 0.5568 and 0.9320), and IV-negative (p = 0.7631 and 0.4655). The duration of fever in children received oseltamivir therapy within 48 h was not significantly shorter than that beyond 48 h (p > 0.05). Additionally, percentages and severities of influenza-like symptoms, including headache, myalgia, fatigue, bellyache, vomiting, diarrhea, sore throat, cough, and coryza were not decreased and alleviated after treatment of oseltamivir. Conclusion: Oseltamivir treatment does not significantly shorten the duration of fever, nor does it significantly relieve influenza-like symptoms in children with infection of influenza.
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Affiliation(s)
- Jianru Qin
- NMPA Key Laboratory for Research and Evaluation of Innovative Drug, College of Life Sciences, Henan Normal University, Xinxiang, China
| | - Jilei Lin
- Department of Respiratory, Shanghai Children's Medical Center Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Xiangfei Zhang
- NMPA Key Laboratory for Research and Evaluation of Innovative Drug, College of Life Sciences, Henan Normal University, Xinxiang, China
| | - Shuhua Yuan
- Department of Respiratory, Shanghai Children's Medical Center Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Chiyu Zhang
- Shanghai Public Health Clinical Center, Fudan University, Shanghai, China
| | - Yong Yin
- Department of Respiratory, Shanghai Children's Medical Center Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China
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