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Gegin S, ÖZdemir B, ÖZdemir L, Aksu EA, Pazarli AC, YazicioĞlu B. The Effect of Mask Use on Seasonal Virus Diversity in SARS CoV-2 Negative Patients Treated as Inpatients During the 2021-2022 and 2022-2023 Seasonal Flu Period. Pol J Microbiol 2024; 73:377-382. [PMID: 39268955 PMCID: PMC11395415 DOI: 10.33073/pjm-2024-033] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2024] [Accepted: 07/26/2024] [Indexed: 09/15/2024] Open
Abstract
The study aimed to explore the protective effect of mask use against respiratory tract viral agents during the pandemic. The study included patients with a COVID-19 negative test who were hospitalized in the pulmonary disease clinic with the diagnoses of asthma attack, chronic obstructive pulmonary disease (COPD) exacerbation, and pneumonia in two periods: during mandatory mask use (October 2021 - May 2022) and after the mask mandate was lifted (October 2022 - May 2023). Combined nose and throat swab samples taken from the patients were evaluated for viral agents by using the PCR test method. Viral agents isolated from the patients in the two periods were compared based on hospitalization diagnoses and periods. The study enrolled 1,335 patients, 483 female and 852 male. It was found that viral agents significantly increased during the period without a mask mandate compared to the period when the mask mandate was in effect (41.6% vs. 23.4%) (p < 0.001). During the period without mask mandate, influenza A, H1N1, and RSV/AB viruses significantly increased (p = 0.019, p = 0.003, p < 0.001, respectively). Our results indicated that mask use during the pandemic is protective against the transmission of respiratory tract viruses. Thus, it can be concluded that mask use is important not only in the coronavirus pandemic but also especially in influenza and RSV epidemics.
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Affiliation(s)
- SavaŞ Gegin
- 1Samsun Training and Research Hospital, Pulmonology Clinic, Samsun, Türkiye
| | - Burcu ÖZdemir
- 1Samsun Training and Research Hospital, Pulmonology Clinic, Samsun, Türkiye
| | - Levent ÖZdemir
- 1Samsun Training and Research Hospital, Pulmonology Clinic, Samsun, Türkiye
| | - Esra Arslan Aksu
- 2Samsun University Faculty of Medicine, Pulmonology Department, Samsun, Türkiye
| | - Ahmet Cemal Pazarli
- 3Tokat Gaziosmanpaşa University Faculty of Medicine, Pulmonology Department, Tokat, Türkiye
| | - Bahadir YazicioĞlu
- 4Samsun Training and Research Hospital, Family Medicine, Samsun, Türkiye
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Taye B, Sarna M, Le H, Levy A, Minney‐Smith C, Richmond P, Menzies R, Blyth C, Moore H. Respiratory Viral Testing Rate Patterns in Young Children Attending Tertiary Care Across Western Australia: A Population-Based Birth Cohort Study. Influenza Other Respir Viruses 2024; 18:e70005. [PMID: 39225070 PMCID: PMC11369639 DOI: 10.1111/irv.70005] [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: 06/24/2024] [Revised: 08/13/2024] [Accepted: 08/17/2024] [Indexed: 09/04/2024] Open
Abstract
BACKGROUND An understanding of viral testing rates is crucial to accurately estimate the pathogen-specific hospitalisation burden. We aimed to estimate the patterns of testing for respiratory syncytial virus (RSV), influenza virus, parainfluenza virus (PIV) and human metapneumovirus (hMPV) by geographical location, age and time in children <5 years old in Western Australia. METHODS We conducted a population-based cohort study of children born between 1 January 2010 and 31 December 2021, utilising linked administrative data incorporating birth and death records, hospitalisations and respiratory viral surveillance testing records from state-wide public pathology data. We examined within-hospital testing rates using survival analysis techniques and identified independent predictors of testing using binary logistic regression. RESULTS Our dataset included 46,553 laboratory tests for RSV, influenza, PIV, or hMPV from 355,021 children (52.5% male). Testing rates declined in the metropolitan region over the study period (RSV testing in infants: from 242.11/1000 child-years in 2012 to 155.47/1000 child-years in 2018) and increased thereafter. Conversely, rates increased in non-metropolitan areas (e.g., RSV in Goldfields: from 364.92 in 2012 to 504.37/1000 child-years in 2021). The strongest predictors of testing were age <12 months (adjusted odds ratio [aOR] = 2.25, 95% CI 2.20-2.31), preterm birth (<32 weeks: aOR = 2.90, 95% CI 2.76-3.05) and remote residence (aOR = 0.77, 95% CI 0.73-0.81). CONCLUSION These current testing rates highlight the potential underestimation of respiratory virus hospitalisations by routine surveillance and the need for estimation of the true burden of respiratory virus admissions.
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Affiliation(s)
- Belaynew W. Taye
- Wesfarmers Centre of Vaccines and Infectious Diseases, Telethon Kids InstituteUniversity of Western AustraliaPerthAustralia
- School of Population HealthCurtin UniversityPerthAustralia
| | - Mohinder Sarna
- Wesfarmers Centre of Vaccines and Infectious Diseases, Telethon Kids InstituteUniversity of Western AustraliaPerthAustralia
- School of Population HealthCurtin UniversityPerthAustralia
| | - Huong Le
- Wesfarmers Centre of Vaccines and Infectious Diseases, Telethon Kids InstituteUniversity of Western AustraliaPerthAustralia
- School of Population HealthCurtin UniversityPerthAustralia
| | - Avram Levy
- Pathogen Genomics and Surveillance Unit, PathWest Laboratory MedicineQEII Medical CentrePerthAustralia
- School of Biomedical SciencesUniversity of Western AustraliaPerthAustralia
| | - Cara Minney‐Smith
- Department of Microbiology, PathWest Laboratory MedicineQEII Medical CentrePerthAustralia
| | - Peter Richmond
- Wesfarmers Centre of Vaccines and Infectious Diseases, Telethon Kids InstituteUniversity of Western AustraliaPerthAustralia
- School of MedicineUniversity of Western AustraliaPerthAustralia
- Department of ImmunologyPerth Children's HospitalPerthAustralia
| | - Robert Menzies
- Sanofi VaccinesSanofi‐Aventis, Australia and New Zealand, SydneyMacquarie ParkAustralia
| | - Christopher C. Blyth
- Wesfarmers Centre of Vaccines and Infectious Diseases, Telethon Kids InstituteUniversity of Western AustraliaPerthAustralia
- Department of Microbiology, PathWest Laboratory MedicineQEII Medical CentrePerthAustralia
- School of MedicineUniversity of Western AustraliaPerthAustralia
| | - Hannah C. Moore
- Wesfarmers Centre of Vaccines and Infectious Diseases, Telethon Kids InstituteUniversity of Western AustraliaPerthAustralia
- School of Population HealthCurtin UniversityPerthAustralia
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Xu X, Pan Z, Dong H, Zhang Y, Xu L, Wang P, Wang Y, Li J, Jiang W, Hao C. Inhibition, transition, and surge: dynamic evolution of pediatric respiratory pathogen trends amid COVID-19 pandemic policy adjustments. Front Public Health 2024; 12:1420929. [PMID: 39238540 PMCID: PMC11374627 DOI: 10.3389/fpubh.2024.1420929] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2024] [Accepted: 08/12/2024] [Indexed: 09/07/2024] Open
Abstract
Background The implementation of a zero-COVID policy for 3 years in China during the COVID-19 pandemic significantly impacted a broad spectrum of acute respiratory tract infections (ARTIs). The epidemiological characteristics of ARTI pathogens in children following the cessation of the zero-COVID policy remain unclear. Methods Etiologically diagnostic data from 82,708 children with ARTIs at the Children's Hospital of Soochow University during 2016-2023 were analyzed for 8 pathogens (human respiratory syncytial virus [HRSV], influenza A [FluA], FluB, human parainfluenza virus [HPIV], adenovirus [ADV], human rhinovirus [HRV], bocavirus [BoV], and mycoplasma pneumoniae [MP]). The changes in respiratory infections in Suzhou, China during the first year (2020, Phase I) and the second and third years of the pandemic (2021-2022, Phase II) and the first year after the end of zero-COVID policy (2023, Phase III) versus that in the pre-pandemic years (2016-2019) were compared. Results When compared with the average pre-pandemic levels, the pathogen-positive rate decreased by 19.27% in Phase I (OR: 0.70; 95% CI: 0.67-0.74), increased by 32.87% in Phase II (OR: 1.78; 95% CI: 1.72-1.84), and increased by 79.16% in Phase III (OR: 4.58; 95% CI: 4.37-4.79). In Phase I, the positive rates of HRSV, FluA, ADV, and MP decreased by 26.72, 58.97, 72.85, and 67.87%, respectively, and the positive rates of FluB, HPIV, HRV, and BoV increased by 86.84, 25, 32.37, and 16.94%, respectively. In Phase III, the positive rates of HRSV, FluA, FluB, HPIV, ADV, and HRV increased by 39.74, 1046.15, 118.42, 116.57, 131.13, and 146.40%, respectively, while the positive rate of BoV decreased by 56.12%. MP was inhibited during the epidemic, and MP showed a delayed outbreak after the ending of the zero-COVID policy. Compared with the average pre-pandemic levels, the MP-positive rate in Phase III increased by 116.7% (OR: 2.86; 95% CI: 2.74-2.99), with the highest increase in 0-1-year-old children. Conclusion The strict and large-scale implementation of the zero-COVID policy in the early stages of the COVID-19 pandemic was the main driving factor for the sharp reduction in the rate of children's respiratory pathogenic infections. The termination of this policy can cause a resurgence or escalation of pathogenic infections.
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Affiliation(s)
- Xuena Xu
- Department of Respiratory Medicine, Children's Hospital of Soochow University, Suzhou, China
| | - Zhenzhen Pan
- Department of Respiratory Medicine, Children's Hospital of Soochow University, Suzhou, China
- Department of Respiratory Medicine and Clinical Allergy Center, Affiliated Children's Hospital of Jiangnan University, Wuxi, China
| | - Heting Dong
- Department of Respiratory Medicine, Children's Hospital of Soochow University, Suzhou, China
| | - Yizhu Zhang
- Department of Respiratory Medicine, Children's Hospital of Soochow University, Suzhou, China
| | - Lina Xu
- Department of Respiratory Medicine, Children's Hospital of Soochow University, Suzhou, China
| | - Pengli Wang
- Department of Respiratory Medicine, Children's Hospital of Soochow University, Suzhou, China
| | - Yufeng Wang
- Department of Respiratory Medicine, Children's Hospital of Soochow University, Suzhou, China
| | - Jiaoyang Li
- Department of Respiratory Medicine, Children's Hospital of Soochow University, Suzhou, China
| | - Wujun Jiang
- Department of Respiratory Medicine, Children's Hospital of Soochow University, Suzhou, China
| | - Chuangli Hao
- Department of Respiratory Medicine, Children's Hospital of Soochow University, Suzhou, China
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Hou M, Liu G, Meng C, Dong L, Fang Y, Wang L, Wang N, Cai C, Wang H. Circulation patterns and molecular characteristics of respiratory syncytial virus among hospitalized children in Tianjin, China, before and during the COVID-19 pandemic (2017-2022). Virol Sin 2024:S1995-820X(24)00114-7. [PMID: 39067791 DOI: 10.1016/j.virs.2024.07.004] [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: 10/25/2023] [Accepted: 07/24/2024] [Indexed: 07/30/2024] Open
Abstract
Respiratory syncytial virus (RSV) is the main pathogen that causes hospitalization for acute lower respiratory tract infections (ALRIs) in children. With the reopening of communities and schools, the resurgence of RSV in the COVID-19 post-pandemic era has become a major concern. To understand the circulation patterns and genotype variability of RSV in Tianjin before and during the COVID-19 pandemic, a total of 19,531 nasopharyngeal aspirate samples from hospitalized children in Tianjin from July 2017 to June 2022 were evaluated. Direct immunofluorescence and polymerase chain reaction (PCR) were used for screening RSV-positive samples and subtyping, respectively. Further analysis of mutations in the second hypervariable region (HVR2) of the G gene was performed through Sanger sequencing. Our results showed that 16.46% (3215/19,531) samples were RSV positive and a delayed increase in the RSV infection rates occurred in the winter season from December 2020 to February 2021, with the average RSV-positive rate of 35.77% (519/1451). The ON1, with H258Q and H266L substitutions, and the BA9, with T290I and T312I substitutions, are dominant strains that alternately circulate every 1-2 years in Tianjin, China, from July 2017 to June 2022. In addition, novel substitutions, such as N296Y, K221T, N230K, V251A in the BA9 genotype, and L226I in the ON1 genotype, emerged during the COVID-19 pandemic. Analysis of clinical characteristics indicated no significant differences between RSV-A and RSV-B groups. This study provides a theoretical basis for clinical prevention and treatment. However, further studies are needed to explore the regulatory mechanism of host immune responses to different lineages of ON1 and BA9 in the future.
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Affiliation(s)
- Mengzhu Hou
- Tianjin Pediatric Research Institute, Tianjin Children's Hospital (Children's Hospital of Tianjin University), Tianjin Key Laboratory of Birth Defects for Prevention and Treatment, Tianjin, 300134, China
| | - Guangping Liu
- Graduate School, Tianjin University of Traditional Chinese Medicine, Tianjin, 301617, China
| | - Chao Meng
- Department of Medical Laboratory, Tianjin Second People's Hospital, Tianjin, 300192, China
| | - Lili Dong
- Department of Respiratory, Tianjin Children's Hospital (Children's Hospital of Tianjin University), Tianjin, 300134, China
| | - Yulian Fang
- Tianjin Pediatric Research Institute, Tianjin Children's Hospital (Children's Hospital of Tianjin University), Tianjin Key Laboratory of Birth Defects for Prevention and Treatment, Tianjin, 300134, China
| | - Lu Wang
- Tianjin Pediatric Research Institute, Tianjin Children's Hospital (Children's Hospital of Tianjin University), Tianjin Key Laboratory of Birth Defects for Prevention and Treatment, Tianjin, 300134, China
| | - Ning Wang
- Tianjin Pediatric Research Institute, Tianjin Children's Hospital (Children's Hospital of Tianjin University), Tianjin Key Laboratory of Birth Defects for Prevention and Treatment, Tianjin, 300134, China
| | - Chunquan Cai
- Tianjin Pediatric Research Institute, Tianjin Children's Hospital (Children's Hospital of Tianjin University), Tianjin Key Laboratory of Birth Defects for Prevention and Treatment, Tianjin, 300134, China.
| | - Hanjie Wang
- School of Life Sciences, Tianjin University and Tianjin Engineering Center of Micro-Nano Biomaterials and Detection-Treatment Technology, Tianjin Key Laboratory of Function and Application of Biological Macromolecular Structures, Tianjin, 300072, China.
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Fung T, Goh J, Chisholm RA. Long-term effects of non-pharmaceutical interventions on total disease burden in parsimonious epidemiological models. J Theor Biol 2024; 587:111817. [PMID: 38599566 DOI: 10.1016/j.jtbi.2024.111817] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2023] [Revised: 03/28/2024] [Accepted: 04/03/2024] [Indexed: 04/12/2024]
Abstract
The recent global COVID-19 pandemic resulted in governments enacting non-pharmaceutical interventions (NPIs) targeted at reducing transmission of SARS-CoV-2. But the NPIs also affected the transmission of viruses causing non-target seasonal respiratory diseases, including influenza and respiratory syncytial virus (RSV). In many countries, the NPIs were found to reduce cases of such seasonal respiratory diseases, but there is also evidence that subsequent relaxation of NPIs led to outbreaks of these diseases that were larger than pre-pandemic ones, due to the accumulation of susceptible individuals prior to relaxation. Therefore, the net long-term effects of NPIs on the total disease burden of non-target diseases remain unclear. Knowledge of this is important for infectious disease management and maintenance of public health. In this study, we shed light on this issue for the simplified scenario of a set of NPIs that prevent or reduce transmission of a seasonal respiratory disease for about a year and are then removed, using mathematical analyses and numerical simulations of a suite of four epidemiological models with varying complexity and generality. The model parameters were estimated using empirical data pertaining to seasonal respiratory diseases and covered a wide range. Our results showed that NPIs reduced the total disease burden of a non-target seasonal respiratory disease in the long-term. Expressed as a percentage of population size, the reduction was greater for larger values of the basic reproduction number and the immunity loss rate, reflecting larger outbreaks and hence more infections averted by imposition of NPIs. Our study provides a foundation for exploring the effects of NPIs on total disease burden in more-complex scenarios.
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Affiliation(s)
- Tak Fung
- Department of Biological Sciences, Faculty of Science, National University of Singapore, 14 Science Drive 4, Singapore 117558, Singapore.
| | - Jonah Goh
- Department of Biological Sciences, Faculty of Science, National University of Singapore, 14 Science Drive 4, Singapore 117558, Singapore.
| | - Ryan A Chisholm
- Department of Biological Sciences, Faculty of Science, National University of Singapore, 14 Science Drive 4, Singapore 117558, Singapore.
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Wisgrill L, Martens A, Kasbauer R, Eigenschink M, Pummer L, Redlberger-Fritz M, Végvári Á, Warth B, Berger A, Fyhrquist N, Alenius H. Network analysis reveals age- and virus-specific circuits in nasal epithelial cells of extremely premature infants. Allergy 2024. [PMID: 38898695 DOI: 10.1111/all.16196] [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: 02/27/2024] [Revised: 04/15/2024] [Accepted: 05/01/2024] [Indexed: 06/21/2024]
Abstract
BACKGROUND AND OBJECTIVES Viral respiratory infections significantly affect young children, particularly extremely premature infants, resulting in high hospitalization rates and increased health-care burdens. Nasal epithelial cells, the primary defense against respiratory infections, are vital for understanding nasal immune responses and serve as a promising target for uncovering underlying molecular and cellular mechanisms. METHODS Using a trans-well pseudostratified nasal epithelial cell system, we examined age-dependent developmental differences and antiviral responses to influenza A and respiratory syncytial virus through systems biology approaches. RESULTS Our studies revealed differences in innate-receptor repertoires, distinct developmental pathways, and differentially connected antiviral network circuits between neonatal and adult nasal epithelial cells. Consensus network analysis identified unique and shared cellular-viral networks, emphasizing highly relevant virus-specific pathways, independent of viral replication kinetics. CONCLUSION This research highlights the importance of nasal epithelial cells in innate antiviral immune responses and offers crucial insights that allow for a deeper understanding of age-related differences in nasal epithelial cell immunity following respiratory virus infections.
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Affiliation(s)
- Lukas Wisgrill
- Division of Neonatology, Pediatric Intensive Care and Neuropediatrics, Comprehensive Center for Pediatrics, Medical University of Vienna, Vienna, Austria
- Exposome Austria, Research Infrastructure and National EIRENE Hub, Vienna, Austria
| | - Anke Martens
- Division of Neonatology, Pediatric Intensive Care and Neuropediatrics, Comprehensive Center for Pediatrics, Medical University of Vienna, Vienna, Austria
| | - Rajmund Kasbauer
- Division of Neonatology, Pediatric Intensive Care and Neuropediatrics, Comprehensive Center for Pediatrics, Medical University of Vienna, Vienna, Austria
| | - Michael Eigenschink
- Division of Neonatology, Pediatric Intensive Care and Neuropediatrics, Comprehensive Center for Pediatrics, Medical University of Vienna, Vienna, Austria
| | - Linda Pummer
- Division of Neonatology, Pediatric Intensive Care and Neuropediatrics, Comprehensive Center for Pediatrics, Medical University of Vienna, Vienna, Austria
| | | | - Ákos Végvári
- Proteomics Biomedicum, Division of Chemistry I, Department of Medical Biochemistry and Biophysics, Karolinska Institutet, Stockholm, Sweden
- Division of Chemistry I, Department of Medical Biochemistry and Biophysics, Karolinska Institutet, Stockholm, Sweden
| | - Benedikt Warth
- Exposome Austria, Research Infrastructure and National EIRENE Hub, Vienna, Austria
- Faculty of Chemistry, Department of Food Chemistry and Toxicology, University of Vienna, Vienna, Austria
| | - Angelika Berger
- Division of Neonatology, Pediatric Intensive Care and Neuropediatrics, Comprehensive Center for Pediatrics, Medical University of Vienna, Vienna, Austria
| | - Nanna Fyhrquist
- Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
- Human microbiome research program (HUMI), Medicum, University of Helsinki, Helsinki, Finland
| | - Harri Alenius
- Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
- Human microbiome research program (HUMI), Medicum, University of Helsinki, Helsinki, Finland
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Westfall JM, Bonilla AO, Lapadula MC, Zingoni PL, Wong WCW, Wensaas KA, Pace WD, Silva-Valencia J, Scattini LF, Ng APP, Manski-Nankervis JA, Ling ZJ, Li Z, Heald AH, Laughlin A, Kristiansson RS, Hallinan CM, Goh LH, Gaona G, Flottorp S, de Lusignan S, Cuba-Fuentes MS, Baste V, Tu K. Changes in primary care visits for respiratory illness during the COVID-19 pandemic: a multinational study by the International Consortium of Primary Care Big Data Researchers (INTRePID). Front Med (Lausanne) 2024; 11:1343646. [PMID: 38952865 PMCID: PMC11215147 DOI: 10.3389/fmed.2024.1343646] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2023] [Accepted: 05/20/2024] [Indexed: 07/03/2024] Open
Abstract
Objectives The majority of patients with respiratory illness are seen in primary care settings. Given COVID-19 is predominantly a respiratory illness, the INTernational ConsoRtium of Primary Care BIg Data Researchers (INTRePID), assessed the pandemic impact on primary care visits for respiratory illnesses. Design Definitions for respiratory illness types were agreed on collectively. Monthly visit counts with diagnosis were shared centrally for analysis. Setting Primary care settings in Argentina, Australia, Canada, China, Norway, Peru, Singapore, Sweden and the United States. Participants Over 38 million patients seen in primary care settings in INTRePID countries before and during the pandemic, from January 1st, 2018, to December 31st, 2021. Main outcome measures Relative change in the monthly mean number of visits before and after the onset of the pandemic for acute infectious respiratory disease visits including influenza, upper and lower respiratory tract infections and chronic respiratory disease visits including asthma, chronic obstructive pulmonary disease, respiratory allergies, and other respiratory diseases. Results INTRePID countries reported a marked decrease in the average monthly visits for respiratory illness. Changes in visits varied from -10.9% [95% confidence interval (CI): -33.1 to +11.3%] in Norway to -79.9% (95% CI: -86.4% to -73.4%) in China for acute infectious respiratory disease visits and - 2.1% (95% CI: -12.1 to +7.8%) in Peru to -59.9% (95% CI: -68.6% to -51.3%) in China for chronic respiratory illness visits. While seasonal variation in allergic respiratory illness continued during the pandemic, there was essentially no spike in influenza illness during the first 2 years of the pandemic. Conclusion The COVID-19 pandemic had a major impact on primary care visits for respiratory presentations. Primary care continued to provide services for respiratory illness, although there was a decrease in infectious illness during the COVID pandemic. Understanding the role of primary care may provide valuable information for COVID-19 recovery efforts and planning for future global emergencies.
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Affiliation(s)
| | | | - María C. Lapadula
- Department of Family and Community Medicine, University of Toronto, Toronto, ON, Canada
| | - Paula L. Zingoni
- Ministry of Health of the Autonomous City of Buenos Aires, Buenos Aires, Argentina
| | - William C. W. Wong
- Department of Family Medicine and Primary Care, The University of Hong Kong-Shenzhen Hospital, Shenzhen, China
- Department of Family Medicine and Primary Care, School of Clinical Medicine, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, China
| | - Knut A. Wensaas
- Research Unit for General Practice, NORCE Norwegian Research Centre AS, Bergen, Norway
| | | | - Javier Silva-Valencia
- Center for Research in Primary Health Care (CINAPS), Universidad Peruana Cayetano Heredia, Lima, Peru
- North York General Hospital, Toronto, ON, Canada
| | - Luciano F. Scattini
- Ministry of Health of the Autonomous City of Buenos Aires, Buenos Aires, Argentina
| | - Amy P. P. Ng
- Department of Family Medicine and Primary Care, The University of Hong Kong-Shenzhen Hospital, Shenzhen, China
- Department of Family Medicine and Primary Care, School of Clinical Medicine, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, China
| | - Jo-Anne Manski-Nankervis
- Department of General Practice and Primary Care, The University of Melbourne, Melbourne, VIC, Australia
| | - Zheng J. Ling
- Division of Family Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Zhuo Li
- Department of Family Medicine and Primary Care, The University of Hong Kong-Shenzhen Hospital, Shenzhen, China
| | - Adrian H. Heald
- School of Medical Sciences, Division of Diabetes, Endocrinology and Gastroenterology, University of Manchester, Manchester, United Kingdom
| | - Adrian Laughlin
- Department of General Practice and Primary Care, The University of Melbourne, Melbourne, VIC, Australia
| | | | - Christine M. Hallinan
- Department of General Practice and Primary Care, The University of Melbourne, Melbourne, VIC, Australia
| | - Lay H. Goh
- Division of Family Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | | | - Signe Flottorp
- Centre for Epidemic Interventions Research, Norwegian Institute of Public Health, Oslo, Norway
- Department of General Practice, University of Oslo, Oslo, Norway
| | - Simon de Lusignan
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, United Kingdom
| | - María S. Cuba-Fuentes
- Center for Research in Primary Health Care (CINAPS), Universidad Peruana Cayetano Heredia, Lima, Peru
| | - Valborg Baste
- National Centre for Emergency Primary Health Care, NORCE Norwegian Research Centre, Bergen, Norway
| | - Karen Tu
- Department of Family and Community Medicine, University of Toronto, Toronto, ON, Canada
- Departments of Research and Innovation and Family Medicine-North York General Hospital, Toronto Western Family Health Team-University Health Network, Toronto, ON, Canada
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Burvenich R, De Boodt S, Lowie L, Janssens A, Beerten SG, Vaes B, Toelen J, Verbakel JY. Temporal trends in antibiotic prescribing and serious and nonserious infections in children presenting to general practice: a registry-based longitudinal cohort study of 162 507 individuals. J Antimicrob Chemother 2024; 79:1397-1406. [PMID: 38714502 DOI: 10.1093/jac/dkae117] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2024] [Accepted: 04/02/2024] [Indexed: 05/10/2024] Open
Abstract
BACKGROUND It is crucial to understand the trends in paediatric antibiotic prescribing and serious and nonserious infections to improve antibiotic prescribing practices for children in ambulatory care. OBJECTIVES Assessing trends in paediatric antibiotic prescribing and infection incidence in general practice from 2002 to 2022. METHODS In this retrospective cohort study using INTEGO network data from 162 507 patients in Flanders (Belgium), we calculated antibiotic prescribing rates and proportions alongside incidence rates of serious and nonserious infections, stratified by age (0-1, 2-6, 7-12 years) and municipality. We performed autoregressive moving average time-series analyses and seasonality analyses. RESULTS From 2002 to 2022, antibiotic prescribing rate decreased significantly: 584/1000 person-years (PY) (95% CI 571-597) to 484/1000PY (95% CI 478-491); so did antibiotic overall prescribing proportion: 46.3% (95% CI 45.1-47.6) to 23.3% (95% CI 22.9-23.7) (59.3% amoxicillin and 17.8% broad spectrum). Prescribing proportions dropped significantly for nonserious (45.6% to 20.9%) and increased for serious infections (64.1% to 69.8%). Proportions significantly dropped for acute suppurative otitis media (74.7% to 64.1%), upper respiratory tract infections (44.9% to 16.6%), bronchitis/bronchiolitis (73.6% to 44.1%) and acute tonsillopharyngitis (59.5% to 21.7%), while significantly increasing for pneumonia (65.2% to 80.2%). Nonserious and serious infection incidence rates increased from 785/1000PY and 34.2/1000PY to 1223/1000PY and 64.1/1000PY, respectively. Blood and CRP testing proportions increased significantly. CONCLUSIONS Antibiotic prescribing in general practice for children declined from 2002 to 2022. Further targeted antibiotic stewardship initiatives are needed to reduce the use of broad-spectrum antibiotics and antibiotic prescribing for conditions such as otitis media and bronchitis/bronchiolitis.
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Affiliation(s)
- Ruben Burvenich
- Department of Public Health and Primary Care, Leuven Unit for Health and Technology Assessment Research (LUHTAR), KU Leuven, 7 Kapucijnenvoer, Leuven, 3000, Belgium
- Department of Public Health and Primary Care, Academic Centre for General Practice, KU Leuven, 7 Kapucijnenvoer, Leuven, 3000, Belgium
- Department of Family Medicine and Primary Healthcare, Ghent University, 10 Corneel Heymanslaan, Ghent, 9000, Belgium
- Menzies Institute for Medical Research, University of Tasmania, 17 Liverpool Street, Hobart, Tasmania, 7000, Australia
| | - Sien De Boodt
- Faculty of Medicine, KU Leuven, 49 Herestraat, Leuven, 3000, Belgium
| | - Lien Lowie
- Faculty of Medicine, KU Leuven, 49 Herestraat, Leuven, 3000, Belgium
| | - Arne Janssens
- Department of Public Health and Primary Care, Academic Centre for General Practice, KU Leuven, 7 Kapucijnenvoer, Leuven, 3000, Belgium
| | - Simon Gabriël Beerten
- Department of Public Health and Primary Care, Academic Centre for General Practice, KU Leuven, 7 Kapucijnenvoer, Leuven, 3000, Belgium
| | - Bert Vaes
- Department of Public Health and Primary Care, Academic Centre for General Practice, KU Leuven, 7 Kapucijnenvoer, Leuven, 3000, Belgium
| | - Jaan Toelen
- Woman and Child, Department of Development and Regeneration, KU Leuven, Leuven, Belgium
- Department of Pediatrics, University Hospitals Leuven, Leuven, Belgium
| | - Jan Yvan Verbakel
- Department of Public Health and Primary Care, Leuven Unit for Health and Technology Assessment Research (LUHTAR), KU Leuven, 7 Kapucijnenvoer, Leuven, 3000, Belgium
- Department of Public Health and Primary Care, Academic Centre for General Practice, KU Leuven, 7 Kapucijnenvoer, Leuven, 3000, Belgium
- Nuffield Department of Primary Care Health Sciences, NIHR Community Healthcare Medtech and IVD Cooperative, University of Oxford, Woodstock Road, Oxford, OX2 6GG, UK
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9
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Simusika P, Okamoto M, Dapat C, Muleya W, Malisheni M, Azam S, Imamura T, Saito M, Mwape I, Mpabalwani E, Monze M, Oshitani H. Characterization of human respiratory syncytial virus in children with severe acute respiratory infection before and during the COVID-19 pandemic. IJID REGIONS 2024; 11:100354. [PMID: 38596821 PMCID: PMC11002793 DOI: 10.1016/j.ijregi.2024.03.009] [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: 03/11/2024] [Accepted: 03/13/2024] [Indexed: 04/11/2024]
Abstract
Objectives Annual outbreaks of human respiratory syncytial virus (HRSV) are caused by newly introduced and locally persistent strains. During the COVID-19 pandemic, global and local circulation of HRSV significantly decreased. This study was conducted to characterize HRSV in 2018-2022 and to analyze the impact of COVID-19 on the evolution of HRSV. Design/methods Combined oropharyngeal and nasopharyngeal swabs were collected from children hospitalized with severe acute respiratory infection at two hospitals in Zambia. The second hypervariable region of the attachment gene G was targeted for phylogenetic analysis. Results Of 3113 specimens, 504 (16.2%) were positive for HRSV, of which 131 (26.0%) and 66 (13.1%) were identified as HRSVA and HRSVB, respectively. In early 2021, an increase in HRSV was detected, caused by multiple distinct clades of HRSVA and HRSVB. Some were newly introduced, whereas others resulted from local persistence. Conclusions This study provides insights into the evolution of HRSV, driven by global and local circulation. The COVID-19 pandemic had a temporal impact on the evolution pattern of HRSV. Understanding the evolution of HRSV is vital for developing strategies for its control.
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Affiliation(s)
- Paul Simusika
- Tohoku University Graduate School of Medicine, Department of Virology, Sendai, Japan
- University Teaching Hospitals, Pathology and Microbiology Department, Virology Laboratory, Lusaka, Zambia
- Levy Mwanawasa Medical University, Institute of Basic and Biomedical Sciences ,Lusaka, Zambia
| | - Michiko Okamoto
- Tohoku University Graduate School of Medicine, Department of Virology, Sendai, Japan
| | - Clyde Dapat
- Tohoku University Graduate School of Medicine, Department of Virology, Sendai, Japan
| | - Walter Muleya
- University of Zambia, School of Veterinary Medicine, Department of Biomedical Sciences, Lusaka, Zambia
| | - Moffat Malisheni
- University Teaching Hospitals, Pathology and Microbiology Department, Virology Laboratory, Lusaka, Zambia
| | - Sikandar Azam
- Tohoku University Graduate School of Medicine, Department of Virology, Sendai, Japan
| | - Takeaki Imamura
- Tohoku University Graduate School of Medicine, Department of Virology, Sendai, Japan
| | - Mayuko Saito
- Tohoku University Graduate School of Medicine, Department of Virology, Sendai, Japan
| | - Innocent Mwape
- Center for Infectious Disease Research in Zambia, Lusaka, Zambia
| | - Evans Mpabalwani
- University of Zambia, School of Medicine, Department of Pediatrics and Child Health, Lusaka, Zambia
| | - Mwaka Monze
- University Teaching Hospitals, Pathology and Microbiology Department, Virology Laboratory, Lusaka, Zambia
| | - Hitoshi Oshitani
- Tohoku University Graduate School of Medicine, Department of Virology, Sendai, Japan
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10
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Gilca R, Amini R, Carazo S, Doggui R, Frenette C, Boivin G, Charest H, Dumaresq J. The Changing Landscape of Respiratory Viruses Contributing to Hospitalizations in Quebec, Canada: Results From an Active Hospital-Based Surveillance Study. JMIR Public Health Surveill 2024; 10:e40792. [PMID: 38709551 DOI: 10.2196/40792] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2022] [Revised: 02/15/2024] [Accepted: 03/20/2024] [Indexed: 05/07/2024] Open
Abstract
BACKGROUND A comprehensive description of the combined effect of SARS-CoV-2 and respiratory viruses other than SARS-CoV-2 (ORVs) on acute respiratory infection (ARI) hospitalizations is lacking. OBJECTIVE This study aimed to compare the viral etiology of ARI hospitalizations before the pandemic (8 prepandemic influenza seasons, 2012-13 to 2019-20) and during 3 pandemic years (periods of increased SARS-CoV-2 and ORV circulation in 2020-21, 2021-22, and 2022-23) from an active hospital-based surveillance network in Quebec, Canada. METHODS We compared the detection of ORVs and SARS-CoV-2 during 3 pandemic years to that in 8 prepandemic influenza seasons among patients hospitalized with ARI who were tested systematically by the same multiplex polymerase chain reaction (PCR) assay during periods of intense respiratory virus (RV) circulation. The proportions of infections between prepandemic and pandemic years were compared by using appropriate statistical tests. RESULTS During prepandemic influenza seasons, overall RV detection was 92.7% (1384/1493) (respiratory syncytial virus [RSV]: 721/1493, 48.3%; coinfections: 456/1493, 30.5%) in children (<18 years) and 62.8% (2723/4339) (influenza: 1742/4339, 40.1%; coinfections: 264/4339, 6.1%) in adults. Overall RV detection in children was lower during pandemic years but increased from 58.6% (17/29) in 2020-21 (all ORVs; coinfections: 7/29, 24.1%) to 90.3% (308/341) in 2021-22 (ORVs: 278/341, 82%; SARS-CoV-2: 30/341, 8.8%; coinfections: 110/341, 32.3%) and 88.9% (361/406) in 2022-23 (ORVs: 339/406, 84%; SARS-CoV-2: 22/406, 5.4%; coinfections: 128/406, 31.5%). In adults, overall RV detection was also lower during pandemic years but increased from 43.7% (333/762) in 2020-21 (ORVs: 26/762, 3.4%; SARS-CoV-2: 307/762, 40.3%; coinfections: 7/762, 0.9%) to 57.8% (731/1265) in 2021-22 (ORVs: 179/1265, 14.2%; SARS-CoV-2: 552/1265, 43.6%; coinfections: 42/1265, 3.3%) and 50.1% (746/1488) in 2022-23 (ORVs: 409/1488, 27.5%; SARS-CoV-2: 337/1488, 22.6%; coinfections: 36/1488, 2.4%). No influenza or RSV was detected in 2020-21; however, their detection increased in the 2 subsequent years but did not reach prepandemic levels. Compared to the prepandemic period, the peaks of RSV hospitalization shifted in 2021-22 (16 weeks earlier) and 2022-23 (15 weeks earlier). Moreover, the peaks of influenza hospitalization shifted in 2021-22 (17 weeks later) and 2022-23 (4 weeks earlier). Age distribution was different compared to the prepandemic period, especially during the first pandemic year. CONCLUSIONS Significant shifts in viral etiology, seasonality, and age distribution of ARI hospitalizations occurred during the 3 pandemic years. Changes in age distribution observed in our study may reflect modifications in the landscape of circulating RVs and their contribution to ARI hospitalizations. During the pandemic period, SARS-CoV-2 had a low contribution to pediatric ARI hospitalizations, while it was the main contributor to adult ARI hospitalizations during the first 2 seasons and dropped below ORVs during the third pandemic season. Evolving RVs epidemiology underscores the need for increased scrutiny of ARI hospitalization etiology to inform tailored public health recommendations.
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Affiliation(s)
- Rodica Gilca
- Direction des risques biologiques, Institut national de santé publique du Québec, Québec, QC, Canada
- Research Center of Centre hospitalier universitaire de Québec-Université Laval, Québec, QC, Canada
- Département de médecine préventive, Université Laval, Québec, QC, Canada
| | - Rachid Amini
- Direction des risques biologiques, Institut national de santé publique du Québec, Québec, QC, Canada
| | - Sara Carazo
- Direction des risques biologiques, Institut national de santé publique du Québec, Québec, QC, Canada
- Research Center of Centre hospitalier universitaire de Québec-Université Laval, Québec, QC, Canada
- Département de médecine préventive, Université Laval, Québec, QC, Canada
| | - Radhouene Doggui
- Direction des risques biologiques, Institut national de santé publique du Québec, Québec, QC, Canada
| | - Charles Frenette
- Department of Medicine, Division of Infectious Diseases, McGill University Health Center, Montreal, QC, Canada
| | - Guy Boivin
- Research Center of Centre hospitalier universitaire de Québec-Université Laval, Québec, QC, Canada
| | - Hugues Charest
- Laboratoire de santé publique, Institut national de santé publique du Québec, Montreal, QC, Canada
| | - Jeannot Dumaresq
- Departement of Microbiology and Infectiology, Centre intégré de santé et de services sociaux de Chaudière-Appalaches, Levis, QC, Canada
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11
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Qi X, Zhang K, Wang Y, Wan G, Sun J, Sun J, Zhao W. Incidence and characteristics of otitis media with effusion in adults before, during, and after the COVID-19 pandemic. Eur Arch Otorhinolaryngol 2024; 281:2275-2280. [PMID: 38085307 DOI: 10.1007/s00405-023-08338-6] [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: 09/11/2023] [Accepted: 11/06/2023] [Indexed: 04/18/2024]
Abstract
OBJECTIVES To investigate the incidence and characteristics of adult otitis media with effusion (OME) before, during, and after the COVID-19 pandemic. METHODS A retrospective descriptive study was conducted. The incidence, age, sex, affected ear side, time of OME onset according to COVID-19 and days of improvement after conservative treatment were determined to assess the clinical features of adult OME in different periods of the COVID-19 pandemic. RESULTS The incidence of adult OME during these periods was 3.17%, 2.30%, 6.18%, and 3.68%, respectively. Unilateral ear involvement and male sex were more common. The onset of adult OME occurred 7.80 ± 3.97 days after COVID-19 diagnosis, and improvement was observed after 12.24 ± 5.08 days of conservative treatment. Patients in the post-pandemic period were older than those in the non-pandemic period. CONCLUSION The incidence of adult OME in China showed a tendency to decrease, recover, and decrease again following the COVID-19 outbreak. Pandemic prevention and control measures have had a certain impact on reducing the incidence, but the elderly are more prone to this disease.
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Affiliation(s)
- Xiaoyu Qi
- Department of Otolaryngology-Head and Neck Surgery, The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, 443 Huangshan Road, Hefei, 230026, People's Republic of China
| | - Ke Zhang
- Department of Otolaryngology-Head and Neck Surgery, The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, 443 Huangshan Road, Hefei, 230026, People's Republic of China
| | - Yinfeng Wang
- Department of Otolaryngology-Head and Neck Surgery, The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, 443 Huangshan Road, Hefei, 230026, People's Republic of China
| | - Guanglun Wan
- Department of Otolaryngology-Head and Neck Surgery, The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, 443 Huangshan Road, Hefei, 230026, People's Republic of China
| | - Jiaqiang Sun
- Department of Otolaryngology-Head and Neck Surgery, The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, 443 Huangshan Road, Hefei, 230026, People's Republic of China
| | - Jingwu Sun
- Department of Otolaryngology-Head and Neck Surgery, The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, 443 Huangshan Road, Hefei, 230026, People's Republic of China.
| | - Wan Zhao
- Department of Otolaryngology-Head and Neck Surgery, The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, 443 Huangshan Road, Hefei, 230026, People's Republic of China.
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12
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Mazela J, Jackowska T, Czech M, Helwich E, Martyn O, Aleksiejuk P, Smaga A, Glazewska J, Wysocki J. Epidemiology of Respiratory Syncytial Virus Hospitalizations in Poland: An Analysis from 2015 to 2023 Covering the Entire Polish Population of Children Aged under Five Years. Viruses 2024; 16:704. [PMID: 38793586 PMCID: PMC11126078 DOI: 10.3390/v16050704] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2024] [Revised: 04/26/2024] [Accepted: 04/27/2024] [Indexed: 05/26/2024] Open
Abstract
BACKGROUND Respiratory syncytial virus (RSV) is an important cause of childhood hospitalizations. The aim of the study was to estimate the rates of RSV-related hospitalizations in children aged less than 5 years in Poland. METHODS This retrospective observational cohort study was based on data obtained from the National Health Fund in Poland regarding all acute respiratory tract infections and RSV-coded admissions of children (age < 5 years) to public hospitals between July 2015 and June 2023. Patients were stratified based on the following age groups: 0-1 month, 2-3 months, 4-6 months, 7-12 months, 13-24 months, and 25-60 months. RESULTS The number of RSV-related hospitalizations increased every season, both before and through the ending phase of the coronavirus disease 2019 (COVID-19) pandemic. The COVID-19 pandemic was associated with a shift in the seasonality pattern of RSV infection. Hospitalization rates per 1000 inhabitants were the highest for children aged 0-12 months, reaching 47.3 in the 2022/23 season. Within this group, the highest hospitalization rate was observed for children aged 2-3 months-94.9 in the 2022/23 season. During the ending phase of the COVID-19 pandemic, the observed increase in admission rates was 2-, 4-, and 5-fold the pre-COVID rate for children aged <12 months, 12-24 months, and 25-60 months, respectively. CONCLUSIONS In Poland, RSV infections cause a significant burden in hospitalized children aged less than 5 years. RSV-related hospitalizations were most frequent in children aged less than 1 year. The COVID-19 pandemic was associated with a shift in the seasonality pattern of RSV infections. After the pandemic, more RSV-related hospitalizations were observed in older children (aged 13 months and older) vs. the pre-pandemic phase.
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Affiliation(s)
- Jan Mazela
- Department of Neonatology, Poznan University of Medical Sciences in Poznan, 60-535 Poznan, Poland
| | - Teresa Jackowska
- Department of Pediatrics, Centre of Postgraduate Medical Education, 01-813 Warsaw, Poland;
| | - Marcin Czech
- Department of Pharmacoeconomics, Hospital Infection Control Team, Institute of Mother and Child, 01-211 Warsaw, Poland;
| | - Ewa Helwich
- Institute of Mother and Child, 01-211 Warsaw, Poland;
| | - Oliver Martyn
- Sanofi A/S, Vaccines Medical Affairs, DK-2100 København, Denmark;
| | - Pawel Aleksiejuk
- Sanofi Sp. z o.o., Vaccines Medical Affairs, 01-211 Warsaw, Poland
| | - Anna Smaga
- PEX Sp. z o.o., 02-796 Warsaw, Poland; (A.S.); (J.G.)
- National Institute of Public Health NIH—National Research Institute, 00-791 Warsaw, Poland
| | | | - Jacek Wysocki
- Department of Preventive Medicine, Poznan University of Medical Sciences at Poznan, 61-701 Poznan, Poland;
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Korsun N, Trifonova I, Madzharova I, Alexiev I, Uzunova I, Ivanov I, Velikov P, Tcherveniakova T, Christova I. Resurgence of respiratory syncytial virus with dominance of RSV-B during the 2022-2023 season. Front Microbiol 2024; 15:1376389. [PMID: 38628867 PMCID: PMC11019023 DOI: 10.3389/fmicb.2024.1376389] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2024] [Accepted: 03/15/2024] [Indexed: 04/19/2024] Open
Abstract
Background Respiratory syncytial virus (RSV) is a common cause of upper and lower respiratory tract infections. This study aimed to explore the prevalence of respiratory syncytial virus (RSV) and other respiratory viruses in Bulgaria, characterize the genetic diversity of RSV strains, and perform amino acid sequence analyses of RSV surface and internal proteins. Methods Clinical and epidemiological data and nasopharyngeal swabs were prospectively collected from patients with acute respiratory infections between October 2020 and May 2023. Real-time PCR for 13 respiratory viruses, whole-genome sequencing, phylogenetic, and amino acid analyses were performed. Results This study included three epidemic seasons (2020-2021, 2021-2022, and 2022-2023) from week 40 of the previous year to week 20 of the following year. Of the 3,047 patients examined, 1,813 (59.5%) tested positive for at least one viral respiratory pathogen. RSV was the second most detected virus (10.9%) after SARS-CoV-2 (22%). Coinfections between RSV and other respiratory viruses were detected in 68 cases, including 14 with SARS-CoV-2. After two seasons of low circulation, RSV activity increased significantly during the 2022-2023 season. The detection rates of RSV were 3.2, 6.6, and 13.7% in the first, second, and third seasons, respectively. RSV was the most common virus found in children under 5 years old with bronchiolitis (40%) and pneumonia (24.5%). RSV-B drove the 2022-2023 epidemic. Phylogenetic analysis indicated that the sequenced RSV-B strains belonged to the GB5.0.5a and GB5.0.6a genotypes. Amino acid substitutions in the surface and internal proteins, including the F protein antigenic sites were identified compared to the BA prototype strain. Conclusion This study revealed a strong resurgence of RSV in the autumn of 2022 after the lifting of anti-COVID-19 measures, the leading role of RSV as a causative agent of serious respiratory illnesses in early childhood, and relatively low genetic diversity in circulating RSV strains.
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Affiliation(s)
- Neli Korsun
- National Laboratory “Influenza and ARI”, Department of Virology, National Center of Infectious and Parasitic Diseases, Sofia, Bulgaria
| | - Ivelina Trifonova
- National Laboratory “Influenza and ARI”, Department of Virology, National Center of Infectious and Parasitic Diseases, Sofia, Bulgaria
| | - Iveta Madzharova
- National Laboratory “Influenza and ARI”, Department of Virology, National Center of Infectious and Parasitic Diseases, Sofia, Bulgaria
| | - Ivaylo Alexiev
- National Laboratory “Influenza and ARI”, Department of Virology, National Center of Infectious and Parasitic Diseases, Sofia, Bulgaria
| | | | - Ivan Ivanov
- Department of Infectious Diseases, Medical University, Sofia, Bulgaria
| | - Petar Velikov
- Department of Infectious Diseases, Medical University, Sofia, Bulgaria
| | | | - Iva Christova
- National Laboratory “Influenza and ARI”, Department of Virology, National Center of Infectious and Parasitic Diseases, Sofia, Bulgaria
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14
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Xie LY, Wang T, Yu T, Hu X, Yang L, Zhong LL, Zhang B, Zeng SZ. Seasonality of respiratory syncytial virus infection in children hospitalized with acute lower respiratory tract infections in Hunan, China, 2013-2022. Virol J 2024; 21:62. [PMID: 38454522 PMCID: PMC10921640 DOI: 10.1186/s12985-024-02336-8] [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: 01/07/2024] [Accepted: 03/04/2024] [Indexed: 03/09/2024] Open
Abstract
BACKGROUND In China, respiratory syncytial virus (RSV) infections traditionally occur during the spring and winter seasons. However, a shift in the seasonal trend was noted in 2020-2022, during the coronavirus disease 2019 (COVID-19) pandemic. METHODS This study investigated the seasonal characteristics of RSV infection in children hospitalized with acute lower respiratory tract infections (ALRTIs). The RSV epidemic season was defined as RSV positivity in > 10% of the hospitalized ALRTI cases each week. Nine RSV seasons were identified between 2013 and 2022, and nonlinear ordinary least squares regression models were used to assess the differences in year-to-year epidemic seasonality trends. RESULTS We enrolled 49,658 hospitalized children diagnosed with ALRTIs over a 9-year period, and the RSV antigen-positive rate was 15.2% (n = 7,566/49,658). Between 2013 and 2022, the average onset and end of the RSV season occurred in week 44 (late October) and week 17 of the following year, respectively, with a typical duration of 27 weeks. However, at the onset of the COVID-19 pandemic, the usual spring RSV peak did not occur. Instead, the 2020 epidemic started in week 32, and RSV seasonality persisted into 2021, lasting for an unprecedented 87 weeks before concluding in March 2022. CONCLUSIONS RSV seasonality was disrupted during the COVID-19 pandemic, and the season exhibited an unusually prolonged duration. These findings may provide valuable insights for clinical practice and public health considerations.
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Affiliation(s)
- Le-Yun Xie
- Hunan Provincial People's Hospital (The First Affiliated Hospital of Hunan Normal University), 410005, Changsha, China
| | - Tao Wang
- Hunan Provincial People's Hospital (The First Affiliated Hospital of Hunan Normal University), 410005, Changsha, China
| | - Tian Yu
- Hunan Provincial People's Hospital (The First Affiliated Hospital of Hunan Normal University), 410005, Changsha, China.
| | - Xian Hu
- Hunan Provincial People's Hospital (The First Affiliated Hospital of Hunan Normal University), 410005, Changsha, China
| | - Le Yang
- Hunan Provincial People's Hospital (The First Affiliated Hospital of Hunan Normal University), 410005, Changsha, China
| | - Li-Li Zhong
- Hunan Provincial People's Hospital (The First Affiliated Hospital of Hunan Normal University), 410005, Changsha, China
| | - Bing Zhang
- Hunan Provincial People's Hospital (The First Affiliated Hospital of Hunan Normal University), 410005, Changsha, China
| | - Sai-Zhen Zeng
- Hunan Provincial People's Hospital (The First Affiliated Hospital of Hunan Normal University), 410005, Changsha, China.
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15
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Hirotsu Y, Nagakubo Y, Maejima M, Shibusawa M, Hosaka K, Sueki H, Mochizuki H, Omata M. Changes in Viral Dynamics Following the Legal Relaxation of COVID-19 Mitigation Measures in Japan From Children to Adults: A Single Center Study, 2020-2023. Influenza Other Respir Viruses 2024; 18:e13278. [PMID: 38513611 PMCID: PMC10957242 DOI: 10.1111/irv.13278] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2023] [Revised: 02/26/2024] [Accepted: 02/27/2024] [Indexed: 03/23/2024] Open
Abstract
INTRODUCTION Respiratory infections are an ongoing global health challenge. The COVID-19 pandemic triggered global nonpharmacological measures that reshaped public health. In Japan, the shift from legal to individual discretion in pandemic management started on May 8, 2023. However, it still unknown how the relaxation of measures affects respiratory pathogens across age groups. METHODS We collected 16,946 samples from 13,526 patients between February 2020 and September 2023, analyzing the circulating respiratory pathogen dynamics using FilmArray respiratory panel. RESULTS Our analysis revealed significant increases in the positivity rates of respiratory pathogens across multiple age groups after relaxation. The pathogens including adenovirus, Bordetella pertussis, parainfluenza 2 and parainfluenza 4 showed increased positivity predominantly in children aged under 10 years. Conversely, some pathogens including human metapneumovirus, rhinovirus/enterovirus, and respiratory virus (RSV) increased in broad range of age groups. SARS-CoV-2 positivity rates decreased in children under 10 years but increased in those aged over 60 years. DISCUSSION Age-stratified analysis reveals a dynamic pattern of circulating pathogen in each age group after relaxation measures. This study provides essential epidemiologic data that can guide strategies to protect different age groups and effectively respond to respiratory infections in post-COVID-19 era.
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Affiliation(s)
- Yosuke Hirotsu
- Genome Analysis CenterYamanashi Central HospitalKofuYamanashiJapan
| | - Yuki Nagakubo
- Genome Analysis CenterYamanashi Central HospitalKofuYamanashiJapan
- Division of Microbiology in Clinical LaboratoryYamanashi Central HospitalKofuYamanashiJapan
- Division of Genetics and Clinical LaboratoryYamanashi Central HospitalKofuYamanashiJapan
| | - Makoto Maejima
- Division of Microbiology in Clinical LaboratoryYamanashi Central HospitalKofuYamanashiJapan
| | - Masahiro Shibusawa
- Division of Microbiology in Clinical LaboratoryYamanashi Central HospitalKofuYamanashiJapan
| | - Kazuhiro Hosaka
- Division of Microbiology in Clinical LaboratoryYamanashi Central HospitalKofuYamanashiJapan
| | - Hitomi Sueki
- Division of Microbiology in Clinical LaboratoryYamanashi Central HospitalKofuYamanashiJapan
| | - Hitoshi Mochizuki
- Genome Analysis CenterYamanashi Central HospitalKofuYamanashiJapan
- Central Clinical LaboratoryYamanashi Central HospitalKofuYamanashiJapan
- Department of GastroenterologyYamanashi Central HospitalKofuYamanashiJapan
| | - Masao Omata
- Department of GastroenterologyYamanashi Central HospitalKofuYamanashiJapan
- The University of TokyoTokyoJapan
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Kordi R, Chang AJ, Hicar MD. Seasonal Testing, Results, and Effect of the Pandemic on Coxsackievirus Serum Studies. Microorganisms 2024; 12:367. [PMID: 38399771 PMCID: PMC10893248 DOI: 10.3390/microorganisms12020367] [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: 12/10/2023] [Revised: 01/23/2024] [Accepted: 01/24/2024] [Indexed: 02/25/2024] Open
Abstract
Coxsackieviruses (CVs) are common causes of infections and can be life-threatening. Unfortunately, rigorous studies guiding the clinician in interpreting CV serum antibody titer testing is lacking. To explore the epidemiology of circulating CVs and the serological test utility in aiding diagnosis of CV infections in our community, we obtained results of CV immunologic diagnostic tests between 2018 and 2022 from a regional healthcare database. For CV type A, rare individuals had positive CF (complement fixation) tests whereas all 16 individuals with IFA testing showed at least one positive serotype. For CV type B CF testing, 52.2% of 222 patients had at least one serotype positive, with B5 being most common and also the most common with higher titers (14.8% with ≥1:32). We found a significant reduction in seropositivity rate during the pandemic in 2020 compared to 2018, which continued through 2022 (OR: 0.2, 95% CI: 0.08-0.49, p-value < 0.001). During the pandemic, the seasonal pattern of positive tests varied from the pre-pandemic pattern. Testing for CVs was increased after the first year of the pandemic. Overall, the variability by month and seasonal change in our data support that CF testing can be used to identify recent CVB infection.
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Affiliation(s)
- Ramesh Kordi
- Department of Pediatric Infectious Diseases, State University of New York at Buffalo, Buffalo, NY 14203, USA;
| | - Arthur J. Chang
- Division of Pediatric Infectious Diseases, University of Nebraska Medical Center, Omaha, NE 68198, USA;
| | - Mark D. Hicar
- Department of Pediatric Infectious Diseases, State University of New York at Buffalo, Buffalo, NY 14203, USA;
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Guadalupe-Fernández V, Martínez-Solanas E, Sabrià-Sunyé A, Ferrer-Mikoly C, Martínez-Mateo A, Ciruela-Navas P, Mendioroz J, Basile L. Investigating epidemiological distribution (temporality and intensity) of respiratory pathogens following COVID-19 de-escalation process in Catalonia, September 2016-June 2021: Analysis of regional surveillance data. PLoS One 2024; 19:e0285892. [PMID: 38335176 PMCID: PMC10857536 DOI: 10.1371/journal.pone.0285892] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2022] [Accepted: 05/03/2023] [Indexed: 02/12/2024] Open
Abstract
BACKGROUND Following the low incidence rates of non-SARS-CoV-2 respiratory viruses registered during the strict lockdown enforced in the pandemic, a resurgence of several endemic viruses in Catalonia (Spain) was noted during the early summer of 2021. OBJECTIVES In this study, we investigated whether the circulation of non-SARS-CoV-2 respiratory viruses in Catalonia, assessed by Microbiological Reporting System of Catalonia (MRSC) and the Epidemiological Surveillance Network of Catalonia, was affected by the strict lockdown measures, as well as, the implication of the Coronavirus Disease 19 (COVID-19) de-escalation process in the late season outbreaks registered during the 2020-2021 season. STUDY DESIGN A retrospective comparison of epidemic patterns in the respiratory viruses' incidence, using regional public health surveillance data from MRSC, was performed between weeks 26/2016 to week 27/2021. Data were expressed as the weekly total number of test positivity for individual viruses. A segmented negative binomial regression model was conducted, with two parameters included (level and trend) for each segment of the time series (2020 pre-lockdown, 2020 post-lockdown and 2021). Results were reported as a unit changed in the strict lockdown. RESULTS A total of 51588 confirmed cases of the different respiratory viruses were included in the analysis, the majority were influenza cases (63.7%). An immediate reduction in the weekly number of cases was observed in 2020 after the COVID-19 outbreak for human adenovirus virus (HAdV) (β2 = -2.606; P <0.01), human parainfluenza virus (HPIV) (β2 = -3.023; P <0.01), influenza virus (IFV) (β2 = -1.259; P <0.01), but not for respiratory syncytial virus (RSV), where the number of cases remained unchanged. During 2020, a significant negative trend was found for RSV (β3 = -0.170, P <0.01), and a positive trend for HAdV (β3 = 0.075, P <0.01). During 2021, a significant reduction in the weekly number of cases was also observed for all respiratory viruses, and a borderline non-significant reduction for HPIV (β3 = -0.027; P = 0.086). Moreover, significant positive trends were found for each viral pathogen, except for influenza during 2020-2021 season, where cases remained close to zero. The respiratory viruses increased activity and their late season epidemic start particularly affected children under 6 years old. CONCLUSIONS Our data not only provides evidence that occurrence of different respiratory virus infections was affected by the strict lockdown taken against SARS-CoV-2 but it also shows a late resurgence of seasonal respiratory viruses' cases during the 2020-2021 season following the relaxation of COVID-19-targeted non-pharmaceutical interventions.
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Affiliation(s)
- Víctor Guadalupe-Fernández
- Sub-Directorate General of Surveillance and Response to Public Health Emergencies, Public Health Agency of Catalonia, Generalitat of Catalonia, Barcelona, Spain
- Research Support Unit of Central Catalonia, University Institute for Research in Primary Health Care Jordi Gol i Gurina, Sant Fruitós de Bages, Spain
| | - Erica Martínez-Solanas
- Sub-Directorate General of Surveillance and Response to Public Health Emergencies, Public Health Agency of Catalonia, Generalitat of Catalonia, Barcelona, Spain
| | - Aurora Sabrià-Sunyé
- Sub-Directorate General of Surveillance and Response to Public Health Emergencies, Public Health Agency of Catalonia, Generalitat of Catalonia, Barcelona, Spain
| | - Carol Ferrer-Mikoly
- Sub-Directorate General of Surveillance and Response to Public Health Emergencies, Public Health Agency of Catalonia, Generalitat of Catalonia, Barcelona, Spain
| | - Ana Martínez-Mateo
- Sub-Directorate General of Surveillance and Response to Public Health Emergencies, Public Health Agency of Catalonia, Generalitat of Catalonia, Barcelona, Spain
- CIBER Epidemiologia y Salud Pública (CIBERESP), Instituto Salud Carlos III, Madrid, Spain
| | - Pilar Ciruela-Navas
- Sub-Directorate General of Surveillance and Response to Public Health Emergencies, Public Health Agency of Catalonia, Generalitat of Catalonia, Barcelona, Spain
- CIBER Epidemiologia y Salud Pública (CIBERESP), Instituto Salud Carlos III, Madrid, Spain
| | - Jacobo Mendioroz
- Sub-Directorate General of Surveillance and Response to Public Health Emergencies, Public Health Agency of Catalonia, Generalitat of Catalonia, Barcelona, Spain
- Research Support Unit of Central Catalonia, University Institute for Research in Primary Health Care Jordi Gol i Gurina, Sant Fruitós de Bages, Spain
| | - Luca Basile
- Sub-Directorate General of Surveillance and Response to Public Health Emergencies, Public Health Agency of Catalonia, Generalitat of Catalonia, Barcelona, Spain
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van Kasteren PB, Gelderloos AT, Nicolaie MA, den Hartog G, Vissers M, Luytjes W, Rots NY, van Beek J. Prevalence of human respiratory pathogens and associated mucosal cytokine levels in young children and adults: a cross-sectional observational study in the Netherlands during the winter of 2012/2013. Pathog Dis 2024; 82:ftae010. [PMID: 38714349 PMCID: PMC11132126 DOI: 10.1093/femspd/ftae010] [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: 10/24/2023] [Revised: 02/16/2024] [Accepted: 05/06/2024] [Indexed: 05/09/2024] Open
Abstract
Respiratory pathogens can cause severe disease and even death, especially in the very young and very old. Studies investigating their prevalence often focus on individuals presenting to healthcare providers with symptoms. However, the design of prevention strategies, e.g. which target groups to vaccinate, will benefit from knowledge on the prevalence of, risk factors for and host response to these pathogens in the general population. In this study, upper respiratory samples (n = 1311) were collected cross-sectionally during winter from 11- and 24-month old children, their parents, and adults ≥60 years of age that were recruited irrespective of seeking medical care. Almost all children, approximately two-thirds of parents and a quarter of older adults tested positive for at least one pathogen, often in the absence of symptoms. Viral interference was evident for the combination of rhinovirus and respiratory syncytial virus. Attending childcare facilities and having siblings associated with increased pathogen counts in children. On average, children showed increased levels of mucosal cytokines compared to parents and especially proinflammatory molecules associated with the presence of symptoms. These findings may guide further research into transmission patterns of respiratory pathogens and assist in determining the most appropriate strategies for the prediction and prevention of disease.
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Affiliation(s)
- Puck B van Kasteren
- Center for Infectious Disease Control, National Institute for Public Health and the Environment, Antonie van Leeuwenhoeklaan 9, 3721 MA, Bilthoven, The Netherlands
| | - Anne T Gelderloos
- Center for Infectious Disease Control, National Institute for Public Health and the Environment, Antonie van Leeuwenhoeklaan 9, 3721 MA, Bilthoven, The Netherlands
| | - Mioara Alina Nicolaie
- Center for Infectious Disease Control, National Institute for Public Health and the Environment, Antonie van Leeuwenhoeklaan 9, 3721 MA, Bilthoven, The Netherlands
| | - Gerco den Hartog
- Center for Infectious Disease Control, National Institute for Public Health and the Environment, Antonie van Leeuwenhoeklaan 9, 3721 MA, Bilthoven, The Netherlands
| | - Marloes Vissers
- Center for Infectious Disease Control, National Institute for Public Health and the Environment, Antonie van Leeuwenhoeklaan 9, 3721 MA, Bilthoven, The Netherlands
| | - Willem Luytjes
- Center for Infectious Disease Control, National Institute for Public Health and the Environment, Antonie van Leeuwenhoeklaan 9, 3721 MA, Bilthoven, The Netherlands
| | - Nynke Y Rots
- Center for Infectious Disease Control, National Institute for Public Health and the Environment, Antonie van Leeuwenhoeklaan 9, 3721 MA, Bilthoven, The Netherlands
| | - Josine van Beek
- Center for Infectious Disease Control, National Institute for Public Health and the Environment, Antonie van Leeuwenhoeklaan 9, 3721 MA, Bilthoven, The Netherlands
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19
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Rhoden J, Hoffmann AT, Stein JF, Rocha BSD, Barros VMD, Silva EVD, Fleck JD, Rigotto C. Viral coinfection in hospitalized patients during the COVID-19 pandemic in Southern Brazil: a retrospective cohort study. Respir Res 2024; 25:71. [PMID: 38317218 PMCID: PMC10840208 DOI: 10.1186/s12931-024-02708-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2023] [Accepted: 01/25/2024] [Indexed: 02/07/2024] Open
Abstract
PURPOSE Since the worldwide spread of SARS-CoV-2, different strategies have been followed to combat the pandemic and limit virus transmission. In the meantime, other respiratory viruses continued to circulate, though at decreased rates. METHODS This study was conducted between June and July 2022, in a hospital in the metropolitan region of Rio Grande do Sul state, in the southernmost state of Brazil. The 337 hospitalized patients included those with respiratory symptoms without delimitation of age. Reverse transcription-quantitative real-time polymerase chain reaction detected 15 different respiratory viruses and confirmed coinfections in the samples. Different statistical tests were applied to evaluate the association between associations of clinical characteristics and coinfection. RESULTS Sampling corresponds to 337 selected and 330 patients analyzed. The principal clinical outcome found was hospital discharge in 309 (94%) cases, while 21 (6%) resulted in death. The principal viral agents related to coinfections were Human rhinovirus, Human enterovirus, and Respiratory syncytial virus. The most frequent viral agent detected was SARS-CoV-2, with 60 (18%) infections, followed by 51 (15%) cases of Respiratory syncytial virus B (15%) and 44 (13%) cases of Human rhinovirus 1. Coinfection was mainly observed in children, while adults and the elderly were more affected by a single infection. Analyzing COVID-19 vaccination, 175 (53%) were unvaccinated while the remainder had at least one dose of the vaccine. CONCLUSIONS This study presents information to update the understanding of viral circulation in the region. Furthermore, the findings clarify the behavior of viral infections and possible coinfections in hospitalized patients, considering different ages and clinical profiles. In addition, this knowledge can help to monitor the population's clinical manifestations and prevent future outbreaks of respiratory viruses.
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Affiliation(s)
- Jaqueline Rhoden
- Laboratório de Microbiologia Molecular, Universidade Feevale, Rodovia ERS-239, N◦ 2755, Prédio Vermelho, Piso 1, Sala 103, Vila Nova, Novo Hamburgo, Rio Grande Do Sul, CEP 93525-075, Brazil.
- Santa Casa de Misericórdia de Porto Alegre, Hospital Dom Vicente Scherer, Centro Histórico, Av. Independência, Nº 155, Porto Alegre, Rio Grande Do Sul, CEP 90035- 074, Brazil.
| | - Andressa Taíz Hoffmann
- Santa Casa de Misericórdia de Porto Alegre, Hospital Dom Vicente Scherer, Centro Histórico, Av. Independência, Nº 155, Porto Alegre, Rio Grande Do Sul, CEP 90035- 074, Brazil
| | - Janaína Franciele Stein
- Laboratório de Microbiologia Molecular, Universidade Feevale, Rodovia ERS-239, N◦ 2755, Prédio Vermelho, Piso 1, Sala 103, Vila Nova, Novo Hamburgo, Rio Grande Do Sul, CEP 93525-075, Brazil
| | - Bruna Seixas da Rocha
- Laboratório de Microbiologia Molecular, Universidade Feevale, Rodovia ERS-239, N◦ 2755, Prédio Vermelho, Piso 1, Sala 103, Vila Nova, Novo Hamburgo, Rio Grande Do Sul, CEP 93525-075, Brazil
| | - Vinícius Monteagudo de Barros
- Laboratório de Microbiologia Molecular, Universidade Feevale, Rodovia ERS-239, N◦ 2755, Prédio Vermelho, Piso 1, Sala 103, Vila Nova, Novo Hamburgo, Rio Grande Do Sul, CEP 93525-075, Brazil
| | - Eduardo Viegas da Silva
- Centro Estadual de Vigilância em Saúde do Rio Grande Do Sul, Av. Ipiranga, 5400, Jardim Botânico, Porto Alegre, Rio Grande Do Sul, CEP 90450-190, Brazil
| | - Juliane Deise Fleck
- Laboratório de Microbiologia Molecular, Universidade Feevale, Rodovia ERS-239, N◦ 2755, Prédio Vermelho, Piso 1, Sala 103, Vila Nova, Novo Hamburgo, Rio Grande Do Sul, CEP 93525-075, Brazil
| | - Caroline Rigotto
- Laboratório de Microbiologia Molecular, Universidade Feevale, Rodovia ERS-239, N◦ 2755, Prédio Vermelho, Piso 1, Sala 103, Vila Nova, Novo Hamburgo, Rio Grande Do Sul, CEP 93525-075, Brazil
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20
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Abushahin A, Toma H, Alnaimi A, Abu-Hasan M, Alneirab A, Alzoubi H, Belavendra A, Janahi I. Impact of COVID‑19 pandemic restrictions and subsequent relaxation on the prevalence of respiratory virus hospitalizations in children. BMC Pediatr 2024; 24:91. [PMID: 38302912 PMCID: PMC10835825 DOI: 10.1186/s12887-024-04566-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/13/2023] [Accepted: 01/15/2024] [Indexed: 02/03/2024] Open
Abstract
BACKGROUND The COVID-19 pandemic and the consequently adopted worldwide control measures have resulted in global changes in the epidemiology and severity of other respiratory viruses. We compared the number and severity of viral acute lower respiratory tract infection (ALRTI) hospitalizations and determined changes in causative respiratory pathogens before, during, and after the pandemic among young children in Qatar. METHODS In this single-center retrospective study, we reviewed data of children ≤ 36 months old who were admitted to Sidra Medicine in Qatar with a viral ALRTI during winter seasons (September-April) between 2019 and 2023. The study period was divided into three distinct seasons based on the pandemic-imposed restrictions as follows: (1) the period between September 2019 and April 2020 was considered the pre-COVID-19 pandemic season; (2) the periods between September 2020 and April 2021, and the period between January and April 2022 were considered the COVID-19 pandemic seasons; and (3) the periods between September 2022 and April 2023 was considered the post-COVID-19 pandemic season. RESULTS During the COVID-19 season, 77 patients were admitted, compared with 153 patients during the pre-COVID-19 season and 230 patients during the post-COVID-19 season. RSV was the dominant virus during the pre-COVID-19 season, with a detection rate of 50.9%. RSV infection rate dropped significantly during the COVID-19 season to 10.4% and then increased again during the post-COVID-19 season to 29.1% (P < 0.001). Rhinovirus was the dominant virus during the COVID-19 (39.1%) and post-COVID-19 seasons (61%) compared to the pre-COVID-19 season (31.4%) (P < 0.001). The average length of hospital stay was significantly longer in the post-COVID-19 season than in the pre-COVID-19 and COVID-19 seasons (P < 0.001). No significant differences in the pediatric intensive care unit (PICU) admission rate (P = 0.22), PICU length of stay (p = 0.479), or respiratory support requirements were detected between the three seasons. CONCLUSION Our study showed reduced viral ALRTI hospitalizations in Qatar during the COVID-19 pandemic with reduced RSV detection. An increase in viral ALRTI hospitalizations accompanied by a resurgence of RSV circulation following the relaxation of COVID-19 restrictions was observed without changes in disease severity.
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Affiliation(s)
- Ahmed Abushahin
- Department of Pediatric Medicine, Division of Pulmonology, Sidra Medicine, Doha, Qatar.
- Weill Cornel Medicine-Qatar (WCM-Q), Doha, Qatar.
| | - Haneen Toma
- Department of Pediatric Medicine, Division of Pulmonology, Sidra Medicine, Doha, Qatar
| | - Amal Alnaimi
- Department of Pediatric Medicine, Division of Pulmonology, Sidra Medicine, Doha, Qatar
- Weill Cornel Medicine-Qatar (WCM-Q), Doha, Qatar
| | - Mutasim Abu-Hasan
- Department of Pediatric Medicine, Division of Pulmonology, Sidra Medicine, Doha, Qatar
| | - Abdullah Alneirab
- Department of Pediatric Medicine, Division of Pulmonology, Sidra Medicine, Doha, Qatar
| | - Hadeel Alzoubi
- Department of Pediatric Medicine, Division of Pulmonology, Sidra Medicine, Doha, Qatar
| | - Antonisamy Belavendra
- Department of Pediatric Medicine, Division of Pulmonology, Sidra Medicine, Doha, Qatar
| | - Ibrahim Janahi
- Department of Pediatric Medicine, Division of Pulmonology, Sidra Medicine, Doha, Qatar
- Weill Cornel Medicine-Qatar (WCM-Q), Doha, Qatar
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21
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Li F, Lu RJ, Zhang YH, Shi P, Ao YY, Cao LF, Zhang YL, Tan WJ, Shen J. Clinical and molecular epidemiology of enterovirus D68 from 2013 to 2020 in Shanghai. Sci Rep 2024; 14:2161. [PMID: 38272942 PMCID: PMC10810781 DOI: 10.1038/s41598-024-52226-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2023] [Accepted: 01/16/2024] [Indexed: 01/27/2024] Open
Abstract
Enterovirus D68 (EV-D68) is an emerging pathogen that has caused outbreaks of severe respiratory disease worldwide, especially in children. We aim to investigate the prevalence and genetic characteristics of EV-D68 in children from Shanghai. Nasopharyngeal swab or bronchoalveolar lavage fluid samples collected from children hospitalized with community-acquired pneumonia were screened for EV-D68. Nine of 3997 samples were EV-D68-positive. Seven of nine positive samples were sequenced and submitted to GenBank. Based on partial polyprotein gene (3D) or complete sequence analysis, we found the seven strains belong to different clades and subclades, including three D1 (detected in 2013 and 2014), one D2 (2013), one D3 (2019), and two B3 (2014 and 2018). Overall, we show different clades and subclades of EV-D68 spread with low positive rates (0.2%) among children in Shanghai between 2013 and 2020. Amino acid mutations were found in the epitopes of the VP1 BC and DE loops and C-terminus; similarity analysis provided evidence for recombination as an important mechanism of genomic diversification. Both single nucleotide mutations and recombination play a role in evolution of EV-D68. Genetic instability within these clinical strains may indicate large outbreaks could occur following cumulative mutations.
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Affiliation(s)
- Fei Li
- Infectious Disease Department, Children's Hospital of Fudan University, National Children's Medical Center, Shanghai, China
| | - Rou-Jian Lu
- National Institute for Viral Disease Control and Prevention, China CDC, Beijing, China
| | - Yu-Han Zhang
- Infectious Disease Department, Children's Hospital of Fudan University, National Children's Medical Center, Shanghai, China
| | - Peng Shi
- Statistics and Data Management Center, Children's Hospital of Fudan University, National Children's Medical Center, Shanghai, China
| | - Yuan-Yun Ao
- Virology Department, Children's Hospital of Fudan University, National Children's Medical Center, Shanghai, China
| | - Lin-Feng Cao
- Virology Department, Children's Hospital of Fudan University, National Children's Medical Center, Shanghai, China
| | - Yu-Lan Zhang
- Wuhan Institute of Virology, Chinese Academy of Sciences, Wuhan, China
| | - Wen-Jie Tan
- National Institute for Viral Disease Control and Prevention, China CDC, Beijing, China.
| | - Jun Shen
- Infectious Disease Department, Children's Hospital of Fudan University, National Children's Medical Center, Shanghai, China.
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22
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Hassan MZ, Islam MA, Haider S, Shirin T, Chowdhury F. Respiratory Syncytial Virus-Associated Deaths among Children under Five before and during the COVID-19 Pandemic in Bangladesh. Viruses 2024; 16:111. [PMID: 38257812 PMCID: PMC10818674 DOI: 10.3390/v16010111] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2023] [Revised: 12/12/2023] [Accepted: 12/15/2023] [Indexed: 01/24/2024] Open
Abstract
Respiratory syncytial virus (RSV) is a leading cause of acute lower respiratory infections in young children worldwide. RSV-associated deaths in children are underreported in Bangladesh. We analyzed hospital-based surveillance data on severe acute respiratory infections (SARIs) in under-five children before (August 2009-February 2020) and during the COVID-19 pandemic (March 2020-March 2022). Using the World Health Organization definition, we identified SARI cases in 14 tertiary-level hospitals. Nasopharyngeal and oropharyngeal swabs were collected for real-time reverse-transcriptase-polymerase chain reaction (rRT-PCR) testing of six respiratory viruses, including RSV. SARI deaths during the pandemic (2.6%, 66) were higher than pre-pandemic (1.8%, 159; p < 0.001). Nearly half of pandemic deaths (47%) had underlying respiratory viruses, similar to the pre-pandemic rate (45%). RSV detection in deaths was consistent pre-pandemic (13%, 20/159) and during the pandemic (12%, 8/66). Children aged < 6 months constituted 57% (16) of RSV-related deaths. Evaluating interventions like maternal vaccination and infant monoclonal antibody prophylaxis is crucial to address RSV, a major contributor to under-five SARI deaths.
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Affiliation(s)
- Md Zakiul Hassan
- International Centre for Diarrhoeal Disease Bangladesh (icddr,b), Dhaka 1213, Bangladesh; (M.A.I.); (S.H.); (F.C.)
| | - Md. Ariful Islam
- International Centre for Diarrhoeal Disease Bangladesh (icddr,b), Dhaka 1213, Bangladesh; (M.A.I.); (S.H.); (F.C.)
| | - Saleh Haider
- International Centre for Diarrhoeal Disease Bangladesh (icddr,b), Dhaka 1213, Bangladesh; (M.A.I.); (S.H.); (F.C.)
| | - Tahmina Shirin
- Institute of Epidemiology, Disease Control and Research (IEDCR), Dhaka 1212, Bangladesh;
| | - Fahmida Chowdhury
- International Centre for Diarrhoeal Disease Bangladesh (icddr,b), Dhaka 1213, Bangladesh; (M.A.I.); (S.H.); (F.C.)
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23
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Matera L, Manti S, Petrarca L, Pierangeli A, Conti MG, Mancino E, Leonardi S, Midulla F, Nenna R. An overview on viral interference during SARS-CoV-2 pandemic. Front Pediatr 2023; 11:1308105. [PMID: 38178911 PMCID: PMC10764478 DOI: 10.3389/fped.2023.1308105] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/05/2023] [Accepted: 12/07/2023] [Indexed: 01/06/2024] Open
Abstract
Respiratory viruses represent the most frequent cause of mortality, morbidity and high healthcare costs for emergency visits and hospitalization in the pediatric age. Respiratory viruses can circulate simultaneously and can potentially infect the same host, determining different types of interactions, the so-called viral interference. The role of viral interference has assumed great importance since December 2019, when the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) came on the scene. The aim of this narrative review is to present our perspective regarding research in respiratory virus interference and discuss recent advances on the topic because, following SARS-CoV-2 restrictions mitigation, we are experimenting the co-circulation of respiratory viruses along with SARS-CoV-2. This scenario is raising many concerns about possible virus-virus interactions, both positive and negative, and the clinical, diagnostic and therapeutic management of these coinfections. Moreover, we cannot rule out that also climatic conditions and social behaviours are involved. Thus, this situation can lead to different population epidemic dynamics, including changes in the age of the targeted population, disease course and severity, highlighting the need for prospective epidemiologic studies and mathematical modelling able to predict the timing and magnitude of epidemics caused by SARS-CoV-2/seasonal respiratory virus interactions in order to adjust better public health interventions.
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Affiliation(s)
- Luigi Matera
- Department of Maternal Infantile and Urological Sciences, Sapienza University of Rome, Rome, Italy
| | - Sara Manti
- Department of Human and Pediatric Pathology, Pediatric Unit, G. Martino Hospital, University of Messina, Messina, Italy
| | - Laura Petrarca
- Department of Maternal Infantile and Urological Sciences, Sapienza University of Rome, Rome, Italy
| | - Alessandra Pierangeli
- Laboratory of Virology, Department of Molecular Medicine, Affiliated to Istituto Pasteur Italia, Sapienza University of Rome, Rome, Italy
| | - Maria Giulia Conti
- Department of Maternal Infantile and Urological Sciences, Sapienza University of Rome, Rome, Italy
| | - Enrica Mancino
- Department of Maternal Infantile and Urological Sciences, Sapienza University of Rome, Rome, Italy
| | - Salvatore Leonardi
- Pediatric Respiratory Unit, Department of Clinical and Experimental Medicine, University of Catania, Catania, Italy
| | - Fabio Midulla
- Department of Maternal Infantile and Urological Sciences, Sapienza University of Rome, Rome, Italy
| | - Raffaella Nenna
- Department of Maternal Infantile and Urological Sciences, Sapienza University of Rome, Rome, Italy
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24
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Jiang W, Chen S, Lv M, Zhang Z, Wang Z, Shao X, Hua S, Hao C, Wang Y. Are we ready to face the next wave of RSV surge after the COVID-19 Omicron pandemic in China? Front Cell Infect Microbiol 2023; 13:1216536. [PMID: 38152122 PMCID: PMC10751930 DOI: 10.3389/fcimb.2023.1216536] [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: 05/04/2023] [Accepted: 11/14/2023] [Indexed: 12/29/2023] Open
Abstract
Background China had its first wave of COVID-19 in 2020 and second wave of COVID-19 Omicron in 2022. The number of RSV cases decreased sharply in 2020 and 2022. Investigation of the resurge of RSV infections after the first wave of COVID-19 will guide us to take preventive actions before the resurge of RSV infections after the second wave of COVID-19 Omicron. Methods We analysed epidemiological and clinical data of 59934 patients with lower respiratory tract infections (LRTI) from a prospective long-term cohort surveillance programme in Suzhou, China, collected from February 2016 to January 2022. The annual incidence of RSV infection in children aged<16 years in 2020 and 2021 was compared with the pre-pandemic years 2016 to 2019. We also compared the clinical characteristics, and RSV-related ICU admissions between pre-pandemic years and 2021. Results Among children with LRTI, the positive rate of RSV increased by 70.7% in 2021 compared to the average level in the pre-pandemic years. The RSV resurge in 2021 was most prominently in children aged 2-4 years (a significant rise compared with the expected value 149.1%; 95%CI, 67.7% to 378%, P<.01). The percentage of RSV-related ICU admissions decreased in 2021 (3.2% vs 6.7%, P<0.01). The death rate of RSV infections in 2021 was 0.2%, while that in pre-pandemic years was only 0.02%. RSV-associated death in immunocompetent children (complicated by necrotizing encephalitis) was firstly occurred in 2021. Conclusions Our findings raise concerns for RSV control in Southeast China after the COVID-19 pandemic especially for children aged 2-4 years. Although ICU admissions were significantly reduced in this resurgence, we could not ignore the increase of RSV-associated death.
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Affiliation(s)
- Wujun Jiang
- Department of Respiratory Medicine, Children’s Hospital of Soochow University, Suzhou, China
| | - Sainan Chen
- Department of Respiratory Medicine, Children’s Hospital of Soochow University, Suzhou, China
| | - Meng Lv
- Department of Respiratory Medicine, Children’s Hospital of Soochow University, Suzhou, China
| | - Zhen Zhang
- Department of Respiratory Medicine, Children’s Hospital of Soochow University, Suzhou, China
| | - Zhihui Wang
- Department of Respiratory Medicine, Children’s Hospital of Soochow University, Suzhou, China
| | - Xuejun Shao
- Clinical Laboratory, Children’s Hospital of Soochow University, Suzhou, China
| | - Shenghao Hua
- Clinical Laboratory, Children’s Hospital of Soochow University, Suzhou, China
| | - Chuangli Hao
- Department of Respiratory Medicine, Children’s Hospital of Soochow University, Suzhou, China
| | - Yuqing Wang
- Department of Respiratory Medicine, Children’s Hospital of Soochow University, Suzhou, China
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25
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Forero EL, Knoester M, Gard L, Ott A, Brandenburg AH, McCall MBB, Niesters HGM, Van Leer-Buter C. Changes in enterovirus epidemiology after easing of lockdown measures. J Clin Virol 2023; 169:105617. [PMID: 37977075 DOI: 10.1016/j.jcv.2023.105617] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2023] [Revised: 10/13/2023] [Accepted: 11/01/2023] [Indexed: 11/19/2023]
Abstract
INTRODUCTION Public health measures aimed at controlling transmission of SARS-CoV-2, otherwise known as "lockdown" measures, had profound effects on circulation of non-SARS viruses, many of which decreased to very low levels. The interrupted transmission of these viruses may have lasting effects. Some of the influenza clades seem to have disappeared during this period, a phenomenon which is described as a "funnel effect". It is currently unknown if the lockdown measures had any effect on the diversity of circulating viruses, other than influenza. Enteroviruses are especially interesting in this context, as the clinical presentation of an infection with a particular enterovirus-type may be clade-dependent. METHODS AND MATERIALS Enteroviruses were detected in clinical materials using a 5'UTR-based detection PCR, and partial VP-1 sequences were obtained, using methods described before. All samples with EV detections from a large part of the Netherlands were included in the study. The samples originated from general practitioners, general hospitals, university hospitals and public health offices. RESULTS Five EV-genotypes circulated in significant numbers before and after the lockdown, EV-D68, E-11, CV-A6, CV-B5 and CV-A2. All five genotypes showed decreased genetic diversity after the lockdown, and four indicate a significant number of sequences clustering together with a very high sequence homology. Moreover, children with E-11 and CV-B5 detections were significantly older after the lockdown than before. CONCLUSIONS The reduced enterovirus transmission in the Netherlands during the pandemic, seems to have led to a decrease in genetic diversity in the five most commonly detected enterovirus serotypes.
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Affiliation(s)
- Erley Lizarazo Forero
- Department of medical Microbiology and Infection Prevention, University of Groningen, University Medical Center Groningen, The Netherlands
| | - Marjolein Knoester
- Department of medical Microbiology and Infection Prevention, University of Groningen, University Medical Center Groningen, The Netherlands
| | - Lilli Gard
- Department of medical Microbiology and Infection Prevention, University of Groningen, University Medical Center Groningen, The Netherlands
| | - Alewijn Ott
- Certe, department of Medical Microbiology Groningen, The Netherlands
| | - Afke H Brandenburg
- Certe, department of Medical Microbiology Friesland|NOP, The Netherlands
| | - Matthew B B McCall
- Department of Medical Microbiology, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Hubert G M Niesters
- Department of medical Microbiology and Infection Prevention, University of Groningen, University Medical Center Groningen, The Netherlands
| | - Coretta Van Leer-Buter
- Department of medical Microbiology and Infection Prevention, University of Groningen, University Medical Center Groningen, The Netherlands.
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Kouis P, Lemonaris M, Xenophontos E, Panayiotou A, Yiallouros PK. The impact of COVID-19 lockdown measures on symptoms control in children with asthma: A systematic review and meta-analysis of observational cohort studies. Pediatr Pulmonol 2023; 58:3213-3226. [PMID: 37606188 DOI: 10.1002/ppul.26646] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/22/2023] [Revised: 08/01/2023] [Accepted: 08/10/2023] [Indexed: 08/23/2023]
Abstract
OBJECTIVES Reported reductions in emergency department visits and hospitalizations for asthma in previous studies have suggested a beneficial effect of the coronavirus disease of 2019 (COVID-19) lockdown measures on asthma morbidity. Nevertheless, studies relying on administrative data may overestimate the true impact of lockdowns due to changes in health-seeking behavior and reduced availability of pediatric asthma services during the pandemic. In this study, we systematically reviewed the literature and identified observational cohort studies that focused on nonadministrative data to assess the true impact of COVID-19 lockdowns on symptom control in children with asthma. METHODS A systematic literature search was conducted between January 2020 and August 2022 (International Prospective Register of Systematic Reviews ID: CRD42022354369). The impact of COVID-19 lockdowns across studies was expressed as a standardized mean difference (SMD) for continuous outcomes and as a summary relative risk (RR) for binary outcomes. RESULTS During the lockdown periods, the pooled asthma symptoms control test score (SMD: 1.99, 95% confidence interval [CI]: 0.75, 3.24, I2 : 98.4%) and the proportion of children with well-controlled asthma (RR: 1.35, 95% CI: 1.06, 1.71, I2 : 77.6%) were significantly increased. On the other hand, the pooled proportion of children with poorly controlled asthma (RR: 0.47, 95% CI: 0.38, 0.57, I2 : 0.0%) was significantly decreased. CONCLUSIONS During COVID-19 lockdowns, asthma symptoms and breakthrough disease exacerbations were significantly reduced in children with asthma. Further research is warranted on potential interventions aiming to enhance asthma control after the pandemic while taking into consideration their acceptability and potential tradeoffs.
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Affiliation(s)
- Panayiotis Kouis
- Respiratory Physiology Laboratory, Medical School, University of Cyprus, Nicosia, Cyprus
| | - Marios Lemonaris
- Respiratory Physiology Laboratory, Medical School, University of Cyprus, Nicosia, Cyprus
- Medical School, University of Nicosia, Nicosia, Cyprus
| | - Eleana Xenophontos
- Cyprus International Institute for Environmental and Public Health, School of Health Sciences, Cyprus University of Technology, Limassol, Cyprus
| | - Andrie Panayiotou
- Cyprus International Institute for Environmental and Public Health, School of Health Sciences, Cyprus University of Technology, Limassol, Cyprus
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Mubarak S, Alsmadi O, Tbakhi A, Ata OA, Hassan A, AlGhawrie H. Impact of the SARS-CoV-2 pandemic on the overall respiratory viruses' transmission in a cancer care setting. Immun Inflamm Dis 2023; 11:e1073. [PMID: 38018583 PMCID: PMC10664391 DOI: 10.1002/iid3.1073] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2023] [Revised: 08/27/2023] [Accepted: 10/25/2023] [Indexed: 11/30/2023] Open
Abstract
INTRODUCTION AND OBJECTIVE The emergence of the COVID-19 pandemic raised questions about the interaction between severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and other respiratory viruses. The objective of this study is to validate the impact of the SARS-CoV-2 pandemic and its interventional measures on the respiratory viruses' transmission/infection rates. METHODS A retrospective chart review was conducted for cancer patients who underwent laboratory-confirmed respiratory virus polymerase chain reaction (PCR) testing from January 2018 to June 2022. COVID-19 PCR tests from March 2020 to June 2022 were also included. Joinpoint regression analysis was applied to evaluate trends in respiratory virus rates. Statistical analysis was performed using Statistical Package for Social Science software. RESULTS A total of 6298 respiratory virus PCRs and 40,000 COVID-19 PCRs were performed. Data showed a significant decrease in respiratory viruses' positive cases, total respiratory tests, and respiratory viruses' activity during the pandemic period compared with the pre-pandemic period (p = .0209, .026, and .028, respectively). The joinpoint regression analysis showed a significant decrease of 13.85% in the tested positive cases of respiratory viruses between the years 2018 and 2022. Monthly, the analysis indicated a significant decrease in the positive cases by 13.46% from December 2019 to May 2021. Weekly analysis following lockdown initiation showed a reduction in respiratory virus cases. CONCLUSION This study provides valuable insights into the interplay between COVID-19 and other respiratory viruses, suggesting that the measures taken for COVID-19 were effective in reducing the spread of viral respiratory infections, aiding future infection control strategies to protect vulnerable populations, including cancer patients, from seasonal respiratory infections.
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Affiliation(s)
- Sawsan Mubarak
- Infection Control ProgramKing Hussein Cancer CenterAmmanJordan
| | - Osama Alsmadi
- Department of Cell Therapy & Applied GenomicsKing Hussein Cancer CenterAmmanJordan
| | - Abdelghani Tbakhi
- Department of Cell Therapy & Applied GenomicsKing Hussein Cancer CenterAmmanJordan
| | - Osama Abu Ata
- Department of Internal MedicineKing Hussein Cancer CenterAmmanJordan
| | - Ala'a Hassan
- Department of Cell Therapy & Applied GenomicsKing Hussein Cancer CenterAmmanJordan
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Li Y, Liang Y, Tang J, Li N, Yang Y, Guo W, Lin C, Wu J, Lin Y, Chen Q. Clinical impact of human parainfluenza virus infections before and during the COVID-19 pandemic in Southern China. Microbes Infect 2023; 25:105219. [PMID: 37734534 DOI: 10.1016/j.micinf.2023.105219] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2023] [Revised: 09/07/2023] [Accepted: 09/15/2023] [Indexed: 09/23/2023]
Abstract
Human parainfluenza viruses (HPIVs) are a leading cause of acute respiratory tract infections (ARTIs). Non-pharmaceutical interventions (NPIs) were widely administered to combat the pandemic of the coronavirus disease 2019 (COVID-19). Respiratory specimens were obtained from 10,454 hospitalized children with ARTIs to detect HPIV. We investigated differences in epidemiological and clinical characteristics of HPIV infections before (2017-2019) and during the COVID-19 pandemic (2020-2022). HPIVs were detected in 392 (3.75%, 392/10,454) patients, of whom 70 (17.86%), 48 (12.24%), and 274 (69.90%) were positive for HPIV1, HPIV2, and HPIV3, respectively. Detection rates of HPIV3 were higher in 2020-2022 than in 2017-2019 (3.38% vs. 2.24%). The seasonal distribution of HPIV1 showed no difference, but HPIV3 peaked between September and December during the COVID-19 pandemic, which differed from previous epidemiological patterns. Compared to the period before the COVID-19 pandemic, there has been a noticeable decrease in the incidence of asthma, moist rales, and emesis in patients infected with HPIV1 and in asthma, expectoration, and severe pneumonia in patients infected with HPIV3 during 2020-2022. The detection rates of HPIV increased in Southern China during the COVID-19 outbreak, which underlines the importance of continuous surveillance of HPIV in the next epidemic season.
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Affiliation(s)
- Ya Li
- Department of Laboratory Medicine, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
| | - Ying Liang
- Department of Laboratory Medicine, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
| | - Jiaqi Tang
- Department of Laboratory Medicine, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
| | - Ning Li
- Department of Laboratory Medicine, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
| | - Yihao Yang
- Department of Laboratory Medicine, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
| | - Wenyu Guo
- Department of Laboratory Medicine, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
| | - Cheng Lin
- Department of Laboratory Medicine, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
| | - Jinyu Wu
- Department of Laboratory Medicine, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
| | - Yongping Lin
- Department of Laboratory Medicine, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, China; KingMed School of Laboratory Medicine, Guangzhou Medical University, Guangzhou, China; Department of Laboratory Medicine, Cancer Hospital Chinese Academy of Medical Sciences, Shenzhen Center, Shenzhen, China.
| | - Qigao Chen
- Department of Laboratory Medicine, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, China; KingMed School of Laboratory Medicine, Guangzhou Medical University, Guangzhou, China.
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Tang M, Dong W, Yuan S, Chen J, Lin J, Wu J, Zhang J, Yin Y, Zhang L. Comparison of respiratory pathogens in children with community-acquired pneumonia before and during the COVID-19 pandemic. BMC Pediatr 2023; 23:535. [PMID: 37891511 PMCID: PMC10605329 DOI: 10.1186/s12887-023-04246-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/18/2023] [Accepted: 08/11/2023] [Indexed: 10/29/2023] Open
Abstract
BACKGROUND Multifaceted non-pharmaceutical interventions during the COVID-19 pandemic have not only reduced the transmission of SARS-CoV2, but have had an effect on the prevalence of other pathogens. This retrospective study aimed to compare and analyze the changes of respiratory pathogens in hospitalized children with community-acquired pneumonia. METHODS From January 2019 to December 2020, children with community-acquired pneumonia were selected from the Department of Respiratory Medicine, Shanghai Children's Medical Center. On the first day of hospitalization, sputum, throat swabs, venous blood samples from them were collected for detection of pathogens. RESULTS A total of 2596 children with community-acquired pneumonia were enrolled, including 1871 patients in 2019 and 725 in 2020. The detection rate in 2020 was lower than in 2019, whether single or multiple pathogens. Compared with 2019, the detection rate of virus, especially parainfluenza virus, influenza virus and respiratory syncytial virus, all decreased in 2020. On the contrary, the prevalence of human rhinovirus was much higher than that in 2019. In addition, the positivity rate for bacteria did not change much over the two years, which seemed to be less affected by COVID-19. And Mycoplasma pneumoniae which broke out in 2019 has been in low prevalence since March 2020 even following the reopening of school. CONCLUSIONS Strict public health interventions for COVID-19 in China have effectively suppressed the spread of not only SARS-CoV2 but parainfluenza virus, influenza virus and Mycoplasma pneumonia as well. However, it had a much more limited effect on bacteria and rhinovirus. Therefore, more epidemiological surveillance of respiratory pathogens will help improve early preventive measures.
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Affiliation(s)
- Mingyu Tang
- Department of Respiratory Medicine, Shanghai Children's Medical Center, Shanghai Jiao Tong University School of Medicine, 1678 Dongfang Rd, Shanghai, 200127, China
| | - Wenfang Dong
- Department of Respiratory Medicine, Shanghai Children's Medical Center, Shanghai Jiao Tong University School of Medicine, 1678 Dongfang Rd, Shanghai, 200127, China
| | - Shuhua Yuan
- Department of Respiratory Medicine, Shanghai Children's Medical Center, Shanghai Jiao Tong University School of Medicine, 1678 Dongfang Rd, Shanghai, 200127, China
| | - Jiande Chen
- Department of Respiratory Medicine, Shanghai Children's Medical Center, Shanghai Jiao Tong University School of Medicine, 1678 Dongfang Rd, Shanghai, 200127, China
| | - Jie Lin
- Department of Respiratory Medicine, Shanghai Children's Medical Center, Shanghai Jiao Tong University School of Medicine, 1678 Dongfang Rd, Shanghai, 200127, China
| | - Jinhong Wu
- Department of Respiratory Medicine, Shanghai Children's Medical Center, Shanghai Jiao Tong University School of Medicine, 1678 Dongfang Rd, Shanghai, 200127, China
| | - Jing Zhang
- Department of Respiratory Medicine, Shanghai Children's Medical Center, Shanghai Jiao Tong University School of Medicine, 1678 Dongfang Rd, Shanghai, 200127, China
| | - Yong Yin
- Department of Respiratory Medicine, Shanghai Children's Medical Center, Shanghai Jiao Tong University School of Medicine, 1678 Dongfang Rd, Shanghai, 200127, China.
| | - Lei Zhang
- Department of Respiratory Medicine, Shanghai Children's Medical Center, Shanghai Jiao Tong University School of Medicine, 1678 Dongfang Rd, Shanghai, 200127, China.
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Gil E, Roy S, Best T, Hatcher J, Breuer J. Increasing rhinovirus prevalence in paediatric intensive care patients since the SARS-CoV2 pandemic. J Clin Virol 2023; 166:105555. [PMID: 37536014 DOI: 10.1016/j.jcv.2023.105555] [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: 07/05/2023] [Revised: 07/27/2023] [Accepted: 07/28/2023] [Indexed: 08/05/2023]
Abstract
BACKGROUND Rhinovirus (HRV) is a significant seasonal pathogen in children. The emergence of SARS-CoV2, and the social restrictions introduced in, disrupted viral epidemiology. Here we describe the experience of Great Ormond Street Hospital (GOSH), where HRV almost entirely disappeared from the paediatric intensive care units (PICU) during the first national lockdown and then rapidly re-emerged with a fast-increasing incidence, leading to concerns about possible nosocomial transmission in a vulnerable population. OBJECTIVES To describe alterations in HRV infection amongst PICU patients at GOSH since the emergence of SARS-COV2 STUDY DESIGN: 10,950 nasopharyngeal aspirate viral PCR samples from GOSH PICU patients from 2019 to 2023 were included. 3083 returned a positive result for a respiratory virus, with 1530 samples positive for HRV. 66 HRV isolates from August 2020 - Jan 2021, the period of rapidly increasing HRV incidence, were sequenced. Electronic health record data was retrospectively collected for the same period. RESULTS Following a reduction in the incidence of HRV infection during the first national lockdown, multiple genotypes of HRV emerged amongst GOSH PICU patients, with the incidence of HRV infection rapidly surging to levels higher than that seen prior to the emergence of SARS-CoV2 and continuing to circulate at increased incidence year-round. CONCLUSIONS The incidence of HRV infection amongst GOSH PICU patients is markedly higher than prior to the emergence of SARS-CoV2, a pattern not seen in other respiratory viruses. The increased burden of HRV-infection in vulnerable PICU patients has both clinical and infection prevention and control Implications.
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Affiliation(s)
- Eliza Gil
- Department of Clinical Research, London School of Hygiene and Tropical Medicine; Department of Microbiology, Virology & Infection Control, Great Ormond Street Hospital for Children, UK; Infection, Immunity and Inflammation Department, GOS Institute of Child Health, University College London, London, UK.
| | - Sunando Roy
- Infection, Immunity and Inflammation Department, GOS Institute of Child Health, University College London, London, UK
| | - Tim Best
- Department of Microbiology, Virology & Infection Control, Great Ormond Street Hospital for Children, UK
| | - James Hatcher
- Department of Microbiology, Virology & Infection Control, Great Ormond Street Hospital for Children, UK
| | - Judith Breuer
- Department of Microbiology, Virology & Infection Control, Great Ormond Street Hospital for Children, UK; Infection, Immunity and Inflammation Department, GOS Institute of Child Health, University College London, London, UK
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Tramuto F, Maida CM, Mazzucco W, Costantino C, Amodio E, Sferlazza G, Previti A, Immordino P, Vitale F. Molecular Epidemiology and Genetic Diversity of Human Respiratory Syncytial Virus in Sicily during Pre- and Post-COVID-19 Surveillance Seasons. Pathogens 2023; 12:1099. [PMID: 37764907 PMCID: PMC10534943 DOI: 10.3390/pathogens12091099] [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: 07/21/2023] [Revised: 08/23/2023] [Accepted: 08/26/2023] [Indexed: 09/29/2023] Open
Abstract
Human respiratory syncytial virus (hRSV) is an important pathogen of acute respiratory tract infection of global significance. In this study, we investigated the molecular epidemiology and the genetic variability of hRSV over seven surveillance seasons between 2015 and 2023 in Sicily, Italy. hRSV subgroups co-circulated through every season, although hRSV-B mostly prevailed. After the considerable reduction in the circulation of hRSV due to the widespread implementation of non-pharmaceutical preventive measures during the COVID-19 pandemic, hRSV rapidly re-emerged at a high intensity in 2022-2023. The G gene was sequenced for genotyping and analysis of deduced amino acids. A total of 128 hRSV-A and 179 hRSV-B G gene sequences were obtained. The phylogenetic analysis revealed that the GA2.3.5a (ON1) and GB5.0.5a (BA9) genotypes were responsible for the hRSV epidemics in Sicily.; only one strain belonged to the genotype GB5.0.4a. No differences were observed in the circulating genotypes during pre- and post-pandemic years. Amino acid sequence alignment revealed the continuous evolution of the G gene, with a combination of amino acid changes specifically appearing in 2022-2023. The predicted N-glycosylation sites were relatively conserved in ON1 and BA9 genotype strains. Our findings augment the understanding and prediction of the seasonal evolution of hRSV at the local level and its implication in the monitoring of novel variants worth considering in better design of candidate vaccines.
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Affiliation(s)
- Fabio Tramuto
- Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties “G. D’Alessandro”—Hygiene Section, University of Palermo, 90134 Palermo, Italy; (C.M.M.); (W.M.); (C.C.); (E.A.); (P.I.); (F.V.)
- Regional Reference Laboratory for Molecular Surveillance of Influenza, Clinical Epidemiology Unit, University Hospital “Paolo Giaccone”, 90127 Palermo, Italy; (G.S.); (A.P.)
| | - Carmelo Massimo Maida
- Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties “G. D’Alessandro”—Hygiene Section, University of Palermo, 90134 Palermo, Italy; (C.M.M.); (W.M.); (C.C.); (E.A.); (P.I.); (F.V.)
- Regional Reference Laboratory for Molecular Surveillance of Influenza, Clinical Epidemiology Unit, University Hospital “Paolo Giaccone”, 90127 Palermo, Italy; (G.S.); (A.P.)
| | - Walter Mazzucco
- Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties “G. D’Alessandro”—Hygiene Section, University of Palermo, 90134 Palermo, Italy; (C.M.M.); (W.M.); (C.C.); (E.A.); (P.I.); (F.V.)
- Regional Reference Laboratory for Molecular Surveillance of Influenza, Clinical Epidemiology Unit, University Hospital “Paolo Giaccone”, 90127 Palermo, Italy; (G.S.); (A.P.)
| | - Claudio Costantino
- Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties “G. D’Alessandro”—Hygiene Section, University of Palermo, 90134 Palermo, Italy; (C.M.M.); (W.M.); (C.C.); (E.A.); (P.I.); (F.V.)
- Regional Reference Laboratory for Molecular Surveillance of Influenza, Clinical Epidemiology Unit, University Hospital “Paolo Giaccone”, 90127 Palermo, Italy; (G.S.); (A.P.)
| | - Emanuele Amodio
- Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties “G. D’Alessandro”—Hygiene Section, University of Palermo, 90134 Palermo, Italy; (C.M.M.); (W.M.); (C.C.); (E.A.); (P.I.); (F.V.)
| | - Giuseppe Sferlazza
- Regional Reference Laboratory for Molecular Surveillance of Influenza, Clinical Epidemiology Unit, University Hospital “Paolo Giaccone”, 90127 Palermo, Italy; (G.S.); (A.P.)
| | - Adriana Previti
- Regional Reference Laboratory for Molecular Surveillance of Influenza, Clinical Epidemiology Unit, University Hospital “Paolo Giaccone”, 90127 Palermo, Italy; (G.S.); (A.P.)
| | - Palmira Immordino
- Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties “G. D’Alessandro”—Hygiene Section, University of Palermo, 90134 Palermo, Italy; (C.M.M.); (W.M.); (C.C.); (E.A.); (P.I.); (F.V.)
| | - Francesco Vitale
- Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties “G. D’Alessandro”—Hygiene Section, University of Palermo, 90134 Palermo, Italy; (C.M.M.); (W.M.); (C.C.); (E.A.); (P.I.); (F.V.)
- Regional Reference Laboratory for Molecular Surveillance of Influenza, Clinical Epidemiology Unit, University Hospital “Paolo Giaccone”, 90127 Palermo, Italy; (G.S.); (A.P.)
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Tydeman F, Pfeffer PE, Vivaldi G, Holt H, Talaei M, Jolliffe D, Davies G, Lyons RA, Griffiths C, Kee F, Sheikh A, Shaheen SO, Martineau AR. Rebound in asthma exacerbations following relaxation of COVID-19 restrictions: a longitudinal population-based study (COVIDENCE UK). Thorax 2023; 78:752-759. [PMID: 36423925 PMCID: PMC10359556 DOI: 10.1136/thorax-2022-219591] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2022] [Accepted: 10/10/2022] [Indexed: 01/01/2023]
Abstract
BACKGROUND The imposition of restrictions on social mixing early in the COVID-19 pandemic was followed by a reduction in asthma exacerbations in multiple settings internationally. Temporal trends in social mixing, incident acute respiratory infections (ARI) and asthma exacerbations following relaxation of COVID-19 restrictions have not yet been described. METHODS We conducted a population-based longitudinal study in 2312 UK adults with asthma between November 2020 and April 2022. Details of face covering use, social mixing, incident ARI and severe asthma exacerbations were collected via monthly online questionnaires. Temporal changes in these parameters were visualised using Poisson generalised additive models. Multilevel logistic regression was used to test for associations between incident ARI and risk of asthma exacerbations, adjusting for potential confounders. RESULTS Relaxation of COVID-19 restrictions from April 2021 coincided with reduced face covering use (p<0.001), increased frequency of indoor visits to public places and other households (p<0.001) and rising incidence of COVID-19 (p<0.001), non-COVID-19 ARI (p<0.001) and severe asthma exacerbations (p=0.007). Incident non-COVID-19 ARI associated independently with increased risk of asthma exacerbation (adjusted OR 5.75, 95% CI 4.75 to 6.97) as did incident COVID-19, both prior to emergence of the omicron variant of SARS-CoV-2 (5.89, 3.45 to 10.04) and subsequently (5.69, 3.89 to 8.31). CONCLUSIONS Relaxation of COVID-19 restrictions coincided with decreased face covering use, increased social mixing and a rebound in ARI and asthma exacerbations. Associations between incident ARI and risk of severe asthma exacerbation were similar for non-COVID-19 ARI and COVID-19, both before and after emergence of the SARS-CoV-2 omicron variant. STUDY REGISTRATION NUMBER NCT04330599.
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Affiliation(s)
- Florence Tydeman
- Blizard Institute, Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London, UK
| | - Paul E Pfeffer
- William Harvey Research Institute, Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London, UK
- Department of Respiratory Medicine, Barts Health NHS Trust, London, UK
| | - Giulia Vivaldi
- Blizard Institute, Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London, UK
- Wolfson Institute of Population Health, Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London, UK
| | - Hayley Holt
- Blizard Institute, Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London, UK
- Wolfson Institute of Population Health, Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London, UK
| | - Mohammad Talaei
- Wolfson Institute of Population Health, Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London, UK
| | - David Jolliffe
- Blizard Institute, Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London, UK
- Wolfson Institute of Population Health, Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London, UK
| | - Gwyneth Davies
- Department of Population Data Science, Swansea University Medical School, Swansea University, Swansea, UK
- Asthma UK Centre for Applied Research, Swansea University Medical School, Swansea University, Swansea, UK
| | - Ronan A Lyons
- Department of Population Data Science, Swansea University Medical School, Swansea University, Swansea, UK
| | - Christopher Griffiths
- Wolfson Institute of Population Health, Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London, UK
- Asthma UK Centre for Applied Research, Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London, UK
| | - Frank Kee
- Northern Health and Social Care Trust and Queens University Belfast, Queens University, Belfast, UK
| | - Aziz Sheikh
- Usher Institute of Population Health Sciences and Informatics, University of Edinburgh, Edinburgh, UK
- Asthma UK Centre for Applied Research, University of Edinburgh, Edinburgh, UK
| | - Seif O Shaheen
- Wolfson Institute of Population Health, Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London, UK
| | - Adrian R Martineau
- Blizard Institute, Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London, UK
- Department of Respiratory Medicine, Barts Health NHS Trust, London, UK
- Asthma UK Centre for Applied Research, Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London, UK
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Pappe E, Hammerich R, Saccomanno J, Sgarbossa T, Pohrt A, Schmidt B, Grah C, Eisenmann S, Holland A, Eggeling S, Stanzel F, Witzenrath M, Hübner RH. Impact of Coronavirus Disease 2019 on Hospital Admissions, Health Status, and Behavioral Changes of Patients with COPD. CHRONIC OBSTRUCTIVE PULMONARY DISEASES (MIAMI, FLA.) 2023; 10:211-223. [PMID: 37140947 PMCID: PMC10484494 DOI: 10.15326/jcopdf.2022.0383] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 04/20/2023] [Indexed: 05/05/2023]
Abstract
Introduction Patients with chronic obstructive pulmonary disease (COPD) have an increased risk of acquiring severe coronavirus disease 2019 (COVID-19), which is why self-isolation was recommended. However, long periods of social isolation, accompanied by limited access to health care systems, might influence the outcome of patients with severe COPD negatively. Methods Data from COPD and pneumonia patients at Charité-Universitätsmedizin Berlin and the volume of endoscopic lung volume reduction (ELVR) surgeries from the German Lung Emphysema Registry (Lungenemphysem Register e.V.) were analyzed from pre-pandemic (2012 to 2019) to the pandemic period (2020 and 2021). In addition, 52 patients with COPD Global initiative for chronic Obstructive Lung Disease (GOLD) stage 4 status included in the lung emphysema registry received questionnaires during lockdowns from June 2020 to April 2021. Results Admissions and ventilation therapies administered to COPD patients significantly decreased during the COVID-19 pandemic. Likewise, there was a reduction in ELVR treatments and follow-ups registered in German emphysema centers. Mortality was slightly higher among patients hospitalized with COPD during the pandemic. Increasing proportions of COPD patients with GOLD stage 3 and GOLD stage 4 status reported behavioral changes and subjective feelings of increasing COPD symptoms the longer the lockdown lasted. However, COPD symptom questionnaires revealed stable COPD symptoms over the pandemic time period. Summary This study reveals reduced COPD admissions and elective treatment procedures of COPD patients during the pandemic, but a slight increase in mortality among patients hospitalized with COPD, irrespective of COVID-19. Correspondingly, patients with severe COPD reported subjective deterioration of their health status, probably caused by their very strict compliance with lockdown measures.
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Affiliation(s)
- Eva Pappe
- Department of Infectious Diseases and Respiratory Medicine, Charité-Universitätsmedizin Berlin, Berlin, Germany
| | - Ralf Hammerich
- Administrative Office for Clinical Quality and Risk Management, Charité-Universitätsmedizin Berlin, Berlin, Germany
| | - Jacopo Saccomanno
- Department of Infectious Diseases and Respiratory Medicine, Charité-Universitätsmedizin Berlin, Berlin, Germany
| | - Thomas Sgarbossa
- Department of Infectious Diseases and Respiratory Medicine, Charité-Universitätsmedizin Berlin, Berlin, Germany
| | - Anne Pohrt
- Institute of Biometry and Clinical Epidemiology, Charité-Universitätsmedizin Berlin, Berlin, Germany
| | - Bernd Schmidt
- Department of Respiratory Medicine, DRK Kliniken Berlin Mitte, Berlin, Germany
| | - Christian Grah
- Department of Internal Medicine and Respiratory Medicine, Clinic Havelhöhe Berlin, Berlin, Germany
| | - Stephan Eisenmann
- Department of Internal Medicine I, Pulmonary Medicine, University Hospital Halle (Saale), Germany
| | - Angelique Holland
- Department of Medicine, Pulmonary and Critical Care Medicine, University Medical Center Giessen and Marburg, Philipps-University Marburg, Marburg, Germany
| | - Stephan Eggeling
- Department of Thoracic Surgery, Vivantes Netzwerk für Gesundheit, Klinikum Neukölln, Berlin, Germany
| | | | - Martin Witzenrath
- Department of Infectious Diseases and Respiratory Medicine, Charité-Universitätsmedizin Berlin, Berlin, Germany
| | - Ralf-Harto Hübner
- Department of Infectious Diseases and Respiratory Medicine, Charité-Universitätsmedizin Berlin, Berlin, Germany
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Takamure K, Iwatani Y, Amano H, Yagi T, Uchiyama T. Inactivation characteristics of a 280 nm Deep-UV irradiation dose on aerosolized SARS-CoV-2. ENVIRONMENT INTERNATIONAL 2023; 177:108022. [PMID: 37301046 PMCID: PMC10241504 DOI: 10.1016/j.envint.2023.108022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/03/2023] [Revised: 06/03/2023] [Accepted: 06/03/2023] [Indexed: 06/12/2023]
Abstract
A non-filter virus inactivation unit was developed that can control the irradiation dose of aerosolized viruses by controlling the lighting pattern of a 280 nm deep-UV (DUV)-LED and the air flowrate. In this study, the inactivation properties of aerosolized SARS-CoV-2 were quantitatively evaluated by controlling the irradiation dose to the virus inside the inactivation unit. The RNA concentration of SARS-CoV-2 remained constant when the total irradiation dose of DUV irradiation to the virus exceeded 16.5 mJ/cm2. This observation suggests that RNA damage may occur in regions below the detection threshold of RT-qPCR assay. However, when the total irradiation dose was less than 16.5 mJ/cm2, the RNA concentration monotonically increased with a decreasing LED irradiation dose. However, the nucleocapsid protein concentration of SARS-CoV-2 was not predominantly dependent on the LED irradiation dose. The plaque assay showed that 99.16% of the virus was inactivated at 8.1 mJ/cm2 of irradiation, and no virus was detected at 12.2 mJ/cm2 of irradiation, resulting in a 99.89% virus inactivation rate. Thus, an irradiation dose of 23% of the maximal irradiation capacity of the virus inactivation unit can activate more than 99% of SARS-CoV-2. These findings are expected to enhance versatility in various applications. The downsizing achieved in our study renders the technology apt for installation in narrow spaces, while the enhanced flowrates establish its viability for implementation in larger facilities.
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Affiliation(s)
- Kotaro Takamure
- Institute of Materials and Systems for Sustainability, Nagoya University, Nagoya 464-8601, Japan.
| | - Yasumasa Iwatani
- Clinical Research Center, National Hospital Organization Nagoya Medical Center, Nagoya 460-0001, Japan
| | - Hiroshi Amano
- Institute of Materials and Systems for Sustainability, Nagoya University, Nagoya 464-8601, Japan
| | - Tetsuya Yagi
- Department of Infectious Diseases, Nagoya University Hospital, Nagoya 466-0065, Japan
| | - Tomomi Uchiyama
- Institute of Materials and Systems for Sustainability, Nagoya University, Nagoya 464-8601, Japan
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Moscovich DP, Averbuch D, Kerem E, Cohen-Cymberknoh M, Berkun Y, Brooks R, Reiff S, Meir MB, Wolf D, Breuer O. Pediatric respiratory admissions and related viral infections during the COVID-19 pandemic. Pediatr Pulmonol 2023. [PMID: 37097057 DOI: 10.1002/ppul.26434] [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: 12/10/2022] [Revised: 04/06/2023] [Accepted: 04/16/2023] [Indexed: 04/26/2023]
Abstract
INTRODUCTION The COVID-19 pandemic has affected the incidence of respiratory viral infections. Our aim was to assess changes in pediatric admissions due to respiratory diseases and associated respiratory viral infections. METHODS An observational study including all respiratory admissions to the pediatric departments from January 2015 to August 2021. We compared respiratory admission percentage, respiratory viral panel results and clinical characteristics of these admissions between two study periods, January 2015 to February 2020 (pre-COVID-19 era) and March 2020 to August 2021 (COVID-19 era). RESULTS A total of 8774 respiratory admissions were included, 7157 pre-COVID-19 era and 1617 COVID-19 era. Relative to all pediatric admissions, there was a 17% decrease in respiratory admission percentage during the COVID-19 era (p < 0.001) and a 31% and 22% decreased in the admission percentages due to bronchiolitis (p < 0.001) and pneumonia (p < 0.001), respectively. However, admission percentages for asthma, wheezing illness, complicated pneumonia, and stridor remained the same. There was a significant decrease in the detection of a respiratory viral pathogen associated with these respiratory admissions (p < 0.001). This was related to a significant decrease in the detection of respiratory syncytial virus (RSV) (37% vs. 27%, p < 0.001) and influenza (5% vs. 0.3%, p < 0.001), but not other respiratory viruses. An alteration in the circulation pattern of most respiratory viruses, was observed. CONCLUSIONS During the COVID-19 pandemic, a decrease in the prevalence of RSV and influenza was associated with a significant decrease in admissions for bronchiolitis and pediatric pneumonia. This may allow us to estimate the significance of preventive measures for RSV and influenza on pediatric respiratory admissions.
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Affiliation(s)
- Dana Peer Moscovich
- Pediatric Pulmonology Unit, Hadassah Medical Center and Faculty of Medicine, Hebrew University of Jerusalem, Israel
- Departments of Pediatrics, Hadassah Medical Center and Faculty of Medicine, Hebrew University of Jerusalem, Israel
| | - Diana Averbuch
- Departments of Pediatrics, Hadassah Medical Center and Faculty of Medicine, Hebrew University of Jerusalem, Israel
- Pediatric Infectious Diseases, Hadassah Medical Center and Faculty of Medicine, Hebrew University of Jerusalem, Israel
| | - Eitan Kerem
- Pediatric Pulmonology Unit, Hadassah Medical Center and Faculty of Medicine, Hebrew University of Jerusalem, Israel
- Departments of Pediatrics, Hadassah Medical Center and Faculty of Medicine, Hebrew University of Jerusalem, Israel
| | - Malena Cohen-Cymberknoh
- Pediatric Pulmonology Unit, Hadassah Medical Center and Faculty of Medicine, Hebrew University of Jerusalem, Israel
- Departments of Pediatrics, Hadassah Medical Center and Faculty of Medicine, Hebrew University of Jerusalem, Israel
| | - Yackov Berkun
- Departments of Pediatrics, Hadassah Medical Center and Faculty of Medicine, Hebrew University of Jerusalem, Israel
| | - Rebecca Brooks
- Departments of Pediatrics, Hadassah Medical Center and Faculty of Medicine, Hebrew University of Jerusalem, Israel
| | - Shimon Reiff
- Departments of Pediatrics, Hadassah Medical Center and Faculty of Medicine, Hebrew University of Jerusalem, Israel
| | - Maskit Bar Meir
- Paediatrics and Infectious Diseases Division, Shaare Zedek Medical and Faculty of Medicine, Hebrew University of Jerusalem, Israel
| | - Dana Wolf
- Department of Clinical Microbiology and Infectious Diseases, Hadassah Medical Center, Faculty of Medicine, Hebrew University of Jerusalem, Jerusalem, Israel
| | - Oded Breuer
- Pediatric Pulmonology Unit, Hadassah Medical Center and Faculty of Medicine, Hebrew University of Jerusalem, Israel
- Departments of Pediatrics, Hadassah Medical Center and Faculty of Medicine, Hebrew University of Jerusalem, Israel
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Hirae K, Hoshina T, Koga H. Impact of the COVID-19 pandemic on the epidemiology of other communicable diseases in Japan. Int J Infect Dis 2023; 128:265-271. [PMID: 36642212 PMCID: PMC9837205 DOI: 10.1016/j.ijid.2023.01.013] [Citation(s) in RCA: 20] [Impact Index Per Article: 20.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2022] [Revised: 12/29/2022] [Accepted: 01/09/2023] [Indexed: 01/15/2023] Open
Abstract
OBJECTIVES To elucidate the impact of the COVID-19 pandemic on the epidemiology of other infectious diseases. DESIGN We investigated the epidemiology of 36 communicable diseases during 2015-2021 in Japan and compared the number of cases in each disease between the prepandemic (2015-2019) and intrapandemic (2020-2021) periods. Relationships between the incidence of the infectious diseases and the COVID-19 pandemic were also investigated. RESULTS Of 36 communicable diseases, the number of cases in the 27 diseases (75%) mainly caused by pathogens transmitted by droplet or contact was lower intrapandemic than prepandemic, and the cases of 21 diseases (58%) continued to decrease intrapandemic. The number of cases of six diseases (17%) was higher intrapandemic than prepandemic, and the cases of two diseases (5.6%), Japanese spotted fever and syphilis, continued to increase intrapandemic. Time trend analyses revealed a positive correlation between case numbers of communicable diseases and the COVID-19 pandemic, whereas the case numbers of hand-foot-and-mouth disease and respiratory syncytial virus infection rebounded in 2021 after decreasing in 2020. CONCLUSION The COVID-19 pandemic has greatly impacted the epidemiology of communicable diseases, suggesting that countermeasures against COVID-19 and lifestyle changes might be involved in these epidemiological changes.
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Affiliation(s)
- Kenji Hirae
- Department of Pediatrics, National Hospital Organization Beppu Medical Center, Beppu, Japan.
| | - Takayuki Hoshina
- Department of Pediatrics, School of Medicine, University of Occupational and Environmental Health, Kitakyushu, Japan.
| | - Hiroshi Koga
- Department of Pediatrics, National Hospital Organization Beppu Medical Center, Beppu, Japan.
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Hauch R, Hinrichs M, Ruhwald R, Schrum J, Rutkowski S, Woessmann W, Winkler B. Impact of COVID-19 Related Restrictions on Infections in Children with Cancer or after Hematopoietic SCTA. KLINISCHE PADIATRIE 2023; 235:159-166. [PMID: 36848939 DOI: 10.1055/a-2000-5388] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 03/01/2023]
Abstract
BACKGROUND Infections are a major concern for immunocompromised children. We investigated whether non-pharmaceutical interventions (NPIs) implemented in the general population during the coronavirus disease 2019 (COVID-19) pandemic in Germany had an impact on frequency, type and severity of infections in these patients. PATIENTS AND METHODS We analyzed all admissions to the clinic of pediatric hematology, oncology and stem cell transplantation (SCT) with (suspected) infection or fever of unknown origin (FUO) from 2018 to 2021. RESULTS We compared a 27-month period before NPIs (Pre-COVID: 01/2018-03/2020; 1041 cases) with a 12-month period with underlying NPIs (COVID: 04/2020-03/2021; 420 cases). During the COVID period the number of in-patient stays with FUO or infections decreased (38,6 cases/month vs. 35,0 cases/month), the median duration of hospital stays was longer (8 d (CI95: 7-8 d) vs. 9 d (CI95: 8-10 d) P=0,02)), the mean number of antibiotics per case increased (2,1 (CI95: 2,0-2,2) vs. 2,5 (CI95: 2,3-2,7); P=0,003)) and a substantial reduction of viral respiratory and gastrointestinal infections per case was seen (0,24 vs. 0,13; P<0,001). Notably, there was no detection of respiratory syncytial virus, influenza and norovirus, between May 2020 and March 2021. Based on need of intensive care measures and further parameters we conclude that severe (bacterial) infections were not significantly reduced by NPIs. CONCLUSIONS Introduction of NPIs in the general population during the COVID-pandemic substantially reduced viral respiratory and gastrointestinal infections in immunocompromised patients, while severe (bacterial) infections were not prevented.
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Affiliation(s)
- Richard Hauch
- Department of Pediatric Hematology and Oncology, University Medical Center Hamburg-Eppendorf, Center for Obstetrics and Pediatrics, Hamburg, Germany.,Research Institute Children's Cancer Center, Department of Pediatric Hematology and Oncology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Malena Hinrichs
- Department of Pediatric Hematology and Oncology, University Medical Center Hamburg-Eppendorf, Center for Obstetrics and Pediatrics, Hamburg, Germany
| | - Rebecca Ruhwald
- Medical controlling, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Johanna Schrum
- Department of Pediatric Hematology and Oncology, Division of Pediatric Stem Cell Transplantation and Immunology, University Medical Center Hamburg-Eppendorf, Center for Obstetrics and Pediatrics, Hamburg, Germany
| | - Stefan Rutkowski
- Department of Pediatric Hematology and Oncology, University Medical Center Hamburg-Eppendorf, Center for Obstetrics and Pediatrics, Hamburg, Germany
| | - Wilhelm Woessmann
- Department of Pediatric Hematology and Oncology, University Medical Center Hamburg-Eppendorf, Center for Obstetrics and Pediatrics, Hamburg, Germany
| | - Beate Winkler
- Department of Pediatric Hematology and Oncology, University Medical Center Hamburg-Eppendorf, Center for Obstetrics and Pediatrics, Hamburg, Germany
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Wang H, Zhu Z, Duan X, Song J, Mao N, Cui A, Wang C, Du H, Wang Y, Li F, Zhou S, Feng D, Li C, Gao H, He J, Li L, Lei Y, Zheng H, Gong T, Hu Y, Xu C, Zhao H, Sun Z, Chen Y, Tang X, Chen M, Deng L, Wang S, Tian X, Zhang T, Si Y, Yuan F, Fan L, Mahemutijiang K, Chen Z, Chen H, Xu W, Zhang Y. Transmission Pattern of Measles Virus Circulating in China During 1993-2021: Genotyping Evidence Supports That China Is Approaching Measles Elimination. Clin Infect Dis 2023; 76:e1140-e1149. [PMID: 36037029 DOI: 10.1093/cid/ciac674] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2022] [Revised: 08/04/2022] [Accepted: 08/17/2022] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND To provide useful insights into measles elimination progress in China, measles surveillance data were reviewed, and the transmission patterns of measles viruses circulating in China during 1993-2021 were analyzed. METHODS Measles incidence data from the National Notifiable Disease Reporting System of the China Center for Disease Control and Prevention were analyzed. A total of 17 570 strains were obtained from 30 of 31 provinces in mainland China during 1993-2021. The recommended genotyping window was amplified. Genotyping analysis was conducted for comparison with the reference strains. Phylogenetic analyses were performed to identify genetic relationships among different lineages within the genotypes. RESULTS With high coverage of routine immunization and intensive supplementary immunization activities, measles incidence has shown a downward trend since 1993, despite 2 resurgences, reaching a historic low level in 2020-2021 (average 0.5 per million). During 1993-2021, 9 genotypes including domestic genotype H1; imported genotypes B3, D4, D8, D9, D11, G3, and H2; and vaccine-associated genotype A were identified. Among them, the genotype H1 strain circulated endemically in China for more than 25 years; the last strain was detected in Yunnan Province in September 2019. Multiple imported genotypes have been identified since 2009 showing different transmission patterns. Since April 2020, no imported strains have been detected, while vaccine-associated genotype A continues to be detected. CONCLUSIONS The evidence of low incidence during 2020-2021 and virological surveillance data in this study confirm that China is currently approaching measles elimination.
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Affiliation(s)
- Huiling Wang
- World Health Organization Western Pacific Regional Office Regional Reference Laboratory of Measles and Rubella, National Health Commission Key Laboratory of Medical Virology and Viral Diseases, National Institute for Viral Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Zhen Zhu
- World Health Organization Western Pacific Regional Office Regional Reference Laboratory of Measles and Rubella, National Health Commission Key Laboratory of Medical Virology and Viral Diseases, National Institute for Viral Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Xiaojian Duan
- World Health Organization Western Pacific Regional Office Regional Reference Laboratory of Measles and Rubella, National Health Commission Key Laboratory of Medical Virology and Viral Diseases, National Institute for Viral Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Jinhua Song
- World Health Organization Western Pacific Regional Office Regional Reference Laboratory of Measles and Rubella, National Health Commission Key Laboratory of Medical Virology and Viral Diseases, National Institute for Viral Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Naiying Mao
- World Health Organization Western Pacific Regional Office Regional Reference Laboratory of Measles and Rubella, National Health Commission Key Laboratory of Medical Virology and Viral Diseases, National Institute for Viral Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Aili Cui
- World Health Organization Western Pacific Regional Office Regional Reference Laboratory of Measles and Rubella, National Health Commission Key Laboratory of Medical Virology and Viral Diseases, National Institute for Viral Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Changyin Wang
- Provincial Measles/Rubella Laboratory, Shandong Provincial Center for Disease Control and Prevention, Jinan, China
| | - Hui Du
- Provincial Measles/Rubella Laboratory, Hebei Provincial Center for Disease Control and Prevention, Shijiazhuang, China
| | - Yan Wang
- Provincial Measles/Rubella Laboratory, Liaoning Provincial Center for Disease Control and Prevention, Shenyang, China
| | - Fangcai Li
- Provincial Measles/Rubella Laboratory, Hunan Provincial Center for Disease Control and Prevention, Changsha, China
| | - Shujie Zhou
- Provincial Measles/Rubella Laboratory, Anhui Provincial Center for Disease Control and Prevention, Hefei, China
| | - Daxing Feng
- Provincial Measles/Rubella Laboratory, Henan Provincial Center for Disease Control and Prevention, Zhengzhou, China
| | - Chongshan Li
- Provincial Measles/Rubella Laboratory, Shanghai Municipal Center for Disease Control and Prevention, Shanghai, China
| | - Hui Gao
- Provincial Measles/Rubella Laboratory, Shanxi Provincial Center for Disease Control and Prevention, Taiyuan, China
| | - Jilan He
- Provincial Measles/Rubella Laboratory, Sichuan Provincial Center for Disease Control and Prevention, Chengdu, China
| | - Liqun Li
- Provincial Measles/Rubella Laboratory, Yunnan Provincial Center for Disease Control and Prevention, Kunming, China
| | - Yue Lei
- Provincial Measles/Rubella Laboratory, Tianjin Municipal Center for Disease Control and Prevention, Tianjin, China
| | - Huanying Zheng
- Provincial Measles/Rubella Laboratory, Guangdong Provincial Center for Disease Control and Prevention, Guangzhou, China
| | - Tian Gong
- Provincial Measles/Rubella Laboratory, Jiangxi Provincial Center for Disease Control and Prevention, Nanchang, China
| | - Ying Hu
- Provincial Measles/Rubella Laboratory, Jiangsu Provincial Center for Disease Control and Prevention, Nanjing, China
| | - Changping Xu
- Provincial Measles/Rubella Laboratory, Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou, China
| | - Hua Zhao
- Provincial Measles/Rubella Laboratory, Chongqing Municipal Center for Disease Control and Prevention, Chongqing, China
| | - Zhaodan Sun
- Provincial Measles/Rubella Laboratory, Heilongjiang Provincial Center for Disease Control and Prevention, Ha'erbin, China
| | - Ying Chen
- Provincial Measles/Rubella Laboratory, Gansu Provincial Center for Disease Control and Prevention, Lanzhou, China
| | - Xiaomin Tang
- Provincial Measles/Rubella Laboratory, Guizhou Provincial Center for Disease Control and Prevention, Guiyang, China
| | - Meng Chen
- Provincial Measles/Rubella Laboratory, Beijing Municipal Center for Disease Control and Prevention, Beijing, China
| | - Lili Deng
- Provincial Measles/Rubella Laboratory, Guangxi Center for Disease Control and Prevention, Nanning, China
| | - Shuang Wang
- Provincial Measles/Rubella Laboratory, Jilin Provincial Center for Disease Control and Prevention, Changchun, China
| | - Xiaoling Tian
- Provincial Measles/Rubella Laboratory, Neimenggu Center for Disease Control and Prevention, Huhehaote, China
| | - Ting Zhang
- Provincial Measles/Rubella Laboratory, Hubei Provincial Center for Disease Control and Prevention, Wuhan, China
| | - Yuan Si
- Provincial Measles/Rubella Laboratory, Shaanxi Provincial Center for Disease Control and Prevention, Xian, China
| | - Fang Yuan
- Provincial Measles/Rubella Laboratory, Ningxia Center for Disease Control and Prevention, Yinchuan, China
| | - Lixia Fan
- Provincial Measles/Rubella Laboratory, Qinghai Provincial Center for Disease Control and Prevention, Xining, China
| | - Kuerban Mahemutijiang
- Provincial Measles/Rubella Laboratory, Xinjiang Center for Disease Control and Prevention, Wulumuqi, China
| | - Zhifei Chen
- Provincial Measles/Rubella Laboratory, Fujian Provincial Center for Disease Control and Prevention, Fuzhou, China
| | - Haiyun Chen
- Provincial Measles/Rubella Laboratory, Hainan Provincial Center for Disease Control and Prevention, Haikou, China
| | - Wenbo Xu
- World Health Organization Western Pacific Regional Office Regional Reference Laboratory of Measles and Rubella, National Health Commission Key Laboratory of Medical Virology and Viral Diseases, National Institute for Viral Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Yan Zhang
- World Health Organization Western Pacific Regional Office Regional Reference Laboratory of Measles and Rubella, National Health Commission Key Laboratory of Medical Virology and Viral Diseases, National Institute for Viral Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China
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Rankin DA, Spieker AJ, Perez A, Stahl AL, Rahman HK, Stewart LS, Schuster JE, Lively JY, Haddadin Z, Probst V, Michaels MG, Williams JV, Boom JA, Sahni LC, Staat MA, Schlaudecker EP, McNeal MM, Harrison CJ, Weinberg GA, Szilagyi PG, Englund JA, Klein EJ, Gerber SI, McMorrow M, Rha B, Chappell JD, Selvarangan R, Midgley CM, Halasa NB. Circulation of Rhinoviruses and/or Enteroviruses in Pediatric Patients With Acute Respiratory Illness Before and During the COVID-19 Pandemic in the US. JAMA Netw Open 2023; 6:e2254909. [PMID: 36749589 PMCID: PMC10408278 DOI: 10.1001/jamanetworkopen.2022.54909] [Citation(s) in RCA: 20] [Impact Index Per Article: 20.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/30/2022] [Accepted: 12/19/2022] [Indexed: 02/08/2023] Open
Abstract
IMPORTANCE Rhinoviruses and/or enteroviruses, which continued to circulate during the COVID-19 pandemic, are commonly detected in pediatric patients with acute respiratory illness (ARI). Yet detailed characterization of rhinovirus and/or enterovirus detection over time is limited, especially by age group and health care setting. OBJECTIVE To quantify and characterize rhinovirus and/or enterovirus detection before and during the COVID-19 pandemic among children and adolescents seeking medical care for ARI at emergency departments (EDs) or hospitals. DESIGN, SETTING, AND PARTICIPANTS This cross-sectional study used data from the New Vaccine Surveillance Network (NVSN), a multicenter, active, prospective surveillance platform, for pediatric patients who sought medical care for fever and/or respiratory symptoms at 7 EDs or hospitals within NVSN across the US between December 2016 and February 2021. Persons younger than 18 years were enrolled in NVSN, and respiratory specimens were collected and tested for multiple viruses. MAIN OUTCOMES AND MEASURES Proportion of patients in whom rhinovirus and/or enterovirus, or another virus, was detected by calendar month and by prepandemic (December 1, 2016, to March 11, 2020) or pandemic (March 12, 2020, to February 28, 2021) periods. Month-specific adjusted odds ratios (aORs) for rhinovirus and/or enterovirus-positive test results (among all tested) by setting (ED or inpatient) and age group (<2, 2-4, or 5-17 years) were calculated, comparing each month during the pandemic to equivalent months of previous years. RESULTS Of the 38 198 children and adolescents who were enrolled and tested, 11 303 (29.6%; mean [SD] age, 2.8 [3.7] years; 6733 boys [59.6%]) had rhinovirus and/or enterovirus-positive test results. In prepandemic and pandemic periods, rhinoviruses and/or enteroviruses were detected in 29.4% (9795 of 33 317) and 30.9% (1508 of 4881) of all patients who were enrolled and tested and in 42.2% (9795 of 23 236) and 73.0% (1508 of 2066) of those with test positivity for any virus, respectively. Rhinoviruses and/or enteroviruses were the most frequently detected viruses in both periods and all age groups in the ED and inpatient setting. From April to September 2020 (pandemic period), rhinoviruses and/or enteroviruses were detectable at similar or lower odds than in prepandemic years, with aORs ranging from 0.08 (95% CI, 0.04-0.19) to 0.76 (95% CI, 0.55-1.05) in the ED and 0.04 (95% CI, 0.01-0.11) to 0.71 (95% CI, 0.47-1.07) in the inpatient setting. However, unlike some other viruses, rhinoviruses and/or enteroviruses soon returned to prepandemic levels and from October 2020 to February 2021 were detected at similar or higher odds than in prepandemic months in both settings, with aORs ranging from 1.47 (95% CI, 1.12-1.93) to 3.01 (95% CI, 2.30-3.94) in the ED and 1.36 (95% CI, 1.03-1.79) to 2.44 (95% CI, 1.78-3.34) in the inpatient setting, and in all age groups. Compared with prepandemic years, during the pandemic, rhinoviruses and/or enteroviruses were detected in patients who were slightly older, although most (74.5% [1124 of 1508]) were younger than 5 years. CONCLUSIONS AND RELEVANCE Results of this study show that rhinoviruses and/or enteroviruses persisted and were the most common respiratory virus group detected across all pediatric age groups and in both ED and inpatient settings. Rhinoviruses and/or enteroviruses remain a leading factor in ARI health care burden, and active ARI surveillance in children and adolescents remains critical for defining the health care burden of respiratory viruses.
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Affiliation(s)
- Danielle A. Rankin
- Department of Pediatrics, Vanderbilt University Medical Center, Nashville, Tennessee
- Vanderbilt Epidemiology PhD Program, Vanderbilt University School of Medicine, Nashville, Tennessee
| | - Andrew J. Spieker
- Department of Biostatistics, Vanderbilt University Medical Center, Nashville, Tennessee
| | - Ariana Perez
- Division of Viral Diseases, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia
- General Dynamics Information Technology Inc, Falls Church, Virginia
| | - Anna L. Stahl
- Department of Pediatrics, Vanderbilt University Medical Center, Nashville, Tennessee
| | - Herdi K. Rahman
- Department of Pediatrics, Vanderbilt University Medical Center, Nashville, Tennessee
| | - Laura S. Stewart
- Department of Pediatrics, Vanderbilt University Medical Center, Nashville, Tennessee
| | - Jennifer E. Schuster
- Division of Pediatric Infectious Diseases, Children’s Mercy Kansas City, Kansas City, Missouri
| | - Joana Y. Lively
- Division of Viral Diseases, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Zaid Haddadin
- Department of Pediatrics, Vanderbilt University Medical Center, Nashville, Tennessee
| | - Varvara Probst
- Department of Pediatrics, Vanderbilt University Medical Center, Nashville, Tennessee
| | - Marian G. Michaels
- Department of Pediatrics, University of Pittsburgh School of Medicine, University of Pittsburgh Medical Center Children’s Hospital of Pittsburgh, Pittsburgh, Pennsylvania
| | - John V. Williams
- Department of Pediatrics, University of Pittsburgh School of Medicine, University of Pittsburgh Medical Center Children’s Hospital of Pittsburgh, Pittsburgh, Pennsylvania
| | - Julie A. Boom
- Department of Pediatrics, Baylor College of Medicine, Houston, Texas
- Texas Children’s Hospital, Houston
| | - Leila C. Sahni
- Department of Pediatrics, Baylor College of Medicine, Houston, Texas
- Texas Children’s Hospital, Houston
| | - Mary A. Staat
- Division of Infectious Diseases, Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati Children’s Hospital Medical Center, Cincinnati, Ohio
| | - Elizabeth P. Schlaudecker
- Division of Infectious Diseases, Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati Children’s Hospital Medical Center, Cincinnati, Ohio
| | - Monica M. McNeal
- Division of Infectious Diseases, Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati Children’s Hospital Medical Center, Cincinnati, Ohio
| | - Christopher J. Harrison
- Division of Pediatric Infectious Diseases, Children’s Mercy Kansas City, Kansas City, Missouri
| | - Geoffrey A. Weinberg
- Department of Pediatrics, University of Rochester School of Medicine and Dentistry, Rochester, New York
| | - Peter G. Szilagyi
- Department of Pediatrics, University of Rochester School of Medicine and Dentistry, Rochester, New York
- Department of Pediatrics, UCLA (University of California, Los Angeles) Mattel Children’s Hospital, UCLA, Los Angeles
| | - Janet A. Englund
- Seattle Children’s Hospital, Department of Pediatrics, University of Washington School of Medicine, Seattle
| | - Eileen J. Klein
- Seattle Children’s Hospital, Department of Pediatrics, University of Washington School of Medicine, Seattle
| | - Susan I. Gerber
- Division of Viral Diseases, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Meredith McMorrow
- Division of Viral Diseases, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Brian Rha
- Division of Viral Diseases, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - James D. Chappell
- Department of Pediatrics, Vanderbilt University Medical Center, Nashville, Tennessee
| | - Rangaraj Selvarangan
- Division of Pediatric Infectious Diseases, Children’s Mercy Kansas City, Kansas City, Missouri
- Department of Pathology and Laboratory Medicine, Children’s Mercy Kansas City, Kansas City, Missouri
| | - Claire M. Midgley
- Division of Viral Diseases, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Natasha B. Halasa
- Department of Pediatrics, Vanderbilt University Medical Center, Nashville, Tennessee
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Chuang YC, Lin KP, Wang LA, Yeh TK, Liu PY. The Impact of the COVID-19 Pandemic on Respiratory Syncytial Virus Infection: A Narrative Review. Infect Drug Resist 2023; 16:661-675. [PMID: 36743336 PMCID: PMC9897071 DOI: 10.2147/idr.s396434] [Citation(s) in RCA: 43] [Impact Index Per Article: 43.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2022] [Accepted: 01/12/2023] [Indexed: 02/01/2023] Open
Abstract
Respiratory syncytial virus (RSV) is one of the most common respiratory viruses. It not only affects young children but also the elderly and immunocompromised patients. After the emergence of SARS-CoV-2 and the corona virus disease 2019 (COVID-19) era, a dramatic reduction in RSV activity was found, which coincided with the implementation of public health and social measures (PHSMs). However, the correlation is more complicated than we initially thought. After PHSMs were gradually lifted, a seasonality shift and a delayed RSV outbreak with greater number of infected patients were found in numerous countries, such as Israel, Australia, South Africa, New Zealand, France, United States, and Japan. Several hypotheses and possible reasons explaining the interaction between SARS-CoV-2 and RSV were mentioned. Since RSV vaccinations are still under investigation, administration of palivizumab should be considered in high-risk patients. In the post-COVID-19 era, greater attention should be paid to a further resurgence of RSV. In this narrative review, we conducted a thorough review of the current knowledge on the epidemiology of RSV during the COVID-19 era, the out-of-season outbreak of RSV, and the data on co-infection with RSV and SARS-CoV-2.
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Affiliation(s)
- Yu-Chuan Chuang
- Department of Internal Medicine, Taichung Veterans General Hospital, Taichung, Taiwan
| | - Kuan-Pei Lin
- Department of Internal Medicine, Taichung Veterans General Hospital, Taichung, Taiwan
| | - Li-An Wang
- Department of Internal Medicine, Taichung Veterans General Hospital, Taichung, Taiwan
| | - Ting-Kuang Yeh
- Division of Infectious Disease, Department of Internal Medicine, Taichung Veterans General Hospital, Taichung, Taiwan,Genomic Center for Infectious Diseases, Taichung Veterans General Hospital, Taichung, Taiwan
| | - Po-Yu Liu
- Division of Infectious Disease, Department of Internal Medicine, Taichung Veterans General Hospital, Taichung, Taiwan,Genomic Center for Infectious Diseases, Taichung Veterans General Hospital, Taichung, Taiwan,Ph.D. in Translational Medicine, National Chung Hsing University, Taichung, Taiwan,Rong Hsing Research Center for Translational Medicine, National Chung Hsing University, Taichung, Taiwan,Department of Post-Baccalaureate Medicine, College of Medicine, National Chung Hsing University, Taichung, Taiwan,Correspondence: Po-Yu Liu, Division of Infectious Disease, Department of Internal Medicine, Taichung Veterans General Hospital, No. 1650, Sec. 4, Taiwan Blvd., Xitun Dist, Taichung City, 407219, Taiwan, Tel +886 4 2359 2525, Email
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Zhu L, Luo T, Yuan Y, Yang S, Niu C, Gong T, Wang X, Xie X, Luo J, Liu E, Fu Z, Tian D. Epidemiological characteristics of respiratory viruses in hospitalized children during the COVID-19 pandemic in southwestern China. Front Cell Infect Microbiol 2023; 13:1142199. [PMID: 37153160 PMCID: PMC10157792 DOI: 10.3389/fcimb.2023.1142199] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2023] [Accepted: 03/16/2023] [Indexed: 05/09/2023] Open
Abstract
Background Multinational studies have reported that the implementation of nonpharmaceutical interventions (NPIs) to control severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) transmission coincided with the decline of other respiratory viruses, such as influenza viruses and respiratory syncytial virus. Objective To investigate the prevalence of common respiratory viruses during the coronavirus disease 2019 (COVID-19) pandemic. Methods Respiratory specimens of children with lower respiratory tract infections (LRTIs) hospitalized at the Children's Hospital of Chongqing Medical University from January 1, 2018 to December 31, 2021 were collected. Seven common pathogens, including respiratory syncytial virus (RSV), adenovirus (ADV), influenza virus A and B (Flu A, Flu B), and parainfluenza virus types 1-3 (PIV1-3), were detected by a multiplex direct immunofluorescence assay (DFA). Demographic data and laboratory test results were analyzed. Results 1) A total of 31,113 children with LRTIs were enrolled, including 8141 in 2018, 8681 in 2019, 6252 in 2020, and 8059 in 2021.The overall detection rates decreased in 2020 and 2021 (P < 0.001). The detection rates of RSV, ADV, Flu A, PIV-1, and PIV-3 decreased when NPIs were active from February to August 2020, with Flu A decreasing most predominantly, from 2.7% to 0.3% (P < 0.05). The detection rates of RSV and PIV-1 resurged and even surpassed the historical level of 2018-2019, while Flu A continued decreasing when NPIs were lifted (P < 0.05). 2) Seasonal patterns of Flu A completely disappeared in 2020 and 2021. The Flu B epidemic was observed until October 2021 after a long period of low detection in 2020. RSV decreased sharply after January 2020 and stayed in a nearly dormant state during the next seven months. Nevertheless, the detection rates of RSV were abnormally higher than 10% in the summer of 2021. PIV-3 decreased significantly after the COVID-19 pandemic; however, it atypically surged from August to November 2020. Conclusion The NPIs implemented during the COVID-19 pandemic affected the prevalence and seasonal patterns of certain viruses such as RSV, PIV-3, and influenza viruses. We recommend continuous surveillance of the epidemiological and evolutionary dynamics of multiple respiratory pathogens, especially when NPIs are no longer necessary.
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Affiliation(s)
- Lin Zhu
- Ministry of Education Key Laboratory of Child Development and Disorders, Chongqing Key Laboratory of Pediatrics, Department of Respiratory Medicine, National Clinical Research Center for Child Health and Disorders, Children’s Hospital of Chongqing Medical University, Chongqing, China
| | - Tingting Luo
- Ministry of Education Key Laboratory of Child Development and Disorders, Chongqing Key Laboratory of Pediatrics, Department of Respiratory Medicine, National Clinical Research Center for Child Health and Disorders, Children’s Hospital of Chongqing Medical University, Chongqing, China
| | - Yining Yuan
- School of Public Health, Chengdu Medical College, Chengdu, China
| | - Shu Yang
- College of Intelligent Medicine, Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Chao Niu
- Ministry of Education Key Laboratory of Child Development and Disorders, Chongqing Key Laboratory of Pediatrics, Department of Respiratory Medicine, National Clinical Research Center for Child Health and Disorders, Children’s Hospital of Chongqing Medical University, Chongqing, China
| | - Ting Gong
- Ministry of Education Key Laboratory of Child Development and Disorders, Chongqing Key Laboratory of Pediatrics, Department of Respiratory Medicine, National Clinical Research Center for Child Health and Disorders, Children’s Hospital of Chongqing Medical University, Chongqing, China
| | - Xueer Wang
- Ministry of Education Key Laboratory of Child Development and Disorders, Chongqing Key Laboratory of Pediatrics, Department of Respiratory Medicine, National Clinical Research Center for Child Health and Disorders, Children’s Hospital of Chongqing Medical University, Chongqing, China
| | - Xiaohong Xie
- Ministry of Education Key Laboratory of Child Development and Disorders, Chongqing Key Laboratory of Pediatrics, Department of Respiratory Medicine, National Clinical Research Center for Child Health and Disorders, Children’s Hospital of Chongqing Medical University, Chongqing, China
| | - Jian Luo
- Ministry of Education Key Laboratory of Child Development and Disorders, Chongqing Key Laboratory of Pediatrics, Department of Respiratory Medicine, National Clinical Research Center for Child Health and Disorders, Children’s Hospital of Chongqing Medical University, Chongqing, China
| | - Enmei Liu
- Ministry of Education Key Laboratory of Child Development and Disorders, Chongqing Key Laboratory of Pediatrics, Department of Respiratory Medicine, National Clinical Research Center for Child Health and Disorders, Children’s Hospital of Chongqing Medical University, Chongqing, China
| | - Zhou Fu
- Ministry of Education Key Laboratory of Child Development and Disorders, Chongqing Key Laboratory of Pediatrics, Department of Respiratory Medicine, National Clinical Research Center for Child Health and Disorders, Children’s Hospital of Chongqing Medical University, Chongqing, China
| | - Daiyin Tian
- Ministry of Education Key Laboratory of Child Development and Disorders, Chongqing Key Laboratory of Pediatrics, Department of Respiratory Medicine, National Clinical Research Center for Child Health and Disorders, Children’s Hospital of Chongqing Medical University, Chongqing, China
- *Correspondence: Daiyin Tian,
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Camp JV, Redlberger-Fritz M. Increased cases of influenza C virus in children and adults in Austria, 2022. J Med Virol 2023; 95:e28201. [PMID: 36210349 PMCID: PMC10091750 DOI: 10.1002/jmv.28201] [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: 07/14/2022] [Revised: 09/30/2022] [Accepted: 10/04/2022] [Indexed: 01/11/2023]
Abstract
Sentinel surveillance of influenza-like illnesses revealed an increase in the cases of influenza C virus in children and adults in Austria, 2022, compared to previous years, following one season (2020/2021), wherein no influenza C virus was detected. Whole-genome sequencing revealed no obvious genetic basis for the increase. We propose that the reemergence is explained by waning immunity from lack of community exposure due to restrictions intended to limit severe acute respiratory syndrome coronavirus 2 spread in prior seasons, pending further investigation.
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Affiliation(s)
- Jeremy V Camp
- Center for Virology, Medical University of Vienna, Vienna, Austria
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43
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Razanajatovo NH, Randriambolamanantsoa TH, Rabarison JH, Randrianasolo L, Ankasitrahana MF, Ratsimbazafy A, Raherinandrasana AH, Razafimanjato H, Raharinosy V, Andriamandimby SF, Heraud JM, Dussart P, Lacoste V. Epidemiological Patterns of Seasonal Respiratory Viruses during the COVID-19 Pandemic in Madagascar, March 2020-May 2022. Viruses 2022; 15:12. [PMID: 36680053 PMCID: PMC9864023 DOI: 10.3390/v15010012] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2022] [Revised: 12/09/2022] [Accepted: 12/16/2022] [Indexed: 12/24/2022] Open
Abstract
Three epidemic waves of coronavirus disease-19 (COVID-19) occurred in Madagascar from March 2020 to May 2022, with a positivity rate of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) of 21% to 33%. Our study aimed to identify the impact of COVID-19 on the epidemiology of seasonal respiratory viruses (RVs) in Madagascar. We used two different specimen sources (SpS). First, 2987 nasopharyngeal (NP) specimens were randomly selected from symptomatic patients between March 2020 and May 2022 who tested negative for SARS-CoV-2 and were tested for 14 RVs by multiplex real-time PCR. Second, 6297 NP specimens were collected between March 2020 and May 2022 from patients visiting our sentinel sites of the influenza sentinel network. The samples were tested for influenza, respiratory syncytial virus (RSV), and SARS-CoV-2. From SpS-1, 19% (569/2987) of samples tested positive for at least one RV. Rhinovirus (6.3%, 187/2987) was the most frequently detected virus during the first two waves, whereas influenza predominated during the third. From SpS-2, influenza, SARS-CoV-2, and RSV accounted for 5.4%, 24.5%, and 39.4% of the detected viruses, respectively. During the study period, we observed three different RV circulation profiles. Certain viruses circulated sporadically, with increased activity in between waves of SARS-CoV-2. Other viruses continued to circulate regardless of the COVID-19 situation. Certain viruses were severely disrupted by the spread of SARS-CoV-2. Our findings underline the importance and necessity of maintaining an integrated disease surveillance system for the surveillance and monitoring of RVs of public health interest.
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Affiliation(s)
| | | | | | - Laurence Randrianasolo
- Epidemiology and Clinical Research Unit, Institut Pasteur of Madagascar, Antananarivo 101, Madagascar
| | - Miamina Fidy Ankasitrahana
- Direction de la Veille Sanitaire, de la Surveillance Epidémiologique et Ripostes, Ministry of Public Health, Antananarivo 101, Madagascar
| | - Arvé Ratsimbazafy
- National Influenza Center, Virology Unit, Institut Pasteur of Madagascar, Antananarivo 101, Madagascar
| | - Antso Hasina Raherinandrasana
- Direction de la Veille Sanitaire, de la Surveillance Epidémiologique et Ripostes, Ministry of Public Health, Antananarivo 101, Madagascar
| | - Helisoa Razafimanjato
- National Influenza Center, Virology Unit, Institut Pasteur of Madagascar, Antananarivo 101, Madagascar
| | - Vololoniaina Raharinosy
- National Influenza Center, Virology Unit, Institut Pasteur of Madagascar, Antananarivo 101, Madagascar
| | - Soa Fy Andriamandimby
- National Influenza Center, Virology Unit, Institut Pasteur of Madagascar, Antananarivo 101, Madagascar
| | | | - Philippe Dussart
- National Influenza Center, Virology Unit, Institut Pasteur of Madagascar, Antananarivo 101, Madagascar
| | - Vincent Lacoste
- National Influenza Center, Virology Unit, Institut Pasteur of Madagascar, Antananarivo 101, Madagascar
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Ma Y, Gao S, Kang Z, Shan L, Jiao M, Li Y, Liang L, Hao Y, Zhao B, Ning N, Gao L, Cui Y, Sun H, Wu Q, Liu H. Epidemiological trend in scarlet fever incidence in China during the COVID-19 pandemic: A time series analysis. Front Public Health 2022; 10:923318. [PMID: 36589977 PMCID: PMC9799716 DOI: 10.3389/fpubh.2022.923318] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2022] [Accepted: 11/29/2022] [Indexed: 12/23/2022] Open
Abstract
Objective Over the past decade, scarlet fever has caused a relatively high economic burden in various regions of China. Non-pharmaceutical interventions (NPIs) are necessary because of the absence of vaccines and specific drugs. This study aimed to characterize the demographics of patients with scarlet fever, describe its spatiotemporal distribution, and explore the impact of NPIs on the disease in the era of coronavirus disease 2019 (COVID-19) in China. Methods Using monthly scarlet fever data from January 2011 to December 2019, seasonal autoregressive integrated moving average (SARIMA), advanced innovation state-space modeling framework that combines Box-Cox transformations, Fourier series with time-varying coefficients, and autoregressive moving average error correction method (TBATS) models were developed to select the best model for comparing between the expected and actual incidence of scarlet fever in 2020. Interrupted time series analysis (ITSA) was used to explore whether NPIs have an effect on scarlet fever incidence, while the intervention effects of specific NPIs were explored using correlation analysis and ridge regression methods. Results From 2011 to 2017, the total number of scarlet fever cases was 400,691, with children aged 0-9 years being the main group affected. There were two annual incidence peaks (May to June and November to December). According to the best prediction model TBATS (0.002, {0, 0}, 0.801, {<12, 5>}), the number of scarlet fever cases was 72,148 and dual seasonality was no longer prominent. ITSA showed a significant effect of NPIs of a reduction in the number of scarlet fever episodes (β2 = -61526, P < 0.005), and the effect of canceling public events (c3) was the most significant (P = 0.0447). Conclusions The incidence of scarlet fever during COVID-19 was lower than expected, and the total incidence decreased by 80.74% in 2020. The results of this study indicate that strict NPIs may be of potential benefit in preventing scarlet fever occurrence, especially that related to public event cancellation. However, it is still important that vaccines and drugs are available in the future.
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Affiliation(s)
- Yunxia Ma
- Department of Social Medicine, Health Management College, Harbin Medical University, Harbin, China
| | - Shanshan Gao
- Department of Social Medicine, Health Management College, Harbin Medical University, Harbin, China
| | - Zheng Kang
- Department of Social Medicine, Health Management College, Harbin Medical University, Harbin, China
| | - Linghan Shan
- Department of Social Medicine, Health Management College, Harbin Medical University, Harbin, China
| | - Mingli Jiao
- Department of Social Medicine, Health Management College, Harbin Medical University, Harbin, China
| | - Ye Li
- Department of Social Medicine, Health Management College, Harbin Medical University, Harbin, China
| | - Libo Liang
- Department of Social Medicine, Health Management College, Harbin Medical University, Harbin, China
| | - Yanhua Hao
- Department of Social Medicine, Health Management College, Harbin Medical University, Harbin, China
| | - Binyu Zhao
- Department of Biostatistics, School of Public Health, Harbin Medical University, Harbin, China
| | - Ning Ning
- Department of Social Medicine, Health Management College, Harbin Medical University, Harbin, China
| | - Lijun Gao
- Department of Social Medicine, Health Management College, Harbin Medical University, Harbin, China
| | - Yu Cui
- Department of Social Medicine, Health Management College, Harbin Medical University, Harbin, China
| | - Hong Sun
- Department of Social Medicine, Health Management College, Harbin Medical University, Harbin, China
| | - Qunhong Wu
- Department of Social Medicine, Health Management College, Harbin Medical University, Harbin, China,*Correspondence: Qunhong Wu
| | - Huan Liu
- Department of Social Medicine, Health Management College, Harbin Medical University, Harbin, China,Huan Liu
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Hazan G, Fox C, Mok H, Haspel J. Age-dependent rebound in asthma exacerbations after COVID-19 lockdown. THE JOURNAL OF ALLERGY AND CLINICAL IMMUNOLOGY. GLOBAL 2022; 1:314-318. [PMID: 36377231 PMCID: PMC9364738 DOI: 10.1016/j.jacig.2022.06.001] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 04/04/2022] [Revised: 05/23/2022] [Accepted: 06/07/2022] [Indexed: 06/16/2023]
Abstract
Background Virus mitigation measures enacted early in the coronavirus infectious disease 2019 (COVID-19) pandemic suppressed common respiratory viruses and reduced the number of obstructive lung disease exacerbations. However, many localities began to ease these precautions in the year 2021, leading to a resurgence of non-COVID viruses. How asthma and chronic obstructive pulmonary disease (COPD) activity responded to this upswing in viral abundance is unclear. Objective Our aim was to examine how viral resurgence during the relaxation of COVID-19 restrictions affected asthma and COPD exacerbations. Methods We analyzed electronic medical records for emergency department (ED) respiratory virus positivity, asthma visits, and COPD visits. We compared the 52-week interval before the COVID-19 restrictions (the pre-lockdown period [March 22, 2019-March 19, 2020]), the 52-week period immediately following enactment of the restrictions (the lockdown period [March 20, 2020-March 18, 2021]), and the 52-week period thereafter (the post-lockdown period [March 19, 2021-March 18, 2022]). We used MetaCYCLE to analyze seasonal trends in our data. Results The post-lockdown period was marked by a 400% increase in viral positivity compared with during the lockdown period. Asthma- and COPD-related ED visits each rose 37% compared with during the lockdown, with the rebound in asthma ED visits concentrated in individuals younger than 20 years. Interestingly, after the lockdown period, asthma ED visits overcorrected in children younger than 5 years, rising 81% compared with before the lockdown. Seasonal rhythms in asthma and COPD exacerbations were suppressed during the lockdown and recovered after the lockdown. Conclusions COVID-19 precautions had the unexpected effect of magnifying early-childhood asthma activity once common respiratory viruses recurred. These results may have implications for the future use of virus mitigation strategies in young children.
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Affiliation(s)
- Guy Hazan
- Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Washington University School of Medicine, St Louis, Mo
- Division of Pediatric Allergy and Pulmonary Medicine, Department of Pediatrics, Washington University School of Medicine, St Louis, Mo
| | - Carolyn Fox
- Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Washington University School of Medicine, St Louis, Mo
| | - Huram Mok
- Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Washington University School of Medicine, St Louis, Mo
| | - Jeffrey Haspel
- Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Washington University School of Medicine, St Louis, Mo
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46
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Kreger JE, Hershenson MB. Effects of COVID-19 and Social Distancing on Rhinovirus Infections and Asthma Exacerbations. Viruses 2022; 14:2340. [PMID: 36366439 PMCID: PMC9698629 DOI: 10.3390/v14112340] [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: 10/07/2022] [Revised: 10/21/2022] [Accepted: 10/24/2022] [Indexed: 02/01/2023] Open
Abstract
Since their discovery in the 1950s, rhinoviruses (RVs) have been recognized as a major causative agent of the "common cold" and cold-like illnesses, accounting for more than 50% of upper respiratory tract infections. However, more than that, respiratory viral infections are responsible for approximately 50% of asthma exacerbations in adults and 80% in children. In addition to causing exacerbations of asthma, COPD and other chronic lung diseases, RVs have also been implicated in the pathogenesis of lower respiratory tract infections including bronchiolitis and community acquired pneumonia. Finally, early life respiratory viral infections with RV have been associated with asthma development in children. Due to the vast genetic diversity of RVs (approximately 160 known serotypes), recurrent infection is common. RV infections are generally acquired in the community with transmission occurring via inhalation of aerosols, respiratory droplets or fomites. Following the outbreak of coronavirus disease 2019 (COVID-19), exposure to RV and other respiratory viruses was significantly reduced due to social-distancing, restrictions on social gatherings, and increased hygiene protocols. In the present review, we summarize the impact of COVID-19 preventative measures on the incidence of RV infection and its sequelae.
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Affiliation(s)
| | - Marc B. Hershenson
- Department of Pediatrics, University of Michigan Medical School, Ann Arbor, MI 48109, USA
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47
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Investigation of turning points in the effectiveness of Covid-19 social distancing. Sci Rep 2022; 12:17783. [PMID: 36273235 PMCID: PMC9588076 DOI: 10.1038/s41598-022-22747-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2022] [Accepted: 10/19/2022] [Indexed: 01/19/2023] Open
Abstract
Covid-19 is the first digitally documented pandemic in history, presenting a unique opportunity to learn how to best deal with similar crises in the future. In this study we have carried out a model-based evaluation of the effectiveness of social distancing, using Austria and Slovenia as examples. Whereas the majority of comparable studies have postulated a negative relationship between the stringency of social distancing (reduction in social contacts) and the scale of the epidemic, our model has suggested a varying relationship, with turning points at which the system changes its predominant regime from 'less social distancing-more cumulative deaths and infections' to 'less social distancing-fewer cumulative deaths and infections'. This relationship was found to persist in scenarios with distinct seasonal variation in transmission and limited national intensive care capabilities. In such situations, relaxing social distancing during low transmission seasons (spring and summer) was found to relieve pressure from high transmission seasons (fall and winter) thus reducing the total number of infections and fatalities. Strategies that take into account this relationship could be particularly beneficial in situations where long-term containment is not feasible.
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48
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Serigstad S, Markussen DL, Ritz C, Ebbesen MH, Knoop ST, Kommedal Ø, Heggelund L, Ulvestad E, Bjørneklett RO, Grewal HMS. The changing spectrum of microbial aetiology of respiratory tract infections in hospitalized patients before and during the COVID-19 pandemic. BMC Infect Dis 2022; 22:763. [PMID: 36180842 PMCID: PMC9523652 DOI: 10.1186/s12879-022-07732-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2022] [Accepted: 09/14/2022] [Indexed: 11/29/2022] Open
Abstract
Background The COVID-19 pandemic was met with strict containment measures. We hypothesized that societal infection control measures would impact the number of hospital admissions for respiratory tract infections, as well as, the spectrum of pathogens detected in patients with suspected community acquired pneumonia (CAP). Methods This study is based on aggregated surveillance data from electronic health records of patients admitted to the hospitals in Bergen Hospital Trust from January 2017 through June 2021, as well as, two prospective studies of patients with suspected CAP conducted prior to and during the COVID-19 pandemic (pre-COVID cohort versus COVID cohort, respectively). In the prospective cohorts, microbiological detections were ascertained by comprehensive PCR-testing in lower respiratory tract specimens. Mann–Whitney’s U test was used to analyse continuous variables. Fisher’s exact test was used for analysing categorical data. The number of admissions before and during the outbreak of SARS-CoV-2 was compared using two-sample t-tests on logarithmic transformed values. Results Admissions for respiratory tract infections declined after the outbreak of SARS-CoV-2 (p < 0.001). The pre-COVID and the COVID cohorts comprised 96 and 80 patients, respectively. The proportion of viruses detected in the COVID cohort was significantly lower compared with the pre-COVID cohort [21% vs 36%, difference of 14%, 95% CI 4% to 26%; p = 0.012], and the proportion of bacterial- and viral co-detections was less than half in the COVID cohort compared with the pre-COVID cohort (19% vs 45%, difference of 26%, 95% CI 13% to 41%; p < 0.001). The proportion of bacteria detected was similar (p = 0.162), however, a difference in the bacterial spectrum was observed in the two cohorts. Haemophilus influenzae was the most frequent bacterial detection in both cohorts, followed by Streptococcus pneumoniae in the pre-COVID and Staphylococcus aureus in the COVID cohort. Conclusion During the first year of the COVID-19 pandemic, the number of admissions with pneumonia and the microbiological detections in patients with suspected CAP, differed from the preceding year. This suggests that infection control measures related to COVID-19 restrictions have an overall and specific impact on respiratory tract infections, beyond reducing the spread of SARS-CoV-2. Supplementary Information The online version contains supplementary material available at 10.1186/s12879-022-07732-5.
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Affiliation(s)
- Sondre Serigstad
- Emergency Care Clinic, Haukeland University Hospital, 5021, Bergen, Norway. .,Department of Clinical Medicine, University of Bergen, 5021, Bergen, Norway. .,Department of Clinical Science, Bergen Integrated Diagnostic Stewardship Cluster, University of Bergen, 5021, Bergen, Norway.
| | | | - Christian Ritz
- Department of Clinical Science, Bergen Integrated Diagnostic Stewardship Cluster, University of Bergen, 5021, Bergen, Norway.,National Institute of Public Health, University of Southern Denmark, 1455, Copenhagen, Denmark
| | - Marit H Ebbesen
- Department of Microbiology, Haukeland University Hospital, 5021, Bergen, Norway
| | - Siri T Knoop
- Department of Clinical Science, Bergen Integrated Diagnostic Stewardship Cluster, University of Bergen, 5021, Bergen, Norway.,Department of Microbiology, Haukeland University Hospital, 5021, Bergen, Norway
| | - Øyvind Kommedal
- Department of Clinical Science, Bergen Integrated Diagnostic Stewardship Cluster, University of Bergen, 5021, Bergen, Norway.,Department of Microbiology, Haukeland University Hospital, 5021, Bergen, Norway
| | - Lars Heggelund
- Department of Clinical Science, Bergen Integrated Diagnostic Stewardship Cluster, University of Bergen, 5021, Bergen, Norway.,Department of Internal Medicine, Vestre Viken Hospital Trust, 3004, Drammen, Norway
| | - Elling Ulvestad
- Department of Clinical Science, Bergen Integrated Diagnostic Stewardship Cluster, University of Bergen, 5021, Bergen, Norway.,Department of Microbiology, Haukeland University Hospital, 5021, Bergen, Norway
| | - Rune O Bjørneklett
- Emergency Care Clinic, Haukeland University Hospital, 5021, Bergen, Norway.,Department of Clinical Medicine, University of Bergen, 5021, Bergen, Norway
| | - Harleen M S Grewal
- Department of Clinical Science, Bergen Integrated Diagnostic Stewardship Cluster, University of Bergen, 5021, Bergen, Norway. .,Department of Microbiology, Haukeland University Hospital, 5021, Bergen, Norway.
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49
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Bhardwaj S, Choudhary ML, Jadhav S, Vipat V, Ghuge R, Salvi S, Kulkarni R, Kinikar A, Padbidri V, Bafna S, Bavdekare A, D'costa P, Gujar N, Potdar V. A retrospective analysis of respiratory virus transmission before and during the COVID-19 pandemic in Pune the western region of India. Front Public Health 2022; 10:936634. [PMID: 36159243 PMCID: PMC9494283 DOI: 10.3389/fpubh.2022.936634] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2022] [Accepted: 08/18/2022] [Indexed: 01/25/2023] Open
Abstract
Background SARS-CoV-2 was first reported in China in December 2019 and quickly spread across the world. Non-pharmaceutical interventions (NPIs) are the key to control the transmission of respiratory viruses. To stop the spread, NPI is widely recommended and is still followed by most countries. Methods At the National Influenza Center of the Indian Council of Medical Research-National Institute of Virology (ICMR-NIV), the surveillance of severe acute respiratory illness and acute respiratory illness cases for influenza and other respiratory viruses is in place. In this study, we analyzed surveillance data on respiratory viruses and/or SARS-CoV-2 testing from January 2017 to December 2021. Multiplex real-time PCR was used to detect the respiratory viruses. Results Our findings indicate that during the pandemic, the positivity for influenza A and B, metapneumovirus, parainfluenza virus, respiratory syncytial virus, and human coronavirus declined significantly. Conclusion The annual distinct seasonal outbreaks of influenza, RSV, and other respiratory viruses as observed during the pre-COVID-19 period were not observed during the COVID-19 pandemic in years 2020 and 21. Social distancing, lock-downs, and non-pharmaceutical interventions may play an important role in the reduction of respiratory viruses. Understanding the seasonal respiratory virus decline could help public health experts prepare for future respiratory virus pandemics.
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Affiliation(s)
- Sumit Bhardwaj
- Influenza, National Institute of Virology (ICMR), Pune, India
| | | | - Sheetal Jadhav
- Influenza, National Institute of Virology (ICMR), Pune, India
| | - Veena Vipat
- Influenza, National Institute of Virology (ICMR), Pune, India
| | - Rohan Ghuge
- Influenza, National Institute of Virology (ICMR), Pune, India
| | - Sonali Salvi
- B. J. Medical College and Sassoon Hospital, Pune, India
| | | | - Aarti Kinikar
- B. J. Medical College and Sassoon Hospital, Pune, India
| | | | | | | | | | | | - Varsha Potdar
- Influenza, National Institute of Virology (ICMR), Pune, India,*Correspondence: Varsha Potdar
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50
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Jolliffe DA, Holt H, Greenig M, Talaei M, Perdek N, Pfeffer P, Vivaldi G, Maltby S, Symons J, Barlow NL, Normandale A, Garcha R, Richter AG, Faustini SE, Orton C, Ford D, Lyons RA, Davies GA, Kee F, Griffiths CJ, Norrie J, Sheikh A, Shaheen SO, Relton C, Martineau AR. Effect of a test-and-treat approach to vitamin D supplementation on risk of all cause acute respiratory tract infection and covid-19: phase 3 randomised controlled trial (CORONAVIT). BMJ 2022; 378:e071230. [PMID: 36215226 PMCID: PMC9449358 DOI: 10.1136/bmj-2022-071230] [Citation(s) in RCA: 43] [Impact Index Per Article: 21.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 07/14/2022] [Indexed: 02/07/2023]
Abstract
OBJECTIVE To determine the effect of population level implementation of a test-and-treat approach to correction of suboptimal vitamin D status (25-hydroxyvitamin D (25(OH)D) <75 nmol/L) on risk of all cause acute respiratory tract infection and covid 19. DESIGN Phase 3 open label randomised controlled trial. SETTING United Kingdom. PARTICIPANTS 6200 people aged ≥16 years who were not taking vitamin D supplements at baseline. INTERVENTIONS Offer of a postal finger prick test of blood 25(OH)D concentration with provision of a six month supply of lower dose vitamin D (800 IU/day, n=1550) or higher dose vitamin D (3200 IU/day, n=1550) to those with blood 25(OH)D concentration <75 nmol/L, compared with no offer of testing or supplementation (n=3100). Follow-up was for six months. MAIN OUTCOME MEASURES The primary outcome was the proportion of participants with at least one swab test or doctor confirmed acute respiratory tract infection of any cause. A secondary outcome was the proportion of participants with swab test confirmed covid-19. Logistic regression was used to calculate odds ratios and associated 95% confidence intervals. The primary analysis was conducted by intention to treat. RESULTS Of 3100 participants offered a vitamin D test, 2958 (95.4%) accepted and 2674 (86.3%) had 25(OH)D concentrations <75 nmol/L and received vitamin D supplements (n=1328 lower dose, n=1346 higher dose). Compared with 136/2949 (4.6%) participants in the no offer group, at least one acute respiratory tract infection of any cause occurred in 87/1515 (5.7%) in the lower dose group (odds ratio 1.26, 95% confidence interval 0.96 to 1.66) and 76/1515 (5.0%) in the higher dose group (1.09, 0.82 to 1.46). Compared with 78/2949 (2.6%) participants in the no offer group, 55/1515 (3.6%) developed covid-19 in the lower dose group (1.39, 0.98 to 1.97) and 45/1515 (3.0%) in the higher dose group (1.13, 0.78 to 1.63). CONCLUSIONS Among people aged 16 years and older with a high baseline prevalence of suboptimal vitamin D status, implementation of a population level test-and-treat approach to vitamin D supplementation was not associated with a reduction in risk of all cause acute respiratory tract infection or covid-19. TRIAL REGISTRATION ClinicalTrials.gov NCT04579640.
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Affiliation(s)
- David A Jolliffe
- Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London E1 2AT, UK
| | - Hayley Holt
- Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London E1 2AT, UK
- Asthma UK Centre for Applied Research, Queen Mary University of London, London, UK
| | - Matthew Greenig
- Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London E1 2AT, UK
| | - Mohammad Talaei
- Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London E1 2AT, UK
| | - Natalia Perdek
- Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London E1 2AT, UK
| | - Paul Pfeffer
- Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London E1 2AT, UK
| | - Giulia Vivaldi
- Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London E1 2AT, UK
| | - Sheena Maltby
- Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London E1 2AT, UK
| | | | - Nicola L Barlow
- Clinical Biochemistry Department, Black Country Pathology Services, City Hospital, Birmingham, UK
| | - Alexa Normandale
- Clinical Biochemistry Department, Black Country Pathology Services, City Hospital, Birmingham, UK
| | - Rajvinder Garcha
- Clinical Biochemistry Department, Black Country Pathology Services, City Hospital, Birmingham, UK
| | - Alex G Richter
- Institute of Immunology and Immunotherapy, College of Medical and Dental Sciences, University of Birmingham, Birmingham, UK
| | - Sian E Faustini
- Institute of Immunology and Immunotherapy, College of Medical and Dental Sciences, University of Birmingham, Birmingham, UK
| | - Christopher Orton
- Population Data Science, Swansea University Medical School, Swansea, UK
- Health Data Research UK BREATHE Hub, Swansea University, Swansea, UK
| | - David Ford
- Population Data Science, Swansea University Medical School, Swansea, UK
- Health Data Research UK BREATHE Hub, Swansea University, Swansea, UK
| | - Ronan A Lyons
- Population Data Science, Swansea University Medical School, Swansea, UK
- Health Data Research UK BREATHE Hub, Swansea University, Swansea, UK
| | - Gwyneth A Davies
- Population Data Science, Swansea University Medical School, Swansea, UK
- Health Data Research UK BREATHE Hub, Swansea University, Swansea, UK
- Asthma UK Centre for Applied Research, University of Edinburgh, Edinburgh, UK
| | - Frank Kee
- Centre for Public Health (NI), Queen's University Belfast, Belfast, UK
| | - Christopher J Griffiths
- Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London E1 2AT, UK
- Asthma UK Centre for Applied Research, Queen Mary University of London, London, UK
- Health Data Research UK BREATHE Hub, Queen Mary University of London, London, UK
| | - John Norrie
- Usher Institute, University of Edinburgh, Edinburgh, UK
- Health Data Research UK BREATHE Hub, University of Edinburgh, Edinburgh, UK
| | - Aziz Sheikh
- Asthma UK Centre for Applied Research, University of Edinburgh, Edinburgh, UK
- Usher Institute, University of Edinburgh, Edinburgh, UK
- Health Data Research UK BREATHE Hub, University of Edinburgh, Edinburgh, UK
| | - Seif O Shaheen
- Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London E1 2AT, UK
| | - Clare Relton
- Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London E1 2AT, UK
| | - Adrian R Martineau
- Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London E1 2AT, UK
- Asthma UK Centre for Applied Research, Queen Mary University of London, London, UK
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