Risk Factors for Respiratory Syncytial Virus Infections in Moderate/Late Premature Infants in Turkey: A Prospective Multicenter Epidemiological Study

Peripheral Blood and Nasopharyngeal Swab MiRNA-155 Expression in Infants with Respiratory Syncytial Virus Infection

INTRODUCTION

MicroRNA (miR) 155 has been implicated in the regulation of innate and adaptive immunity as well as antiviral responses, but its role during respiratory syncytial virus (RSV) infections is not known. The objective of this study was to investigate the expression of miR-155 using pharyngeal swabs and peripheral blood in infants with RSV infection and uninfected controls.

METHODS

A prospective age-matched study was conducted in primary care in Torino from 1 August 2018 to 31 January 2020. We enrolled 66 subjects, 29 of them patients with RSV infection and 37 age-matched uninfected controls, and collected pharyngeal swabs and peripheral blood in order to assess miR-155 expression with real-time stem-loop-TaqMan real-time PCR.

RESULTS

The data show that there is no correlation between pharyngeal swabs and peripheral blood with respect to miR-155 expression. The 1/ΔCq miR-155 expression levels in throat swabs in RSV bronchiolitis patients and healthy controls were 0.19 ± 0.11 and 0.21 ± 0.09, respectively, and were not significantly different between healthy controls and bronchiolitis (p = 0.8414). In the peripheral blood, miR-155 levels were higher than those of healthy control subjects: 0.1 ± 0.013 and 0.09 ± 0.0007, respectively; p = 0.0002.

DISCUSSION

Our data provide evidence that miR-155 expression is higher in peripheral blood during RSV infection but not in swabs. This difference in the timing of sample recruitment could explain the differences obtained in the results; miR-155 activation is probably only assessable in the very early stages of infection in the swab and remains visible for longer in the blood. New investigations are needed in order to clarify whether the miR-155 expression in swabs can be influenced by different stages of virus disease of infants.

Evaluation of Newborns with Non-COVID-19 Pneumonia Hospitalized in the Neonatal Intensive Care Unit during the COVID-19 Pandemic, Turkey, Izmir 2020–2021

Objective In this study, we aimed to compare the clinical, laboratory, and radiological findings of noncoronavirus disease 2019 (COVID-19) viral agents in newborn infants hospitalized for lower respiratory tract infection during the COVID-19 pandemic.

Methods This prospective cross-sectional study conducted between 11 March 2020 and 31 July 2021 included neonates with lower respiratory tract infections admitted to the neonatal intensive care unit of the Dr. Behcet Uz Children's Hospital. Nasopharyngeal swab samples were taken from all hospitalized patients for multiplex respiratory polymerase chain reaction (PCR) and severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) PCR. The detection of respiratory viral pathogens was performed by multiplex real-time PCR assay (Bosphore Respiratory Pathogens Panel Kit V4, Anatolia Geneworks, Turkey). Infants with SARS-CoV-2 PCR positivity were excluded from the study. Patients' data were obtained from the electronic medical registry system. The non-COVID-19 viruses of the cases were analyzed according to seasonal variation (in/off-season). The pulmonary findings of the cases were classified as normal, infiltration, air bronchogram, and reticulogranular appearance at the time of admission.

Results A total of 80 infants were included during the study period. A multiplex PCR test was performed to identify viral agents affecting the lower respiratory tract of infants; it was determined that 31% (25 out of 80) were respiratory syncytial virus (RSV), 41% (33 out of 80) were rhinovirus (Rhino), and the remaining portion (28%, 22 out of 80) were other viral agents (enterovirus, bocavirus, adenovirus, influenza, and parainfluenza). Compared with Rhino and other viral agents, RSV was detected most frequently in seasonal hospitalizations (p < 0.05). When chest radiography and laboratory findings were evaluated, the rate of “infiltration” /“lymphopenia” was significantly associated with infants with RSV lower respiratory tract infections (p < 0.05).

Conclusion During the pandemic period, RSV affected the prognosis in intensive care unit admissions due to lower respiratory tract infection in newborns.

Is respiratory syncytial virus infection more dangerous than COVID 19 in the neonatal period?

OBJECTIVE

We aimed to compare the clinical features, laboratory findings and primary outcomes of the neonates with RSV and neonates with SARS-CoV-2 infections.

MATERIALS AND METHODS

This nested case-control study included the neonates who were administered in the neonatal intensive care unit (NICU) of the University of Health Sciences, Dr Behçet Uz Children's Hospital during the period of 01 March-30 April 2020. Respiratory PCR samples and COVID-19 samples were taken simultaneously. Only RSV positive and COVID-19 positive infants were compared. Demographic, epidemiological and clinical data were obtained from hospital electronic information system medical records. The chest radiographs at the admission were evaluated by using standard definitions for normal chest X-ray, atelectasis, bronchopenumonia, peribronchial thickening and hyperinflation in various lung volumes.

RESULTS

A total of 30 infants were enrolled in the study and RSV was identified in 20/30 infants (66%). No significant differences were observed between the two groups in terms of general characteristics. Comparing to the infants with Covid-19 infections, infants with RSV infections had significantly higher rates of having oxygen support (p = .03). Total NICU duration time was 6.7 ± 1.6 days in COVID positive group and 11.1 ± 5.1 days in the RSV group (p = .01). Infants with COVID-19 had more normal chest X-rays. Infants with RSV-positive had a significantly higher proportion of atelectasis than those with COVID-19 infants (p = .04).

DISCUSSION

This is the first study that compares RSV infection and COVID-19 infection. RSV infection can be more serious in the neonatal period. In cases with suspected COVID-19 infection, it should be kept in mind if atelectasis is seen on chest radiography. Respiratory failure may be more serious in RSV positive infants and RSV infection may be more dangerous for the neonatal period.