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Galindo-Fraga A, del Carmen Guerra-de-Blas P, Ortiz-Hernández AA, Rubenstein K, Ortega-Villa AM, Ramírez-Venegas A, Valdez-Vázquez R, Moreno-Espinosa S, Llamosas-Gallardo B, Pérez-Patrigeon S, Noyola DE, Magaña-Aquino M, Vilardell-Dávila A, Guerrero ML, Powers JH, Beigel J, Ruiz-Palacios GM. Prospective cohort study of patient demographics, viral agents, seasonality, and outcomes of influenza-like illness in Mexico in the late H1N1-pandemic and post-pandemic years (2010-2014). IJID REGIONS 2024; 12:100394. [PMID: 39045384 PMCID: PMC11265585 DOI: 10.1016/j.ijregi.2024.100394] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/09/2024] [Revised: 06/17/2024] [Accepted: 06/18/2024] [Indexed: 07/25/2024]
Abstract
Objectives Influenza-like illness (ILI) caused by respiratory viruses results in various respiratory clinical manifestations. The ILI002 prospective observational cohort study aimed to describe viral agents, seasonality, and outcomes of patients with ILI during four seasons in the influenza H1N1-pandemic and post-pandemic years (2010-2014). Methods Patients from six Mexican hospitals were enrolled from April 2010 to March 2014. Clinical data and nasopharyngeal swabs were obtained and tested for viral respiratory pathogens by real-time reverse-transcription polymerase chain reaction. Results Of the 5662 enrolled participants, 64.9% were adults and 35.1% were children. Among the 5629 participants with single-pathogen detection, rhinovirus (20.2%), influenza virus (11.2%), respiratory syncytial virus (RSV) (7.2%), and coronavirus (6.8%) were the most frequent pathogens. Co-infection occurred in 14.5% of cases; 49.3% of participants required hospitalization, particularly in RSV cases (42.9% adults, 89.6% children). The mortality rate was 2.8% higher among older adult participants and those with comorbidities. Influenza H1N1 had the highest mortality rate, yet almost half of the deceased had no pathogen. Rhinovirus persisted year-round, while influenza, coronavirus, and RSV peaked during cooler months. Conclusions Analyses showed that some viruses causing ILI may lead to severe disease and hospitalization irrespective of comorbidities. These findings may help in decision-making about public health policies on prevention measures, vaccination, treatment, and administration of health care.
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Affiliation(s)
- Arturo Galindo-Fraga
- Subdirección de Epidemiología Hospitalaria, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City, Mexico
| | | | - Ana A. Ortiz-Hernández
- División de Desarrollo y Enlace Interinstitucional, Instituto Nacional de Pediatría, Mexico City, Mexico
| | - Kevin Rubenstein
- Clinical Monitoring Research Program Directorate, Frederick National Laboratory for Cancer Research, Frederick, MD, USA
| | | | - Alejandra Ramírez-Venegas
- Departamento de Investigación en Tabaquismo y EPOC, Instituto Nacional de Enfermedades Respiratorias Ismael Cosío Villegas, Mexico City, Mexico
| | - Rafael Valdez-Vázquez
- Departamento de Infectología, Hospital General Dr. Manuel Gea González, Mexico City, Mexico
| | | | - Beatriz Llamosas-Gallardo
- División de Desarrollo y Enlace Interinstitucional, Instituto Nacional de Pediatría, Mexico City, Mexico
| | - Santiago Pérez-Patrigeon
- Division of Infectious Diseases, Queen's University, Kingston, Ontario, Canada
- Departamento de Infectología, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City, Mexico
| | - Daniel E. Noyola
- Departamento de Microbiología y Centro de Investigación en Ciencias de la Salud y Biomedicina, Facultad de Medicina, Universidad Autónoma de San Luís Potosí, San Luis Potosí, Mexico
| | | | - Ana Vilardell-Dávila
- The Mexican Emerging Infectious Diseases Clinical Research Network (LaRed), Mexico City, Mexico
| | - M. Lourdes Guerrero
- Departamento de Infectología, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City, Mexico
| | - John H. Powers
- Clinical Research Directorate, Frederick National Laboratory for Cancer Research, Frederick, MD, USA
| | - John Beigel
- National Institute of Allergy and Infectious Diseases, Bethesda, MD, USA
| | - Guillermo M. Ruiz-Palacios
- Departamento de Infectología, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City, Mexico
| | - Mexican Emerging Infectious Disease Clinical Research Network
- Subdirección de Epidemiología Hospitalaria, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City, Mexico
- The Mexican Emerging Infectious Diseases Clinical Research Network (LaRed), Mexico City, Mexico
- División de Desarrollo y Enlace Interinstitucional, Instituto Nacional de Pediatría, Mexico City, Mexico
- Clinical Monitoring Research Program Directorate, Frederick National Laboratory for Cancer Research, Frederick, MD, USA
- National Institute of Allergy and Infectious Diseases, Bethesda, MD, USA
- Departamento de Investigación en Tabaquismo y EPOC, Instituto Nacional de Enfermedades Respiratorias Ismael Cosío Villegas, Mexico City, Mexico
- Departamento de Infectología, Hospital General Dr. Manuel Gea González, Mexico City, Mexico
- Departamento de Infectología, Hospital Infantil de México Federico Gómez, Mexico City, Mexico
- Division of Infectious Diseases, Queen's University, Kingston, Ontario, Canada
- Departamento de Infectología, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City, Mexico
- Departamento de Microbiología y Centro de Investigación en Ciencias de la Salud y Biomedicina, Facultad de Medicina, Universidad Autónoma de San Luís Potosí, San Luis Potosí, Mexico
- Hospital Regional Dr. Ignacio Morones Prieto, San Luis Potosí, Mexico
- Clinical Research Directorate, Frederick National Laboratory for Cancer Research, Frederick, MD, USA
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Dietz E, Pritchard E, Pouwels K, Ehsaan M, Blake J, Gaughan C, Haduli E, Boothe H, Vihta KD, Peto T, Stoesser N, Matthews P, Taylor N, Diamond I, Studley R, Rourke E, Birrell P, De Angelis D, Fowler T, Watson C, Eyre D, House T, Walker AS. SARS-CoV-2, influenza A/B and respiratory syncytial virus positivity and association with influenza-like illness and self-reported symptoms, over the 2022/23 winter season in the UK: a longitudinal surveillance cohort. BMC Med 2024; 22:143. [PMID: 38532381 DOI: 10.1186/s12916-024-03351-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/14/2023] [Accepted: 03/07/2024] [Indexed: 03/28/2024] Open
Abstract
BACKGROUND Syndromic surveillance often relies on patients presenting to healthcare. Community cohorts, although more challenging to recruit, could provide additional population-wide insights, particularly with SARS-CoV-2 co-circulating with other respiratory viruses. METHODS We estimated the positivity and incidence of SARS-CoV-2, influenza A/B, and RSV, and trends in self-reported symptoms including influenza-like illness (ILI), over the 2022/23 winter season in a broadly representative UK community cohort (COVID-19 Infection Survey), using negative-binomial generalised additive models. We estimated associations between test positivity and each of the symptoms and influenza vaccination, using adjusted logistic and multinomial models. RESULTS Swabs taken at 32,937/1,352,979 (2.4%) assessments tested positive for SARS-CoV-2, 181/14,939 (1.2%) for RSV and 130/14,939 (0.9%) for influenza A/B, varying by age over time. Positivity and incidence peaks were earliest for RSV, then influenza A/B, then SARS-CoV-2, and were highest for RSV in the youngest and for SARS-CoV-2 in the oldest age groups. Many test positives did not report key symptoms: middle-aged participants were generally more symptomatic than older or younger participants, but still, only ~ 25% reported ILI-WHO and ~ 60% ILI-ECDC. Most symptomatic participants did not test positive for any of the three viruses. Influenza A/B-positivity was lower in participants reporting influenza vaccination in the current and previous seasons (odds ratio = 0.55 (95% CI 0.32, 0.95)) versus neither season. CONCLUSIONS Symptom profiles varied little by aetiology, making distinguishing SARS-CoV-2, influenza and RSV using symptoms challenging. Most symptoms were not explained by these viruses, indicating the importance of other pathogens in syndromic surveillance. Influenza vaccination was associated with lower rates of community influenza test positivity.
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Affiliation(s)
- Elisabeth Dietz
- Nuffield Department of Medicine, University of Oxford, Oxford, UK.
- The National Institute for Health Research Health Protection Research Unit in Healthcare Associated Infections and Antimicrobial Resistance at the University of Oxford, Oxford, UK.
| | - Emma Pritchard
- Nuffield Department of Medicine, University of Oxford, Oxford, UK
- The National Institute for Health Research Health Protection Research Unit in Healthcare Associated Infections and Antimicrobial Resistance at the University of Oxford, Oxford, UK
| | - Koen Pouwels
- The National Institute for Health Research Health Protection Research Unit in Healthcare Associated Infections and Antimicrobial Resistance at the University of Oxford, Oxford, UK
- Health Economics Research Centre, Nuffield Department of Population Health, University of Oxford, Oxford, UK
| | | | - Joshua Blake
- MRC Biostatistics Unit, University of Cambridge, Cambridge, UK
| | | | - Eric Haduli
- Berkshire and Surrey Pathology Services, Camberley, UK
| | - Hugh Boothe
- Berkshire and Surrey Pathology Services, Camberley, UK
| | | | - Tim Peto
- Nuffield Department of Medicine, University of Oxford, Oxford, UK
- The National Institute for Health Research Health Protection Research Unit in Healthcare Associated Infections and Antimicrobial Resistance at the University of Oxford, Oxford, UK
- Department of Infectious Diseases and Microbiology, Oxford University Hospitals NHS Foundation Trust, John Radcliffe Hospital, Oxford, UK
| | - Nicole Stoesser
- Nuffield Department of Medicine, University of Oxford, Oxford, UK
- The National Institute for Health Research Health Protection Research Unit in Healthcare Associated Infections and Antimicrobial Resistance at the University of Oxford, Oxford, UK
- Department of Infectious Diseases and Microbiology, Oxford University Hospitals NHS Foundation Trust, John Radcliffe Hospital, Oxford, UK
| | - Philippa Matthews
- The Francis Crick Institute, 1 Midland Road, London, UK
- Division of Infection and Immunity, University College London, London, UK
| | | | | | | | | | - Paul Birrell
- MRC Biostatistics Unit, University of Cambridge, Cambridge, UK
- UK Health Security Agency, London, UK
| | | | - Tom Fowler
- UK Health Security Agency, London, UK
- William Harvey Research Institute, Queen Mary University of London, London, UK
| | | | - David Eyre
- The National Institute for Health Research Health Protection Research Unit in Healthcare Associated Infections and Antimicrobial Resistance at the University of Oxford, Oxford, UK
- Big Data Institute, Nuffield Department of Population Health, University of Oxford, Oxford, UK
| | | | - Ann Sarah Walker
- Nuffield Department of Medicine, University of Oxford, Oxford, UK
- The National Institute for Health Research Health Protection Research Unit in Healthcare Associated Infections and Antimicrobial Resistance at the University of Oxford, Oxford, UK
- The National Institute for Health Research Oxford Biomedical Research Centre, University of Oxford, Oxford, UK
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Zhao P, Shao N, Dong J, Su H, Sui H, Zhang T, Yang F. Genetic diversity and characterization of rhinoviruses from Chinese clinical samples with a global perspective. Microbiol Spectr 2023; 11:e0084023. [PMID: 37733296 PMCID: PMC10715137 DOI: 10.1128/spectrum.00840-23] [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: 02/25/2023] [Accepted: 08/03/2023] [Indexed: 09/22/2023] Open
Abstract
IMPORTANCE Based on clinical samples collected in China, we detected and reported 22 types for the first time in China, as well as three types for the first time in Asia, and reported their genetic characteristics and diversity. We identified a novel type of Rhinovirus (RV), A110, highlighting its unique genetic features. We annotated the genomic structure and serotype of all the existing RV sequences in the database, and four novel RV types were identified and their genetic diversity reported. Combined with the sequence annotation, we constructed a complete VP1 data set of RV and conducted the first large-scale evolutionary dynamics analysis of RV. Based on a high-quality data set, we conducted a comprehensive analysis of the guanine-cytosine (GC) content variations among serotypes of RVs. This study provides crucial theoretical support and valuable data for understanding RV's genetic diversity and developing antiviral strategies.
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Affiliation(s)
- Peng Zhao
- NHC Key Laboratory of Systems Biology of Pathogens, Institute of Pathogen Biology, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Nan Shao
- NHC Key Laboratory of Systems Biology of Pathogens, Institute of Pathogen Biology, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Jie Dong
- NHC Key Laboratory of Systems Biology of Pathogens, Institute of Pathogen Biology, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Haoxiang Su
- NHC Key Laboratory of Systems Biology of Pathogens, Institute of Pathogen Biology, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Hongtao Sui
- NHC Key Laboratory of Systems Biology of Pathogens, Institute of Pathogen Biology, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Ting Zhang
- NHC Key Laboratory of Systems Biology of Pathogens, Institute of Pathogen Biology, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Fan Yang
- NHC Key Laboratory of Systems Biology of Pathogens, Institute of Pathogen Biology, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
- Key Laboratory of Respiratory Disease Pathogenomics, Chinese Academy of Medical Sciences, Beijing, China
- State Key Laboratory of Respiratory Health and Multimorbidity, Beijing, China
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Petat H, Schuers M, Marguet C, Humbert X, Le Bas F, Rabiaza A, Corbet S, Leterrier B, Vabret A, Ar Gouilh M. Positive and negative viral associations in patients with acute respiratory tract infections in primary care: the ECOVIR study. Front Public Health 2023; 11:1269805. [PMID: 38074759 PMCID: PMC10706622 DOI: 10.3389/fpubh.2023.1269805] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2023] [Accepted: 10/30/2023] [Indexed: 12/18/2023] Open
Abstract
Introduction Acute respiratory infections (ARIs) are the most common viral infections encountered in primary care settings. The identification of causal viruses is still not available in routine practice. Although new strategies of prevention are being identified, knowledge of the relationships between respiratory viruses remains limited. Materials and methods ECOVIR was a multicentric prospective study in primary care, which took place during two pre-pandemic seasons (2018-2019 and 2019-2020). Patients presenting to their General practitioner (GP) with ARIs were included, without selecting for age or clinical conditions. Viruses were detected on nasal swab samples using a multiplex Polymerase Chain Reaction test focused on 17 viruses [Respiratory Syncytial Virus-A (RSV-A), RSV-B, Rhinovirus/Enterovirus (HRV), human Metapneumovirus (hMPV), Adenovirus (ADV), Coronaviruses (CoV) HKU1, NL63, 229E, OC43, Influenza virus (H1 and H3 subtypes), Influenza virus B, Para-Influenza viruses (PIVs) 1-4, and Bocavirus (BoV)]. Results Among the 668 analyzed samples, 66% were positive for at least one virus, of which 7.9% were viral codetections. The viral detection was negatively associated with the age of patients. BoV, ADV, and HRV occurred more significantly in younger patients than the other viruses (p < 0.05). Codetections were significantly associated with RSV, HRV, BoV, hMPV, and ADV and not associated with influenza viruses, CoV, and PIVs. HRV and influenza viruses were negatively associated with all the viruses. Conversely, a positive association was found between ADV and BoV and between PIVs and BoV. Conclusion Our study provides additional information on the relationships between respiratory viruses, which remains limited in primary care.
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Affiliation(s)
- Hortense Petat
- Department of Paediatrics and Adolescent Medicine Rouen, Univ Rouen Normandie, Dynamicure INSERM UMR 1311, CHU Rouen, Rouen, France
| | - Matthieu Schuers
- Department of General Practice, Univ Rouen Normandie, INSERM U1142, CHU Rouen, Rouen, France
| | - Christophe Marguet
- Department of Paediatrics and Adolescent Medicine Rouen, Univ Rouen Normandie, Dynamicure INSERM UMR 1311, CHU Rouen, Rouen, France
| | - Xavier Humbert
- Department of General Practice, Univ Caen Normandie santé, Caen, France
| | - François Le Bas
- Department of General Practice, Univ Caen Normandie santé, Caen, France
| | - Andry Rabiaza
- Department of General Practice, Univ Caen Normandie santé, Caen, France
| | - Sandrine Corbet
- Department of Virology, Univ Caen Normandie, INSERM Dynamicure UMR 1311, CHU Caen, Caen, France
| | - Bryce Leterrier
- Department of Virology, Univ Caen Normandie, INSERM Dynamicure UMR 1311, CHU Caen, Caen, France
| | - Astrid Vabret
- Department of Virology, Univ Caen Normandie, INSERM Dynamicure UMR 1311, CHU Caen, Caen, France
| | - Meriadeg Ar Gouilh
- Department of Virology, Univ Caen Normandie, INSERM Dynamicure UMR 1311, CHU Caen, Caen, France
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Greffe S, Guerrisi C, Souty C, Vilcu AM, Hayem G, Costantino F, Padovano I, Bourgault I, Trad S, Ponsoye M, Vilaine E, Debin M, Turbelin C, Blanchon T, Hanslik T. Influenza-like illness in individuals treated with immunosuppressants, biologics, and/or systemic corticosteroids for autoimmune or chronic inflammatory disease: A crowdsourced cohort study, France, 2017-2018. Influenza Other Respir Viruses 2023; 17:e13148. [PMID: 37380174 DOI: 10.1111/irv.13148] [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: 12/11/2022] [Revised: 05/03/2023] [Accepted: 05/04/2023] [Indexed: 06/30/2023] Open
Abstract
BACKGROUND Influenza-like illness (ILI) incidence estimates in individuals treated with immunosuppressants and/or biologics and/or corticosteroid for an autoimmune or chronic inflammatory disease are scarce. We compared the ILI incidence among immunocompromised population and the general population. METHOD We conducted a prospective cohort study during the 2017-2018 seasonal influenza epidemic, on the GrippeNet.fr electronic platform, which allows the collection of epidemiological crowdsourced data on ILI, directly from the French general population. The immunocompromised population were adults treated with systemic corticosteroids, immunosuppressants, and/or biologics for an autoimmune or chronic inflammatory disease, recruited directly on GrippeNet.fr and also among patients of the departments of a single university hospital that were asked to incorporate GrippeNet.fr. The general population consisted of adults reporting none of the above treatments or diseases participating in GrippeNet.fr. The incidence of ILI was estimated on a weekly basis and compared between the immunocompromised population and the general population, during the seasonal influenza epidemic. RESULTS Among the 318 immunocompromised patients assessed for eligibility, 177 were included. During the 2017-2018 seasonal influenza epidemic period, immunocompromised population had 1.59 (95% CI: 1.13-2.20) higher odds to experience an ILI episode, compared to the general population (N = 5358). An influenza vaccination was reported by 58% of the immunocompromised population, compared to 41% of the general population (p < 0.001). CONCLUSION During a seasonal influenza epidemic period, the incidence of influenza-like illness was higher in patients treated with immunosuppressants, biologics, and/or corticosteroids for an autoimmune or chronic inflammatory disease, compared to the general population.
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Affiliation(s)
- Ségolène Greffe
- Department of Internal Medicine, Ambroise-Paré Hospital, Assistance Publique-Hôpitaux de Paris (AP-HP), Boulogne-Billancourt, France
| | - Caroline Guerrisi
- Sorbonne Université, INSERM, Institut Pierre Louis d'Épidémiologie et de Santé Publique (IPLESP), Paris, France
| | - Cécile Souty
- Sorbonne Université, INSERM, Institut Pierre Louis d'Épidémiologie et de Santé Publique (IPLESP), Paris, France
| | - Ana-Maria Vilcu
- Sorbonne Université, INSERM, Institut Pierre Louis d'Épidémiologie et de Santé Publique (IPLESP), Paris, France
| | - Gilles Hayem
- Department of Rheumatology, Ambroise-Paré Hospital, Assistance Publique-Hôpitaux de Paris (AP-HP), Boulogne-Billancourt, France
- Department of Rheumatology, Saint-Joseph Hospital, Paris, France
| | - Félicie Costantino
- Department of Rheumatology, Ambroise-Paré Hospital, Assistance Publique-Hôpitaux de Paris (AP-HP), Boulogne-Billancourt, France
- "Simone Veil - Santé" Medical School, Université de Versailles Saint-Quentin-en-Yvelines, Université Paris Saclay, Montigny-le-Bretonneux, France
- Université Paris-Saclay, UVSQ, Inserm U1173, Infection et inflammation, Laboratory of Excellence INFLAMEX, Montigny-Le-Bretonneux, France
| | - Ilaria Padovano
- Department of Rheumatology, Ambroise-Paré Hospital, Assistance Publique-Hôpitaux de Paris (AP-HP), Boulogne-Billancourt, France
| | - Isabelle Bourgault
- "Simone Veil - Santé" Medical School, Université de Versailles Saint-Quentin-en-Yvelines, Université Paris Saclay, Montigny-le-Bretonneux, France
- Department of Dermatology, Ambroise-Paré Hospital, Assistance Publique-Hôpitaux de Paris (AP-HP), Boulogne-Billancourt, France
| | - Salim Trad
- Department of Internal Medicine, Ambroise-Paré Hospital, Assistance Publique-Hôpitaux de Paris (AP-HP), Boulogne-Billancourt, France
| | - Matthieu Ponsoye
- Department of Internal Medicine, Ambroise-Paré Hospital, Assistance Publique-Hôpitaux de Paris (AP-HP), Boulogne-Billancourt, France
- "Simone Veil - Santé" Medical School, Université de Versailles Saint-Quentin-en-Yvelines, Université Paris Saclay, Montigny-le-Bretonneux, France
- Department of Internal Medicine, Foch Hospital, Suresnes, France
| | - Eve Vilaine
- Department of Nephrology, Ambroise-Paré Hospital, Assistance Publique-Hôpitaux de Paris (AP-HP), Boulogne-Billancourt, France
| | - Marion Debin
- Sorbonne Université, INSERM, Institut Pierre Louis d'Épidémiologie et de Santé Publique (IPLESP), Paris, France
| | - Clément Turbelin
- Sorbonne Université, INSERM, Institut Pierre Louis d'Épidémiologie et de Santé Publique (IPLESP), Paris, France
| | - Thierry Blanchon
- Sorbonne Université, INSERM, Institut Pierre Louis d'Épidémiologie et de Santé Publique (IPLESP), Paris, France
| | - Thomas Hanslik
- Department of Internal Medicine, Ambroise-Paré Hospital, Assistance Publique-Hôpitaux de Paris (AP-HP), Boulogne-Billancourt, France
- "Simone Veil - Santé" Medical School, Université de Versailles Saint-Quentin-en-Yvelines, Université Paris Saclay, Montigny-le-Bretonneux, France
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Özgen Alpaydın A, Appak Ö, Sinem Gezer N, Yiğit S, Gündüz Karayazı D, Kuruüzüm Z, Ömeroğlu Şimşek G, Özlem Eren Kutsoylu O, Arzu Sayıner A, Sevinç C, Sabri Uçan E, Levent Uğur Y, Necati Gökmen A, Yapar N. Can Some Viral Respiratory Infections Observed Before the Pandemic Announcement Be Related to SARS-CoV-2? THORACIC RESEARCH AND PRACTICE 2023; 24:91-95. [PMID: 37503645 PMCID: PMC10652072 DOI: 10.5152/thoracrespract.2023.22187] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/03/2022] [Accepted: 10/14/2022] [Indexed: 07/29/2023]
Abstract
OBJECTIVE There have been doubts that SARS-CoV-2 has been circulating before the first case was announced. The aim of this study was to evaluate the possibility of COVID-19 in some cases diagnosed to be viral respiratory tract infection in the pre-pandemic period in our center. MATERIAL AND METHODS Patients who were admitted to our hospital's pulmonary diseases, infectious diseases, and intensive care clinics with the diagnosis of viral respiratory system infection within a 6-month period between October 2019 and March 12, 2020, were screened. Around 248 archived respiratory samples from these patients were analyzed for SARS-CoV-2 ribonucleic acid by real-timequantitative polymerase chain reaction. The clinical, laboratory, and radiological data of the patients were evaluated. RESULTS The mean age of the study group was 47.5 (18-89 years); 103 (41.5%) were female and 145 (58.4%) were male. The most common presenting symptoms were cough in 51.6% (n = 128), fever in 42.7% (n = 106), and sputum in 27.0% (n = 67). Sixty-nine percent (n = 172) of the patients were pre-diagnosed to have upper respiratory tract infection and 22.0% (n = 55) had pneumonia, one-third of the patients (n = 84, 33.8%) were followed in the service. Respiratory viruses other than SARS-CoV-2 were detected in 123 (49.6%) patients. Influenza virus (31.9%), rhinovirus (10.5%), and human metapneumovirus (6.5%) were the most common pathogens, while none of the samples were positive for SARS-CoV-2 RNA. Findings that could be significant for COVID-19 pneumonia were detected in the thorax computed tomography of 7 cases. CONCLUSION The negative SARS-CoV-2 real-time-quantitative polymerase chain reaction results in the respiratory samples of the cases followed up in our hospital for viral pneumonia during the pre-pandemic period support that there was no COVID-19 among our cases during the period in question. However, if clinical suspicion arises, both SARS and non-SARS respiratory viral pathogens should be considered for differential diagnosis.
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Affiliation(s)
- Aylin Özgen Alpaydın
- Department of Pulmonary Diseases, Dokuz Eylül University Faculty of Medicine, İzmir, Turkey
| | - Özgür Appak
- Department of Medical Microbiology, Dokuz Eylül University Faculty of Medicine, İzmir, Turkey
| | - Naciye Sinem Gezer
- Department of Radiology, Dokuz Eylül University Faculty of Medicine, İzmir, Turkey
| | - Salih Yiğit
- Department of Pulmonary Diseases, Dokuz Eylül University Faculty of Medicine, İzmir, Turkey
| | - Damla Gündüz Karayazı
- Department of Pulmonary Diseases, Dokuz Eylül University Faculty of Medicine, İzmir, Turkey
| | - Ziya Kuruüzüm
- Department of Infectious Diseases and Clinical Microbiology, Dokuz Eylül University Faculty of Medicine, İzmir, Turkey
| | - Gökçen Ömeroğlu Şimşek
- Department of Pulmonary Diseases, Dokuz Eylül University Faculty of Medicine, İzmir, Turkey
| | - Oya Özlem Eren Kutsoylu
- Department of Infectious Diseases and Clinical Microbiology, Dokuz Eylül University Faculty of Medicine, İzmir, Turkey
| | - Ayça Arzu Sayıner
- Department of Medical Microbiology, Dokuz Eylül University Faculty of Medicine, İzmir, Turkey
| | - Can Sevinç
- Department of Pulmonary Diseases, Dokuz Eylül University Faculty of Medicine, İzmir, Turkey
| | - Eyüp Sabri Uçan
- Department of Pulmonary Diseases, Dokuz Eylül University Faculty of Medicine, İzmir, Turkey
| | - Yasin Levent Uğur
- Department of Intensive Care Unit, Mehmet Akif Ersoy State Hospital, Çanakkale,Turkey
| | - Ali Necati Gökmen
- Department of Anesthesiology and Reanimation, Dokuz Eylül University Faculty of Medicine, İzmir, Turkey
| | - Nur Yapar
- Department of Infectious Diseases and Clinical Microbiology, Dokuz Eylül University Faculty of Medicine, İzmir, Turkey
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7
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Galindo-Fraga A, Guerra de Blas PDC, Ortega-Villa AM, Mateja A, Ruiz Quiñones JA, Cervantes PR, Barrientos FL, Ortiz-Hernández AA, Llamosas-Gallardo B, Ramírez-Venegas A, Vázquez RV, Chepitel DN, Moreno-Espinosa S, Powers JH, Lourdes Guerrero M, Ruiz-Palacios GM, Beigel J. DIFFERENT CLINICAL PRESENTATIONS OF HUMAN RHINOVIRUS (HRV) SPECIES INFECTION IN CHILDREN AND ADULTS IN MEXICO. Open Forum Infect Dis 2022; 9:ofac303. [PMID: 35891697 PMCID: PMC9308452 DOI: 10.1093/ofid/ofac303] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2022] [Accepted: 06/15/2022] [Indexed: 11/26/2022] Open
Abstract
Background Human rhinoviruses (HRVs) are a common cause of influenza-like illness, with the ability to infect the upper and lower respiratory tracts. In this study we aim to describe the clinical and molecular features of HRV infection in Mexican children and adults. Methods We performed a hospital-based, 4-year multicenter prospective observational cohort study of patients with influenza-like illness. Participants who tested positive for HRV were included. We described demographic, clinical, and laboratory characteristics and the association between HRV types, illness severity, and clinical outcomes. Results Of the 5662 subjects recruited, 1473 (26%) had HRV; of those, 988 (67.1%) were adults (≥18 years) and 485 (32.9%) were children. One hundred sixty-seven (11.33%) samples were sequenced; 101 (60.5%) were rhinovirus species A (HRV-A), 22 (13.2%) were rhinovirus species B (HRV-B), and 44 (26.3%) were rhinovirus species C (HRV-C). Among children and adults, 30.5% and 23.5%, respectively, were hospitalized (non–intensive care unit [ICU]). The odds of HRV-C are higher than HRV-A for participants in the ICU (compared to outpatient) and when platelets, lymphocytes, white blood cells, and lactate dehydrogenase are increased. The odds of HRV-C are higher than HRV-A and HRV-B with shortness of breath. The odds of HRV-A are higher than HRV-B, and the odds of HRV-B are higher than HRV-C, when mild symptoms like muscle ache and headache occur. Conclusions Rhinoviruses are a common cause of influenza-like illness. It is necessary to improve the surveillance, testing, and species identification for these viruses to understand different clinical presentations and risk factors associated with worse outcomes. Clinical Trials Registration. NCT01418287.
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Affiliation(s)
- Arturo Galindo-Fraga
- Departamento de Epidemiología, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán , Mexico City , Mexico
| | | | - Ana M Ortega-Villa
- National Institute of Allergy and Infectious Diseases , Bethesda, MD , USA
| | - Allyson Mateja
- Clinical Monitoring Research Program Directorate, Frederick National Laboratory for Cancer Research , Frederick, Maryland , United States of America
| | - Jesus Arturo Ruiz Quiñones
- Departamento de Epidemiología, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán , Mexico City , Mexico
| | - Pilar Ramos Cervantes
- Departamento de Infectología, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán , Mexico City , Mexico
| | - Fernando Ledesma Barrientos
- Departamento de Infectología, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán , Mexico City , Mexico
| | - Ana A Ortiz-Hernández
- División de Desarrollo y Enlace Interinstitucional, Instituto Nacional de Pediatría Mexico City , Mexico
| | - Beatriz Llamosas-Gallardo
- División de Desarrollo y Enlace Interinstitucional, Instituto Nacional de Pediatría Mexico City , Mexico
| | - Alejandra Ramírez-Venegas
- Departamento de Investigación en Tabaquismo y EPOC, Instituto Nacional de Enfermedades Respiratorias “Ismael Cosío Villegas” , Mexico City , Mexico
| | - Rafael Valdéz Vázquez
- Departamento de Infectología, Hospital General “Dr. Manuel Gea González” , Mexico City , Mexico
| | - Daniel Noyola Chepitel
- Microbiology Department, Facultad de Medicina, Universidad Autónoma de San Luís Potosí , San Luis Potosí , Mexico
| | - Sarbelio Moreno-Espinosa
- Departamento de Infectología, Hospital Infantil de México Federico Gómez, Instituto Nacional de Salud , Mexico City , Mexico
| | - John H Powers
- Clinical Research Directorate, Frederick National Laboratory for Cancer Research, Frederick , Maryland , United States of America
| | - M Lourdes Guerrero
- Departamento de Infectología, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán , Mexico City , Mexico
| | - Guillermo M Ruiz-Palacios
- Departamento de Infectología, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán , Mexico City , Mexico
| | - John Beigel
- National Institute of Allergy and Infectious Diseases , Bethesda, MD , USA
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Pellegrinelli L, Galli C, Bubba L, Seiti A, Anselmi G, Primache V, Signorini L, Delbue S, Binda S, Pariani E. Respiratory syncytial virus in pediatric influenza-like illness cases in Lombardy, Northern Italy, during seven consecutive winter seasons (from 2014-2015 to 2020-2021). Influenza Other Respir Viruses 2021; 16:481-491. [PMID: 34921508 PMCID: PMC8983902 DOI: 10.1111/irv.12940] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2021] [Revised: 10/28/2021] [Accepted: 11/04/2021] [Indexed: 12/01/2022] Open
Abstract
Introduction Respiratory syncytial virus (RSV) is the major cause of lower respiratory tract illness in young children and can also cause influenza‐like illness (ILI). Here we investigated the epidemiological features of RSV infection in pediatric ILI cases in Lombardy (a region in Northern Italy accounting nearly 10 million inhabitants) from 2014–2015 to 2020–2021 winter seasons. Material and Methods Data for this study were retrieved and statistically analyzed from the database of virological influenza surveillance of the regional reference laboratory for Lombardy within the Italian influenza surveillance network (InfluNet). Results RSV accounted for nearly 19% of pediatric ILI with a risk of infection nearly two‐fold greater than that of individuals ≥15 years. RSV positivity rate increased to 28% considering 0–5 years old children. Although in children ≤5 years the risk of infection from influenza viruses resulted nearly two‐fold higher than the risk of RSV infection, the age group 4–6 months and 7–12 months showed a five‐fold greater risk of infection from RSV than from influenza. Children ≤5 years of age with pre‐existing underlying health conditions had a nearly five‐fold greater risk of getting RSV infection than otherwise healthy 0–5 years old children. RSV was identified in ILI cases <15 years of age in all considered winter seasons except in the 2020–2021 season. Discussion Sentinel surveillance of ILI allowed us to identify groups at higher risk of RSV and influenza infection and to define the start, duration, timing, and intensity of the RSV and influenza community circulation. This surveillance approach can be implemented to assess the RSV circulation and impact in a real‐time manner.
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Affiliation(s)
- Laura Pellegrinelli
- Department of Biomedical Sciences for Health, University of Milan, Milan, Italy
| | - Cristina Galli
- Department of Biomedical Sciences for Health, University of Milan, Milan, Italy
| | - Laura Bubba
- Department of Biomedical Sciences for Health, University of Milan, Milan, Italy
| | - Arlinda Seiti
- Department of Biomedical Sciences for Health, University of Milan, Milan, Italy
| | - Giovanni Anselmi
- Department of Biomedical Sciences for Health, University of Milan, Milan, Italy
| | - Valeria Primache
- Department of Biomedical Sciences for Health, University of Milan, Milan, Italy
| | - Lucia Signorini
- Department of Biomedical, Surgical and Dental Sciences, University of Milan, Milan, Italy
| | - Serena Delbue
- Department of Biomedical, Surgical and Dental Sciences, University of Milan, Milan, Italy
| | - Sandro Binda
- Department of Biomedical Sciences for Health, University of Milan, Milan, Italy
| | - Elena Pariani
- Department of Biomedical Sciences for Health, University of Milan, Milan, Italy.,Interuniversity Research Center on Influenza and Other Transmissible Infections (CIRI-IT), University of Genoa, Genoa, Italy
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Elsaid AF, Agrawal S, Agrawal A, Ghoneum M. Dietary Supplementation with Biobran/MGN-3 Increases Innate Resistance and Reduces the Incidence of Influenza-like Illnesses in Elderly Subjects: A Randomized, Double-Blind, Placebo-Controlled Pilot Clinical Trial. Nutrients 2021; 13:nu13114133. [PMID: 34836388 PMCID: PMC8618540 DOI: 10.3390/nu13114133] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2021] [Revised: 11/13/2021] [Accepted: 11/14/2021] [Indexed: 12/13/2022] Open
Abstract
Influenza-like illness (ILI) remains a major cause of severe mortality and morbidity in the elderly. Aging is associated with a decreased ability to sense pathogens and mount effective innate and adaptive immune responses, thus mandating the development of protective nutraceuticals. Biobran/MGN-3, an arabinoxylan from rice bran, has potent anti-aging and immunomodulatory effects, suggesting that it may be effective against ILI. The objective of the current study was to investigate the effect of Biobran/MGN-3 on ILI incidence, natural killer (NK) cell activity, and the expressions of RIG-1 (retinoic acid-inducible gene 1), MDA5 (melanoma differentiation-associated protein 5), and their downstream signaling genes ISG-15 (interferon-stimulated genes 15) and MX1 (myxovirus (influenza) resistance 1, interferon-inducible). A double-blind, placebo-controlled clinical trial included eighty healthy older adults over 55 years old, 40 males and 40 females, who received either a placebo or Biobran/MGN-3 (500 mg/day) for 3 months during known ILI seasonality (peak incidence) in Egypt. The incidence of ILI was confirmed clinically according to the WHO case definition criteria. Hematological, hepatic, and renal parameters were assessed in all subjects, while the activity of NK and NKT (natural killer T) cells was assessed in six randomly chosen subjects in each group by the degranulation assay. The effect of Biobran/MGN-3 on RIG-1 and MDA5, as well as downstream ISG15 and MX1, was assessed in BEAS-2B pulmonary epithelial cells using flow cytometry. The incidence rate and incidence density of ILI in the Biobran/MGN-3 group were 5.0% and 0.57 cases per 1000 person-days, respectively, compared to 22.5% and 2.95 cases per 1000 person-days in the placebo group. Furthermore, Biobran/MGN-3 ingestion significantly enhanced NK activity compared to the basal levels and to the placebo group. In addition, Biobran/MGN-3 significantly upregulated the expression levels of RIG-1, MDA5, ISG15, and MX1 in the human pulmonary epithelial BEAS-2B cell lines. No side effects were observed. Taken together, Biobran/MGN-3 supplementation enhanced the innate immune response of elderly subjects by upregulating the NK activity associated with reduction of ILI incidence. It also upregulated the intracellular RIG-1, MDA5, ISG15, and MX1 expression in pulmonary epithelial tissue cultures. Biobran/MGN-3 could be a novel agent with prophylactic effects against a wide spectrum of respiratory viral infections that warrants further investigation.
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Affiliation(s)
- Ahmed F. Elsaid
- Department of Community Medicine and Public Health, Zagazig University, Zagazig 44519, Egypt
- Correspondence: or
| | - Sudhanshu Agrawal
- Division of Basic and Clinical Immunology, Department of Medicine, University of California, Irvine, CA 92697, USA; (S.A.); (A.A.)
| | - Anshu Agrawal
- Division of Basic and Clinical Immunology, Department of Medicine, University of California, Irvine, CA 92697, USA; (S.A.); (A.A.)
| | - Mamdooh Ghoneum
- Department of Surgery, Charles R. Drew University of Medicine and Science, Los Angeles, CA 90059, USA;
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Management of hospitalized influenza A patients during the season 2018/19 : Comparison of three medical departments and the effect on outcome and antibiotic usage. Wien Klin Wochenschr 2021; 133:1310-1317. [PMID: 34613478 DOI: 10.1007/s00508-021-01950-8] [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: 06/16/2021] [Accepted: 09/03/2021] [Indexed: 10/20/2022]
Abstract
BACKGROUND Diagnosis and treatment of influenza patients are often provided across several medical specialties. We compared patient outcomes at an infectious diseases (ID), a rheumatology (Rheu) and a pulmonology (Pul) department. MATERIAL AND METHODS In this prospective observational multicenter study we included all influenza positive adults who were hospitalized and treated at flu isolation wards in three hospitals in Vienna during the season 2018/2019. RESULTS A total of 490 patients (49% female) with a median age of 73 years (interquartile range [IQR] 61-82) were included. No differences regarding age, sex and most underlying diseases were present at admission. Frequencies of the most common complications differed: acute kidney failure (ID 12.7%, Rheu 21.2%, Pulm 37.1%, p < 0.001), acute heart failure (ID 4.3%, Rheu 17.1%, Pulm 14.4%, p < 0.001) and respiratory insufficiency (ID 45.1%, Rheu 41.5%, Pulm 56.3%, p = 0.030). Oseltamivir prescription was lowest at the pulmonology flu ward (ID 79.6%, Rheu 90.5%, Pulm 61.7%, p < 0.001). In total 176 patients (35.9%) developed pneumonia. Antibiotic selection varied between the departments: amoxicillin/clavulanic acid (ID 28.9%, Rheu 63.8%, Pulm 5.9%, p < 0.001), cefuroxime (ID 28.9%, Rheu 1.3%, Pulm 0%, p < 0.001), 3rd generation cephalosporins (ID 4.4%, Rheu 5%, Pulm 72.5%, p < 0.001), doxycycline (ID 17.8%, Rheu 0%, Pulm 0%, p < 0.001). The median length of stay was significantly different between wards: ID 6 days (IQR 5-8), Rheu 6 days (IQR 5-7) and Pulm 7 days (IQR 5-9.5, p = 0.034). In-hospital mortality was 4.3% and did not differ between specialties. CONCLUSION We detected differences in oseltamivir usage, length of in-hospital stay and antibiotic choices for pneumonia. Influenza-associated mortality was unaffected by specialty.
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11
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Zhang Y, Qiao L, Yao J, Yu N, Mu X, Huang S, Hu B, Li W, Qiu F, Zeng F, Chen C, Zhou Y, Zhang B, Cai T, Wang W, Wu X, Zhou Y, Wang G, Situ B, Lan S, Li N, Li X, Li Z, Li X, Wang C, Yang C, Feng P, Wang H, Zhu S, Xiong Y, Luo M, Shen W, Hu X, Zheng L. Epidemiological and clinical characteristics of respiratory viruses in 4403 pediatric patients from multiple hospitals in Guangdong, China. BMC Pediatr 2021; 21:284. [PMID: 34140022 PMCID: PMC8212487 DOI: 10.1186/s12887-021-02759-0] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/03/2021] [Accepted: 06/03/2021] [Indexed: 02/05/2023] Open
Abstract
Background Acute respiratory infections (ARI) cause considerable morbidity and mortality worldwide, especially in children. Unfortunately, there are limited multi-center data on common viral respiratory infections in south China. Methods A total of 4403 nasal swabs were collected from children in 10 cities in Guangdong, China in 2019. Seven respiratory viruses, influenza A virus (IFA), influenza B virus (IFB), respiratory syncytial virus (RSV), adenoviruses (ADV) and parainfluenza virus types 1–3 (PIV1, PIV2 and PIV3), were detected by direct immunofluorescence antibody assay. The personal information and clinical characteristics were recorded and analyzed. Results The results showed that at least one virus was detected in 1099 (24.96 %) samples. The detection rates of RSV, IFA, ADV, PIV3, PIV1 and PIV2 were 7.13 % (314/4403), 5.31 % (234/4403), 4.02 % (177/4403), 3.04 % (134/4403), 1.70 % (75/4403) and 1.16 % (51/4403), respectively. The detection rate of RSV was highest in 0–6-month-old children at 18.18 % (106/583), while the detection rate of IFA was highest in 12–18-year-old children at 20.48 % (17/83). The total detection rates in winter and spring were 35.67 % (219/614) and 34.56 % (403/1166), higher than those in summer, 17.41 % (284/1631), and autumn, 19.46 % (193/992). Conclusions RSV and IFA were the main respiratory viruses in children. With increasing age the detection rate of RSV decreased in children, but the trends for the detection rates of IFA and IFB were the opposite. This study provided the viral etiology and epidemiology of pediatric patients with ARI in Guangdong, China. Supplementary Information The online version contains supplementary material available at 10.1186/s12887-021-02759-0.
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Affiliation(s)
- Yajie Zhang
- Department of Laboratory Medicine, Nanfang Hospital, Southern Medical University, Guangzhou, China
| | - Lin Qiao
- Guangdong 999 Brain Hospital, Guangzhou, China
| | - Jinxiu Yao
- Yangjiang People's Hospital, Yangjiang, China
| | - Nan Yu
- Zhujiang Hospital, Southern Medical University, Guangzhou, China
| | - Xiaoping Mu
- Guangdong Women and Children Hospital, Guangzhou, China
| | | | - Bo Hu
- The Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, China
| | - Weixuan Li
- The First People's Hospital of Foshan, Foshan, China
| | - Feng Qiu
- Nanhai Hospital, Southern Medical University, Foshan, China
| | - Fangyin Zeng
- The Fifth Affiliated Hospital of Southern Medical University, Guangzhou, China
| | - Cong Chen
- Central People's Hospital of Zhanjiang, Zhanjiang, China
| | - Yuqiu Zhou
- Zhuhai Maternal and Child Health Hospital, Zhuhai, China
| | | | - Tian Cai
- Nanhai District People's Hospital of Foshan, Foshan, China
| | - Weijia Wang
- Zhongshan People's Hospital, Zhongshan, China
| | - Xianjin Wu
- Central People's Hospital of Huizhou, Huizhou, China
| | - Yiwen Zhou
- Shenzhen Hospital of Southern Medical University, Shenzhen, China
| | - Guochang Wang
- School of Economics, Jinan University, Guangdong, Guangzhou, China
| | - Bo Situ
- Department of Laboratory Medicine, Nanfang Hospital, Southern Medical University, Guangzhou, China
| | - Shuling Lan
- Department of Laboratory Medicine, Nanfang Hospital, Southern Medical University, Guangzhou, China
| | - Na Li
- Department of Laboratory Medicine, Nanfang Hospital, Southern Medical University, Guangzhou, China
| | - Xiu Li
- Department of Laboratory Medicine, Nanfang Hospital, Southern Medical University, Guangzhou, China
| | - Zihua Li
- Department of Laboratory Medicine, Nanfang Hospital, Southern Medical University, Guangzhou, China
| | - Xin Li
- Department of Laboratory Medicine, Nanfang Hospital, Southern Medical University, Guangzhou, China
| | - Congrong Wang
- Department of Laboratory Medicine, Nanfang Hospital, Southern Medical University, Guangzhou, China
| | - Chao Yang
- Department of Laboratory Medicine, Nanfang Hospital, Southern Medical University, Guangzhou, China
| | - Pingfeng Feng
- Department of Laboratory Medicine, Nanfang Hospital, Southern Medical University, Guangzhou, China
| | - Hongxia Wang
- Department of Laboratory Medicine, Nanfang Hospital, Southern Medical University, Guangzhou, China
| | - Sijing Zhu
- Nanfang College of Sun Yat-Sen University, Guangdong, Guangzhou, China
| | - Yufeng Xiong
- Department of Laboratory Medicine, Nanfang Hospital, Southern Medical University, Guangzhou, China
| | - Min Luo
- Department of Laboratory Medicine, Nanfang Hospital, Southern Medical University, Guangzhou, China
| | - Wenjuan Shen
- The Seventh Affiliated Hospital, Sun Yat-Sen University, Guangdong, Guangdong, China
| | - Xiumei Hu
- Department of Laboratory Medicine, Nanfang Hospital, Southern Medical University, Guangzhou, China.
| | - Lei Zheng
- Department of Laboratory Medicine, Nanfang Hospital, Southern Medical University, Guangzhou, China.
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Are Posterior Oropharyngeal Saliva Specimens an Acceptable Alternative to Nasopharyngeal Sampling for the Monitoring of SARS-CoV-2 in Primary-Care Settings? Viruses 2021; 13:v13050761. [PMID: 33926069 PMCID: PMC8145717 DOI: 10.3390/v13050761] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2021] [Revised: 04/22/2021] [Accepted: 04/22/2021] [Indexed: 11/30/2022] Open
Abstract
Background: The present study was set up to evaluate the efficacy of virological surveillance using posterior oropharyngeal saliva samples to monitor the COVID-19 pandemic in general practice. Methods: Posterior oropharyngeal saliva samples were collected without restriction on timing or alimentation by general practitioners from patients with acute respiratory infection (ARI) seen in consultation. Saliva samples were tested by real-time reverse transcription polymerase chain reaction for SARS-CoV-2 and 21 other respiratory pathogens. Results for SARS-CoV-2 in saliva samples were compared to results obtained using a nasopharyngeal swab (NPS) collected in a certified medical laboratory before or after the ARI consultation. Results: Overall, 143 ARI patients were enrolled between 6 June 2020, and 19 January 2021. SARS-CoV-2 RNA was detected in 37.0% (n = 53) of saliva samples and in 39.0% (n = 56) of NPS. Both saliva and NPS were positive in 51 patients. Positive and negative results were concordant between saliva samples and NPS in 51 (96.2%) and in 85 (94.4%) patients, respectively, with a Cohen’s Kappa coefficient of 0.89 (95% CI 0.82–0.97, p < 0.001). Other respiratory viruses were detected in 28.0% (n = 40) of the 143 saliva samples. Conclusions: Findings suggest that saliva samples could represent an attractive alternative to NPS for surveillance of SARS-CoV-2 in patients consulting for an ARI in primary care.
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Souty C, Guerrisi C, Masse S, Lina B, van der Werf S, Bernard-Stoecklin S, Turbelin C, Falchi A, Hanslik T, Blanchon T. Impact of the lockdown on the burden of COVID-19 in outpatient care in France, spring 2020. Infect Dis (Lond) 2021; 53:376-381. [PMID: 33512254 DOI: 10.1080/23744235.2021.1880024] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
Abstract
BACKGROUND To limit the spread of SARS-CoV-2 several countries implemented measures to reduce the number of contacts such as a national lockdown. We estimated the impact of the first lockdown on the burden of COVID-19 in the community in France. METHODS Physicians participating in the French Sentinelles network reported the number of patients with an acute respiratory infection (ARI) seen in consultation and performed nasopharyngeal swabs in a sample of these patients (first patient of the week). The swabs were tested by RT-PCR for the presence of SARS-CoV-2. Clinical and virological data were combined to estimate ARI incidence attributable to SARS-CoV-2 from 17 March to 10 May 2020. RESULTS The incidence of ARI attributable to COVID-19 decreased after the second week of the lockdown period from 142 (95%CI [101; 183]) to 41 (95%CI [21; 60]) per 100,000 population. A decrease was observed in all areas in metropolitan France. The youngest age groups (<15-years-old) were least affected with a cumulated incidence estimated to 14 per 100,000 population during the study period. CONCLUSIONS The data collected in primary care suggests that the first lockdown implemented in France during spring 2020 significantly reduced the incidence of acute respiratory infections including COVID-19 in France and limited the geographic spread of SARS-CoV-2.
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Affiliation(s)
- Cécile Souty
- Sorbonne Université, INSERM, Institut Pierre Louis d'épidémiologie et de Santé publique (IPLESP), Paris, France
| | - Caroline Guerrisi
- Sorbonne Université, INSERM, Institut Pierre Louis d'épidémiologie et de Santé publique (IPLESP), Paris, France
| | - Shirley Masse
- UR 7310, Laboratoire de Virologie, Université de Corse, Corte, France
| | - Bruno Lina
- Laboratoire de Virologie des HCL, Institut des Agents Infectieux, CNR des virus à transmission respiratoire (dont la grippe), Hôpital de la Croix Rousse, Lyon, France
| | - Sylvie van der Werf
- National Reference Center for Respiratory Viruses, Molecular Genetics of RNA Viruses, CNRS UMR 3569, Institut Pasteur, Université de Paris, Paris, France
| | | | - Clément Turbelin
- Sorbonne Université, INSERM, Institut Pierre Louis d'épidémiologie et de Santé publique (IPLESP), Paris, France
| | - Alessandra Falchi
- UR 7310, Laboratoire de Virologie, Université de Corse, Corte, France
| | - Thomas Hanslik
- Sorbonne Université, INSERM, Institut Pierre Louis d'épidémiologie et de Santé publique (IPLESP), Paris, France.,Faculty of Health Sciences Simone Veil, University of Versailles Saint Quentin - University of Paris, Versailles, France.,Assistance Publique-Hôpitaux de Paris (APHP), Hôpital Ambroise Paré, Service de Médecine Interne, Boulogne-Billancourt, France
| | - Thierry Blanchon
- Sorbonne Université, INSERM, Institut Pierre Louis d'épidémiologie et de Santé publique (IPLESP), Paris, France
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Estimation of influenza-attributable burden in primary care from season 2014/2015 to 2018/2019, France. Eur J Clin Microbiol Infect Dis 2021; 40:1263-1269. [PMID: 33474677 DOI: 10.1007/s10096-021-04161-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2020] [Accepted: 01/11/2021] [Indexed: 10/22/2022]
Abstract
Influenza viruses cause seasonal epidemics whose intensity varies according to the circulating virus type and subtype. We aim to estimate influenza-like illness (ILI) incidence attributable to influenza viruses in France from October 2014 to May 2019. Physicians participating in the French Sentinelles network reported the number of patients with ILI seen in consultation and performed nasopharyngeal swabs in a sample of these patients. The swabs were tested by RT-PCR for the presence of influenza viruses. These clinical and virological data were combined to estimate ILI incidence attributable to influenza viruses by subtypes and age groups. Influenza incidence rates over seasons ranged from 1.9 (95% CI, 1.9; 2.0) to 3.4% (95% CI, 3.2; 3.6) of the population. Each season, more than half of ILI cases were attributable to influenza. Children under 15 years were the most affected, with influenza incidence rates ranging from 3.0 (95% CI, 2.8;3.3) to 5.7% (95% CI, 5.3;6.1). Co-circulation of several (sub)types of influenza viruses was observed each year, except in 2016/2017 where A(H3N2) viruses accounted for 98.0% of the influenza cases. Weekly ILI incidences attributable to each influenza virus (sub)type were mostly synchronized with ILI incidence, except in 2014/2015 and 2017/2018, where incidence attributable to type B viruses peaked few weeks later. The burden of medically attended influenza among patients with ILI is significant in France, varying considerably across years and age groups. These results show the importance of influenza surveillance in primary care combining clinical and virological data.
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Characteristics associated with COVID-19 or other respiratory viruses' infections at a single-center emergency department. PLoS One 2020; 15:e0243261. [PMID: 33270790 PMCID: PMC7714208 DOI: 10.1371/journal.pone.0243261] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2020] [Accepted: 11/19/2020] [Indexed: 12/25/2022] Open
Abstract
Background Rapid identification of patients with high suspicion of COVID-19 will become a challenge with the co-circulation of multiple respiratory viruses (RVs). We have identified clinical or biological characteristics to help distinguish SARS-CoV-2 from other RVs. Methods We used a prospective cohort including all consecutive patients admitted through the emergency department’s (ED) and presenting respiratory symptoms from November 2019 to April 2020. Patients were tested for RV using multiplex polymerase chain reaction (mPCR) and SARS-CoV-2 RT-PCR. Results 203/508 patients were positive for an RV during the non-SARS-CoV-2 epidemic period (November to February), and 268/596 patients were SARS-CoV-2 positive during the SARS-CoV-2 epidemic (March to April). Younger age, male gender, fever, absence of expectoration and absence of chronic lung disease were statistically associated with SARS-CoV-2 detection. Combining these variables allowed for the distinguishing of SARS-CoV-2 infections with 83, 65, 75 and 76% sensitivity, specificity, PPV and NPV, respectively. Conclusion Patients’ characteristics associated with a positive PCR are common between SARS-CoV-2 and other RVs, but a simple discrimination of strong SARS-CoV-2 suspicion with a limited set of clinical features seems possible. Such scoring could be useful but has to be prospectively evaluated and will not eliminate the need for rapid PCR assays.
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16
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Pellegrinelli L, Galli C, Bubba L, Cereda D, Anselmi G, Binda S, Gramegna M, Pariani E. Respiratory syncytial virus in influenza-like illness cases: Epidemiology and molecular analyses of four consecutive winter seasons (2014-2015/2017-2018) in Lombardy (Northern Italy). J Med Virol 2020; 92:2999-3006. [PMID: 32314816 DOI: 10.1002/jmv.25917] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2020] [Revised: 04/15/2020] [Accepted: 04/17/2020] [Indexed: 12/17/2022]
Abstract
BACKGROUND Besides seasonal influenza viruses (IV), several other pathogens-including respiratory syncytial virus (RSV)-are involved in clinically undistinguished influenza-like illnesses (ILIs). This study aimed at investigating the contribution of RSV in ILI cases in Lombardy (Northern Italy) during four consecutive winter seasons. MATERIALS AND METHODS In the framework of influenza surveillance, respiratory samples from ILI outpatients were collected from 2014-2015 to 2017-2018 season. IV-negative swabs were included in the study and analyzed to detect and molecularly characterize RSV-A and RSV-B. RESULTS A total of 12.9% (135/1047) of samples were positive to RSV that was mostly detected among children ≤5 years (51/183, 27.8%) and those aged 6 to 15 years (30/158, 18.9%), whereas elderly >65 years accounted for 12% of RSV cases (15/125). The median start of RSV epidemic was in the end of November, with a peak in mid-February and a width of nearly 4 months, almost overlapping seasonal influenza epidemic. RSV-A and RSV-B co-circulated in all considered seasons, with RSV-B predominating on RSV-A (63.6% vs 36.4%; P < .001). Most (85.2%) RSV-A belonged to genotype ON1 and the remaining to NA1. All RSV-B clustered within the BA genotype. CONCLUSIONS In this study, RSV significantly contributed to ILI cases, especially among pediatric population (<15 years), although it was detected in all age groups. RSV-B predominated on RSV-A, and the most recent evolved genotypes (BA and ON1, respectively) circulated. Investigating the epidemiological and molecular characteristics of RSV in ILI cases can increase baseline epidemiological information before the introduction of RSV vaccination.
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Affiliation(s)
- Laura Pellegrinelli
- Department of Biomedical Sciences for Health, University of Milan, Milan, Italy
| | - Cristina Galli
- Department of Biomedical Sciences for Health, University of Milan, Milan, Italy
| | - Laura Bubba
- Department of Biomedical Sciences for Health, University of Milan, Milan, Italy
| | | | - Giovanni Anselmi
- Department of Biomedical Sciences for Health, University of Milan, Milan, Italy
| | - Sandro Binda
- Department of Biomedical Sciences for Health, University of Milan, Milan, Italy
| | | | - Elena Pariani
- Department of Biomedical Sciences for Health, University of Milan, Milan, Italy
- Interuniversity Research Center on Influenza and Other Transmissible Infections (CIRI-IT), Genoa, Italy
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17
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Manifestations and Risk Factors in Children Hospitalized with Respiratory Syncytial Virus Infection. ARCHIVES OF PEDIATRIC INFECTIOUS DISEASES 2020. [DOI: 10.5812/pedinfect.108723] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Background: Acute lower respiratory infection (ALRI) is one of the main causes of morbidity and mortality in children under five years of age, and the respiratory syncytial virus (RSV) remains its leading etiological factor. Although RSV infections occur in all age groups, the most severe course is observed among children. The clinical manifestations include both mild upper respiratory infections and severe infections of the lower tract, such as bronchiolitis and pneumonia that can lead to hospitalization and severe complications, including respiratory failure. Objectives: The study aimed to evaluate the manifestations of RSV infection in hospitalized children younger than 18 months of age and predictors of disease severity, as well as their comparison with the same age group hospitalized due to ALRI of different etiology. Methods: A retrospective analysis was performed on medical records of 448 children hospitalized due to ALRI. The analysis was performed on the total study group and subgroups of children with positive and negative results of the nasal swab for RSV detection. In each group, clinical data, laboratory test results, and imaging results were analyzed. Results: The most common manifestation was pneumonia (n = 82; 63.08%). Otitis media was observed mainly in children under six months of age with lowered inflammatory markers (P < 0.05), conjunctivitis in those with a positive family history of allergies (P < 0.05), and pneumonia in children under six months of age, with lower blood oxygen saturation and inflammatory markers, features of acidosis, and fever-free course (P < 0.05). Respiratory failure affected 13 children (10%). However, no predictors of this complication were noted. Conclusions: As pneumonia was the most common manifestation in children with both RSV-positive and RSV-negative ALRI, it seems advisable to perform the imaging of the lungs on admission and carefully monitor the child’s condition during hospitalization. In both groups, special attention should be paid to the youngest children with low inflammatory markers on hospital admission, increased clinical symptoms, and family history of allergies. Nevertheless, widely known risk factors of RSV infection itself do not reflect the risk of developing pneumonia or respiratory failure in its course.
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18
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Chen L, Han X, Bai L, Zhang J. Clinical characteristics and outcomes in adult patients hospitalized with influenza, respiratory syncytial virus and human metapneumovirus infections. Expert Rev Anti Infect Ther 2020; 19:787-796. [PMID: 33141622 DOI: 10.1080/14787210.2021.1846520] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
Abstract
Objectives: To compare the clinical characteristics and outcomes of patients hospitalized with respiratory syncytial virus (RSV), human metapneumovirus (hMPV), and influenza infections.Methods: This study prospectively enrolled 594 patients hospitalized with influenza-like illness (ILI) and laboratory-confirmed RSV, hMPV, or influenza infections over three consecutive influenza seasons at a tertiary hospital in China.Results: While certain clinical features were of value as predictors of infection type, none exhibited good predictive performance as a means of discriminating between these three infections (area under the receiver-operating characteristic curve < 0.70). After controlling for potential confounding variables, RSV infections in pneumonia patients were found to be associated with a 30-day mortality risk comparable to that of influenza patients [odds ratio (OR) 1.016, 95% confidence interval (CI) 0.267-3.856, p = 0.982], whereas hMPV infection was associated with a reduced risk of mortality (OR 0.144, 95% CI 0.027-0.780, p = 0.025). Among those without pneumonia, the 30-day mortality risk in patients with influenza was comparable to that in patients infected with RSV (OR 1.268, 95% CI 0.172-9.355, p = 0.816) or hMPV (OR 1.128, 95% CI 0.122-10.419, p = 0.916).Conclusion: Disease severity associated with these three types of viral infection was inconsistent when comparing patients with and without pneumonia, highlighting the importance of etiologic testing.
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Affiliation(s)
- Liang Chen
- Department of Infectious Diseases, Beijing Jishuitan Hospital, 4th Medical College of Peking University, Beijing, China
| | - Xiudi Han
- Department of Pulmonary and Critical Care Medicine, Qingdao Municipal Hospital, Qingdao City, Shandong Province, China
| | - Lu Bai
- Department of Infectious Diseases, Beijing Jishuitan Hospital, 4th Medical College of Peking University, Beijing, China
| | - Jian Zhang
- Department of Infectious Diseases, Beijing Jishuitan Hospital, 4th Medical College of Peking University, Beijing, China
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19
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Klopfenstein T, Zahra H, Kadiane-Oussou NJ, Lepiller Q, Royer PY, Toko L, Gendrin V, Zayet S. New loss of smell and taste: Uncommon symptoms in COVID-19 patients on Nord Franche-Comte cluster, France. Int J Infect Dis 2020; 100:117-122. [PMID: 32771635 PMCID: PMC7410813 DOI: 10.1016/j.ijid.2020.08.012] [Citation(s) in RCA: 51] [Impact Index Per Article: 12.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2020] [Revised: 07/31/2020] [Accepted: 08/04/2020] [Indexed: 01/08/2023] Open
Abstract
BACKGROUND New loss of smell or taste was not included as common symptoms of COVID-19 until March 2020 when the pandemic started in Western countries. We want to describe the prevalence and features of anosmia and dysgeusia in COVID-19 patients. METHODS We retrospectively investigated the clinical features of confirmed cases of COVID-19 in Nord Franche-Comté Hospital, Trevenans, France, between March, 1st and March, 14th 2020. We used SARS-CoV-2 real time RT-PCR in respiratory samples to confirm the cases. RESULTS Of 70 patient enrolled, the mean age was 57.0 years and 29 patients (41%) were men. Median Charlson comorbidity index was 1.70(±2.5). Twenty-seven (39%) patients had pneumonia. Fatigue (93% [65]), cough (80% [55]) and fever (77% [54]) were the three main symptoms. Neurologic symptoms were present in more than half of the patients: anosmia (53% [37]) and dysgeusia (48% [34]). The mean duration of anosmia was 7.4 (±5, [1-21]) days, 51% (36/70) recovered before 28 days of evolution. Only one patient with anosmia had not recovered at the end of the follow-up. Patients with anosmia had less often a pneumonia (10/37 vs 17/33, p = 0.036), were less often hospitalized (13/37 vs 20/33, p = 0.033) and needed less often oxygen therapy (6/37 vs 17/33, p = 0.002) than patients without anosmia. There were no statistically differences for viral load between patients with anosmia and patients without anosmia (5.5 [2.0-8.6] vs 5.3 [2.1-8.5] log copies/ml respectively, p = 0.670). The fatality of COVID-19 in our study was 6% with four deaths. CONCLUSIONS Anosmia and dysgeusia are present in half of COVID-19 patients. The mean duration of anosmia was 7 days and the outcome seems favorable in less than 28 days.
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Affiliation(s)
| | - Hajer Zahra
- Diabetology Department Nord Franche-Comté Hospital, France
| | | | - Quentin Lepiller
- Virology Department, Centre-Hospitalier Universitaire de Besançon, France
| | | | - Lynda Toko
- Infectious Disease Department, Nord Franche-Comté Hospital, France
| | - Vincent Gendrin
- Infectious Disease Department, Nord Franche-Comté Hospital, France
| | - Souheil Zayet
- Infectious Disease Department, Nord Franche-Comté Hospital, France.
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20
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Zayet S, Kadiane-Oussou NJ, Lepiller Q, Zahra H, Royer PY, Toko L, Gendrin V, Klopfenstein T. Clinical features of COVID-19 and influenza: a comparative study on Nord Franche-Comte cluster. Microbes Infect 2020; 22:481-488. [PMID: 32561409 PMCID: PMC7297177 DOI: 10.1016/j.micinf.2020.05.016] [Citation(s) in RCA: 128] [Impact Index Per Article: 32.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2020] [Revised: 05/27/2020] [Accepted: 05/27/2020] [Indexed: 12/18/2022]
Abstract
Clinical descriptions about influenza-like illnesses (ILI) in COVID-19 seem non-specific. We aimed to compare the clinical features of COVID-19 and influenza. We retrospectively investigated the clinical features and outcomes of confirmed cases of COVID-19 and influenza in Nord Franche-Comté Hospital between February 26th and March 14th 2020. We used SARS-CoV-2 RT-PCR and influenza virus A/B RT-PCR in respiratory samples to confirm the diagnosis. We included 124 patients. The mean age was 59 (±19 [19-98]) years with 69% female. 70 patients with COVID-19 and 54 patients with influenza A/B. Regarding age, sex and comorbidities, no differences were found between the two groups except a lower Charlson index in COVID-19 group (2 [±2.5] vs 3 [±2.4],p = 0.003). Anosmia (53% vs 17%,p < 0.001), dysgeusia (49% vs 20%,p = 0.001), diarrhea (40% vs 20%,p = 0.021), frontal headache (26% vs 9%,p = 0.021) and bilateral cracklings sounds (24% vs 9%,p = 0.034) were statistically more frequent in COVID-19. Sputum production (52% vs 29%,p = 0.010), dyspnea (59% vs 34%,p = 0.007), sore throat (44% vs 20%,p = 0.006), conjunctival hyperhemia (30% vs 4%,p < 0.001), tearing (24% vs 6%,p = 0.004), vomiting (22% vs 3%,p = 0.001) and rhonchi sounds (17% vs 1%,p = 0.002) were more frequent with influenza infection. We described several clinical differences which can help the clinicians during the co-circulation of influenza and SARS-CoV-2.
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Affiliation(s)
- Souheil Zayet
- Infectious Disease Department, Nord Franche-Comté Hospital, France.
| | | | - Quentin Lepiller
- Virology Department, Centre-Hospitalier Universitaire de Besançon, France
| | - Hajer Zahra
- Diabetology Department Nord Franche-Comté Hospital, France
| | | | - Lynda Toko
- Infectious Disease Department, Nord Franche-Comté Hospital, France
| | - Vincent Gendrin
- Infectious Disease Department, Nord Franche-Comté Hospital, France
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21
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Tan JY, Sim XYJ, Wee LE, Chua YY, Cherng BPZ, Ng IM, Conceicao EP, Wong TJ, Yang Y, Aung MK, Ling ML, Venkatachalam I. A comparative study on the clinical features of COVID-19 with non-SARS-CoV-2 respiratory viral infections. J Med Virol 2020; 93:1548-1555. [PMID: 32881022 DOI: 10.1002/jmv.26486] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2020] [Revised: 08/14/2020] [Accepted: 08/30/2020] [Indexed: 01/05/2023]
Abstract
During this coronavirus disease 2019 (COVID-19) pandemic, physicians have the important task of risk stratifying patients who present with acute respiratory illnesses. Clinical presentation of COVID-19, however, can be difficult to distinguish from other respiratory viral infections. Thus, identifying clinical features that are strongly associated with COVID-19 in comparison to other respiratory viruses can aid risk stratification and testing prioritization especially in situations where resources for virological testing and resources for isolation facilities are limited. In our retrospective cohort study comparing the clinical presentation of COVID-19 and other respiratory viral infections, we found that anosmia and dysgeusia were symptoms independently associated with COVID-19 and can be important differentiating symptoms in patients presenting with acute respiratory illness. On the other hand, laboratory abnormalities and radiological findings were not statistically different between the two groups. In comparing outcomes, patients with COVID-19 were more likely to need high dependency or intensive care unit care and had a longer median length of stay. With our findings, we emphasize that epidemiological risk factors and clinical symptoms are more useful than laboratory and radiological abnormalities in differentiating COVID-19 from other respiratory viral infections.
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Affiliation(s)
- Jing Yuan Tan
- Department of Internal Medicine, Singapore General Hospital, Singapore
| | - Xiang Ying Jean Sim
- Department of Infectious Diseases, Singapore General Hospital, Singapore.,Department of Infection Prevention and Epidemiology, Singapore General Hospital, Singapore
| | - Liang En Wee
- Department of Infectious Diseases, Singapore General Hospital, Singapore.,Department of Infection Prevention and Epidemiology, Singapore General Hospital, Singapore
| | - Ying-Ying Chua
- Department of Infectious Diseases, Singapore General Hospital, Singapore
| | | | - Ian Matthias Ng
- Department of Infection Prevention and Epidemiology, Singapore General Hospital, Singapore
| | - Edwin Philip Conceicao
- Department of Internal Medicine, Singapore General Hospital, Singapore.,Department of Infectious Diseases, Singapore General Hospital, Singapore.,Department of Infection Prevention and Epidemiology, Singapore General Hospital, Singapore
| | - Tzu-Jung Wong
- National Dental Research Institute Singapore, National Dental Centre Singapore, Singapore
| | - Yong Yang
- Department of Infection Prevention and Epidemiology, Singapore General Hospital, Singapore
| | - May Kyawt Aung
- Department of Infection Prevention and Epidemiology, Singapore General Hospital, Singapore
| | - Moi Lin Ling
- Department of Infection Prevention and Epidemiology, Singapore General Hospital, Singapore
| | - Indumathi Venkatachalam
- Department of Infectious Diseases, Singapore General Hospital, Singapore.,Department of Infection Prevention and Epidemiology, Singapore General Hospital, Singapore
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22
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Wrotek A, Kobiałka M, Grochowski B, Kamińska I, Pędziwiatr K, Skoczek-Wojciechowska A, Godek M, Jackowska T. Respiratory Complications in Children Hospitalized with Respiratory Syncytial Virus Infection. ADVANCES IN EXPERIMENTAL MEDICINE AND BIOLOGY 2020; 1279:113-120. [PMID: 32314316 DOI: 10.1007/5584_2020_530] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 03/18/2023]
Abstract
The goal of this study was to define the prevalence of respiratory complications, other than bronchiolitis, such as pneumonia, acute otitis media, and conjunctivitis in children treated in a hospital due to respiratory syncytial virus (RSV) infection, with reference to the plausible risk factors. The study included 111 children, aged up to 22 months (median 3 months). Complications were observed in 68 (61%) children, with 32 (29%) children presenting more than one. The most frequent complication was acute otitis media in 53 (48%), pneumonia in 37 (33%), and conjunctivitis in 12 (11%) out of the 111 children. Children with complications were older than those without complications and had fever that lasted for a significantly longer time, both before and during hospitalization, and the fever was stronger. They also presented a significantly lower breathing rate at admission. The age over 3 months was a single risk factor associated with the development of otitis media (OR = 9.8, 95%CI: 3.6-26.7) and pneumonia (OR = 2.8, 95%CI: 1.1-7.3). Other factors such as prematurity, birth weight below 2500 g, exposure to tobacco smoke during pregnancy, and the cessation of breastfeeding below age 6 months were statistically irrelevant to this end. We conclude that complications are very frequent in hospitalized children with RSV infection and their risk increases with the infant age.
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Affiliation(s)
- August Wrotek
- Department of Pediatrics, Medical Center of Postgraduate Medical Education, Warsaw, Poland.,Department of Pediatrics, Bielanski Hospital, Warsaw, Poland
| | - Małgorzata Kobiałka
- Department of Pediatrics, Medical Center of Postgraduate Medical Education, Warsaw, Poland.,Department of Pediatrics, Bielanski Hospital, Warsaw, Poland
| | | | - Iga Kamińska
- Student Research Group at the Bielanski Hospital, Warsaw, Poland
| | - Kaja Pędziwiatr
- Student Research Group at the Bielanski Hospital, Warsaw, Poland
| | | | - Maria Godek
- Student Research Group at the Bielanski Hospital, Warsaw, Poland
| | - Teresa Jackowska
- Department of Pediatrics, Medical Center of Postgraduate Medical Education, Warsaw, Poland. .,Department of Pediatrics, Bielanski Hospital, Warsaw, Poland.
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23
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Verbakel JY, Matheeussen V, Loens K, Kuijstermans M, Goossens H, Ieven M, Butler CC. Performance and ease of use of a molecular point-of-care test for influenza A/B and RSV in patients presenting to primary care. Eur J Clin Microbiol Infect Dis 2020; 39:1453-1460. [PMID: 32172369 PMCID: PMC7343728 DOI: 10.1007/s10096-020-03860-5] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2020] [Accepted: 03/04/2020] [Indexed: 12/11/2022]
Abstract
Annual influenza epidemics cause substantial morbidity and mortality, and the majority of patients with influenza-like illness present to primary care. Point-of-care influenza tests could support treatment decisions. It is critical to establish analytic performance of these platforms in real-life patient samples before uptake can be considered. We aimed to assess the analytical performance and ease of use of the cobas® Liat® PCR POCT in detecting influenza A/B and RSV in samples collected from patients with influenza-like illness in primary care. Sensitivity and specificity of the cobas® Liat® POCT are calculated in comparison with a commercial laboratory-based PCR test (Fast-Track Respiratory Pathogens 21 Plus kit (Fast-Track Diagnostics)). Samples with discordant results were analysed additionally by the RespiFinder 2Smart (PathoFinder) using an Extended Gold Standard (EGS). Acceptability was scored on a five-point Likert scale as well as a failure mode analysis of the cobas® Liat® POCT was performed. Nasal and oropharyngeal swabs were obtained from 140 children and nasopharyngeal swabs from 604 adults (744 patients). The cobas® Liat® POCT had a sensitivity and specificity of 100% (95% CI 99-100%) and 98.1% (95%CI 96.3-99%) for influenza A, 100% (95% CI 97.7-100%) and 99.7% (95%CI 98.7-99.9%) for influenza B and 100% (95% CI 87.1-100%) and 99.4% (95%CI 98.6-99.8%) for RSV, respectively. According to trained lab technicians, the cobas® Liat® POCT was considered easy-to-use, with a fast turn-around-time. Cobas® Liat® POCT is a promising decentralised test platform for influenza A/B and RSV in primary care as it provides fairly rapid results with excellent analytic performance. Point-of-care influenza tests could support treatment decisions in primary care. Cobas® Liat® POCT is a promising decentralised test platform for influenza A/B and RSV in primary care as it provides fairly rapid results with excellent analytic performance.
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Affiliation(s)
- Jan Y Verbakel
- NIHR Community Healthcare MIC, Nuffield Department of Primary Care Health Sciences, University of Oxford, Woodstock Road, Oxford, Oxfordshire, OX26GG, UK.
- Department of Public Health and Primary Care, KU Leuven, Kapucijnenvoer 33, 3000, Leuven, Belgium.
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Woodstock Road, Oxford, Oxfordshire, OX26GG, UK.
| | - Veerle Matheeussen
- Laboratory of Clinical Microbiology, Antwerp University Hospital, Edegem, Belgium
- Laboratory of Medical Microbiology, Vaccine & Infectious Disease Institute (VAXINFECTIO), University of Antwerp, Antwerp, Belgium
| | - Katherine Loens
- Laboratory of Clinical Microbiology, Antwerp University Hospital, Edegem, Belgium
- Laboratory of Medical Microbiology, Vaccine & Infectious Disease Institute (VAXINFECTIO), University of Antwerp, Antwerp, Belgium
| | - Mandy Kuijstermans
- Laboratory of Medical Microbiology, Vaccine & Infectious Disease Institute (VAXINFECTIO), University of Antwerp, Antwerp, Belgium
| | - Herman Goossens
- Laboratory of Clinical Microbiology, Antwerp University Hospital, Edegem, Belgium
- Laboratory of Medical Microbiology, Vaccine & Infectious Disease Institute (VAXINFECTIO), University of Antwerp, Antwerp, Belgium
| | - Margareta Ieven
- Laboratory of Clinical Microbiology, Antwerp University Hospital, Edegem, Belgium
- Laboratory of Medical Microbiology, Vaccine & Infectious Disease Institute (VAXINFECTIO), University of Antwerp, Antwerp, Belgium
| | - Christopher C Butler
- NIHR Community Healthcare MIC, Nuffield Department of Primary Care Health Sciences, University of Oxford, Woodstock Road, Oxford, Oxfordshire, OX26GG, UK
- Department of Public Health and Primary Care, KU Leuven, Kapucijnenvoer 33, 3000, Leuven, Belgium
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24
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Boëlle PY, Souty C, Launay T, Guerrisi C, Turbelin C, Behillil S, Enouf V, Poletto C, Lina B, van der Werf S, Lévy-Bruhl D, Colizza V, Hanslik T, Blanchon T. Excess cases of influenza-like illnesses synchronous with coronavirus disease (COVID-19) epidemic, France, March 2020. ACTA ACUST UNITED AC 2020; 25. [PMID: 32290901 PMCID: PMC7160441 DOI: 10.2807/1560-7917.es.2020.25.14.2000326] [Citation(s) in RCA: 31] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
Several French regions where coronavirus disease (COVID-19) has been reported currently show a renewed increase in ILI cases in the general practice-based Sentinelles network. We computed the number of excess cases by region from 24 February to 8 March 2020 and found a correlation with the number of reported COVID-19 cases so far. The data suggest larger circulation of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in the French population than apparent from confirmed cases.
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Affiliation(s)
- Pierre-Yves Boëlle
- Sorbonne Université, Institut Pierre Louis d'Epidemiologie et de Santé Publique, Paris, France
| | - Cécile Souty
- Sorbonne Université, Institut Pierre Louis d'Epidemiologie et de Santé Publique, Paris, France
| | - Titouan Launay
- Sorbonne Université, Institut Pierre Louis d'Epidemiologie et de Santé Publique, Paris, France
| | - Caroline Guerrisi
- Sorbonne Université, Institut Pierre Louis d'Epidemiologie et de Santé Publique, Paris, France
| | - Clément Turbelin
- Sorbonne Université, Institut Pierre Louis d'Epidemiologie et de Santé Publique, Paris, France
| | - Sylvie Behillil
- Institut Pasteur, Centre Coordonnateur du Centre National de Référence des virus des infections respiratoires (dont la grippe), Paris, France
| | - Vincent Enouf
- Institut Pasteur, Centre Coordonnateur du Centre National de Référence des virus des infections respiratoires (dont la grippe), Paris, France
| | - Chiara Poletto
- INSERM, Institut Pierre Louis d'Epidemiologie et de Santé Publique, Paris, France
| | - Bruno Lina
- Université de Lyon, Virpath, CIRI, INSERM U1111, CNRS UMR5308, ENS Lyon, Université Claude Bernard Lyon 1, Lyon, France.,Laboratoire de Virologie, Hospices Civils de Lyon, Institut des Agents Infectieux (IAI), Centre National de Référence des virus respiratoires (dont la grippe), Centre de Biologie et de Pathologie Nord, Groupement Hospitalier Nord, Lyon, France
| | - Sylvie van der Werf
- Université Paris Diderot, Sorbonne Paris Cité, Unité de Génétique Moléculaire des Virus à ARN, Paris, France.,UMR CNRS 3569, Paris, France.,Institut Pasteur, Centre Coordonnateur du Centre National de Référence des virus des infections respiratoires (dont la grippe), Paris, France.,Institut Pasteur, Unité de Génétique Moléculaire des Virus à ARN, Paris, France
| | | | - Vittoria Colizza
- INSERM, Institut Pierre Louis d'Epidemiologie et de Santé Publique, Paris, France
| | - Thomas Hanslik
- Sorbonne Université, Institut Pierre Louis d'Epidemiologie et de Santé Publique, Paris, France
| | - Thierry Blanchon
- Sorbonne Université, Institut Pierre Louis d'Epidemiologie et de Santé Publique, Paris, France
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25
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Loubet P, Mathieu P, Lenzi N, Galtier F, Lainé F, Lesieur Z, Vanhems P, Duval X, Postil D, Amour S, Rogez S, Lagathu G, L'Honneur AS, Foulongne V, Houhou N, Lina B, Carrat F, Launay O. Characteristics of human metapneumovirus infection in adults hospitalized for community-acquired influenza-like illness in France, 2012-2018: a retrospective observational study. Clin Microbiol Infect 2020; 27:127.e1-127.e6. [PMID: 32283266 PMCID: PMC7195031 DOI: 10.1016/j.cmi.2020.04.005] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2020] [Revised: 03/27/2020] [Accepted: 04/04/2020] [Indexed: 11/26/2022]
Abstract
Objectives To describe the prevalence, clinical features and complications of human metapneumovirus (hMPV) infections in a population of adults hospitalized with influenza-like illness (ILI). Methods This was a retrospective, observational, multicenter cohort study using prospectively collected data from adult patients hospitalized during influenza virus circulation, for at least 24 h, for community-acquired ILI (with symptom onset <7 days). Data were collected from five French teaching hospitals over six consecutive winters (2012–2018). Respiratory viruses were identified by multiplex reverse transcription polymerase chain reaction (RT-PCR) on nasopharyngeal specimens. hMPV + patients were compared with hMPV– patients, influenza+ and respiratory syncytial virus (RSV)+ patients using multivariate logistic regressions. Primary outcome was the prevalence of hMPV in patients hospitalized for ILI. Results Among the 3148 patients included (1449 (46%) women, 1988 (63%) aged 65 and over; 2508 (80%) with chronic disease), at least one respiratory virus was detected in 1604 (51%, 95% confidence interval (CI) 49–53), including 100 cases of hMPV (100/3148, 3% 95% CI 3–4), of which 10 (10%) were viral co-infection. In the hMPV + patients, mean length of stay was 7 days, 62% (56/90) developed a complication, 21% (14/68) were admitted to intensive care unit and 4% (4/90) died during hospitalization. In comparison with influenza + patients, hMPV + patients were more frequently >65 years old (adjusted odds ratio (aOR) = 3.3, 95% CI 1.9–6.3) and presented more acute heart failure during hospitalization (aOR = 1.8, 95% CI 1.0–2.9). Compared with RSV + patients, hMPV + patients had less cancer (aOR = 0.4, 95% CI 0.2–0.9) and were less likely to smoke (aOR = 0.5, 95% CI 0.2–0.9) but had similar outcomes, especially high rates of respiratory and cardiovascular complications. Conclusions Adult hMPV infections mainly affect the elderly and patients with chronic conditions and are responsible for frequent cardiac and pulmonary complications similar to those of RSV infections. At-risk populations would benefit from the development of antivirals and vaccines targeting hMPV.
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Affiliation(s)
- P Loubet
- VBMI, INSERM U1047, Department of Infectious and Tropical Disease, CHU Nîmes, Univ Montpellier, Nîmes, France; Inserm, F-CRIN, Réseau Innovative Clinical Research in Vaccinology (I-REIVAC), Paris, France.
| | - P Mathieu
- Université Paris Descartes, Sorbonne Paris Cité, Inserm, CIC Cochin Pasteur, Assistance Publique Hôpitaux de Paris, Hôpital Cochin, Paris, France
| | - N Lenzi
- Inserm, F-CRIN, Réseau Innovative Clinical Research in Vaccinology (I-REIVAC), Paris, France
| | - F Galtier
- Inserm, F-CRIN, Réseau Innovative Clinical Research in Vaccinology (I-REIVAC), Paris, France; CIC1411, CHU Montpellier, Hôpital Saint Eloi, Montpellier, F-34295, France
| | - F Lainé
- Inserm, F-CRIN, Réseau Innovative Clinical Research in Vaccinology (I-REIVAC), Paris, France; Centre d'Investigations Cliniques, INSERM UMR CIC 1414, Hôpital Pontchaillou, Rennes, France
| | - Z Lesieur
- Inserm, F-CRIN, Réseau Innovative Clinical Research in Vaccinology (I-REIVAC), Paris, France
| | - P Vanhems
- Inserm, F-CRIN, Réseau Innovative Clinical Research in Vaccinology (I-REIVAC), Paris, France; Service d'Hygiène, Epidémiologie et Prévention, Hospices Civils de Lyon, F-69437 Lyon, France
| | - X Duval
- Inserm, F-CRIN, Réseau Innovative Clinical Research in Vaccinology (I-REIVAC), Paris, France; CIC1125, Hôpital Bichat Claude Bernard, Paris, France
| | - D Postil
- CHU Dupuytren, CIC 1435, Limoge Cedex, France
| | - S Amour
- Service d'Hygiène, Epidémiologie et Prévention, Hospices Civils de Lyon, F-69437 Lyon, France
| | - S Rogez
- CHU Dupuytren, Service Bactériologie, Virologie, Hygiène, Limoges Cedex, France
| | - G Lagathu
- Université Rennes-I, Virologie, Hôpital Pontchaillou, Rennes, France
| | - A-S L'Honneur
- AHU, Service de Virologie, Hôpital Cochin, Paris, France
| | - V Foulongne
- Service de Virologie, CHU Montpellier, Hôpital Saint Eloi, Montpellier, F-34295, France
| | - N Houhou
- Laboratoire de Virologie, Hôpital Bichat Claude Bernard, Paris, France
| | - B Lina
- Hospices Civils de Lyon, Laboratoire de Virologie, Institut des Agents Infectieux (IAI), Centre National de Référence des virus Respiratoires France Sud, Hôpital de la Croix-Rousse, 69317 Lyon Cedex 04, France
| | - F Carrat
- Sorbonne Université, INSERM, Institut Pierre Louis d'Epidémiologie et de Santé Publique IPLESP, AP-HP, Hôpital Saint Antoine, F75013 Paris, France
| | - O Launay
- Inserm, F-CRIN, Réseau Innovative Clinical Research in Vaccinology (I-REIVAC), Paris, France; Université Paris Descartes, Sorbonne Paris Cité, Inserm, CIC Cochin Pasteur, Assistance Publique Hôpitaux de Paris, Hôpital Cochin, Paris, France
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