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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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Chen Y, Zhao X, Ye C, Zhou J, Wang J, Ye X. Epidemiology and viral loads of respiratory syncytial virus in hospitalized children prior to and during COVID-19 pandemic in Hangzhou, China. J Med Virol 2024; 96:e29855. [PMID: 39119991 DOI: 10.1002/jmv.29855] [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: 03/13/2024] [Revised: 07/30/2024] [Accepted: 08/01/2024] [Indexed: 08/10/2024]
Abstract
Non-pharmaceutical interventions (NPIs) implemented to control SARS-CoV-2 have significantly influenced the activity of respiratory pathogens. This study investigated epidemiological changes among hospitalized patients with respiratory syncytial virus (RSV) before (2017-2019) and during (2020-2022) the COVID-19 pandemic in Hangzhou, China. We also examined viral load distribution across demographic and temporal variables. Nasopharyngeal swabs were collected and RSV loads were quantified using reverse transcriptase polymerase chain reaction (RT-qPCR). RSV epidemic characteristics, seasonal dynamics, and viral load distributions were compared between pre- and pandemic years. General linear models were employed to assess associations between viral loads and age. Among 19 742 cases, 1576 and 2092 tested positive during the pre- and pandemic years, respectively. From February to July 2020, the implementation of NPIs led to the cessation of RSV circulation. However, after these measures were relaxed, RSV cases resurged over two consecutive seasons during the pandemic, notably affecting older children compared to those in the pre-pandemic years (1.00 years, IQR: 0.50-2.00 vs. 0.58 years, IQR: 0.27-1.00, p < 0.001). Specifically, in 2021-2022, an off-season resurgence of RSV began earlier (mid-June), lasted longer (40 weeks), and involved more positive cases (1238 cases) than both 2020-2021 and pre-pandemic years. Viral load distribution demonstrated a clear age-related relationship in both pre- and pandemic years, with younger children consistently showing higher viral loads, independently of gender and season (all p-values for trends <0.001). These findings highlight the impact of NPIs on RSV epidemiology and underscore the need to prioritize RSV infection prevention in younger children from the perspective of viral load.
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Affiliation(s)
- Yunying Chen
- Department of Laboratory Medicine, Hangzhou Children's Hospital, Hangzhou, People's Republic of China
| | - Xinfeng Zhao
- Department of Laboratory Medicine, Hangzhou Children's Hospital, Hangzhou, People's Republic of China
| | - Cuiying Ye
- Department of Laboratory Medicine, Hangzhou Children's Hospital, Hangzhou, People's Republic of China
| | - Jun Zhou
- Department of Laboratory Medicine, Hangzhou Children's Hospital, Hangzhou, People's Republic of China
| | - Jie Wang
- Department of Laboratory Medicine, Hangzhou Children's Hospital, Hangzhou, People's Republic of China
| | - Xianfei Ye
- Department of Laboratory Medicine, the First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, People's Republic of China
- Key Laboratory of Clinical In Vitro Diagnostic Techniques of Zhejiang Province, Hangzhou, People's Republic of China
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Treggiari D, Pomari C, Zavarise G, Piubelli C, Formenti F, Perandin F. Characteristics of Respiratory Syncytial Virus Infections in Children in the Post-COVID Seasons: A Northern Italy Hospital Experience. Viruses 2024; 16:126. [PMID: 38257826 PMCID: PMC10820224 DOI: 10.3390/v16010126] [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: 11/21/2023] [Revised: 01/11/2024] [Accepted: 01/14/2024] [Indexed: 01/24/2024] Open
Abstract
BACKGROUND Public health measures for COVID-19 mitigation influenced the circulation of Respiratory Syncytial Virus (RSV) during the 2020-2021 winter season. In the following autumn, an unprecedented resurgence of RSV occurred. Our study monitored RSV pediatric infections one and two years after the relaxation of containment measures for the COVID-19 pandemic. METHODS We analyzed diagnostic molecular data for SARS-CoV-2, flu, and RSV infections and clinical data from children with respiratory symptoms referring to our hospital during the 2021-2022 and 2022-2023 seasons. RESULTS In the 2021-2022 season, the number of RSV-affected children was very high, especially for babies <1 year. The outbreak appeared in a shorter interval of time, with a high clinical severity. In the 2022-23 season, a reduced number of infected pediatric patients were detected, with a similar hospitalization rate (46% vs. 40%), and RSV accounted for 12% of the infections. Coinfections were observed in age <2 years. In RSV patients, symptoms were similar across the two seasons. CONCLUSIONS The clinical presentation of RSV in the two post-COVID seasons suggests that the pathophysiology of the virus did not change across these two years. Further studies are needed to continuously monitor RSV to support an effective prevention strategy.
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Affiliation(s)
- Davide Treggiari
- Department of Tropical, Infectious Diseases and Microbiology, IRCCS Sacro Cuore-Don Calabria Hospital, 37024 Negrar di Valpolicella, Verona, Italy; (F.F.); (F.P.)
| | - Chiara Pomari
- Andrus Center, University of Southern California, Los Angeles, CA 90089, USA;
| | - Giorgio Zavarise
- Department of Pediatrics, IRCCS Sacro Cuore-Don Calabria Hospital, 37024 Negrar di Valpolicella, Verona, Italy;
| | - Chiara Piubelli
- Department of Tropical, Infectious Diseases and Microbiology, IRCCS Sacro Cuore-Don Calabria Hospital, 37024 Negrar di Valpolicella, Verona, Italy; (F.F.); (F.P.)
| | - Fabio Formenti
- Department of Tropical, Infectious Diseases and Microbiology, IRCCS Sacro Cuore-Don Calabria Hospital, 37024 Negrar di Valpolicella, Verona, Italy; (F.F.); (F.P.)
| | - Francesca Perandin
- Department of Tropical, Infectious Diseases and Microbiology, IRCCS Sacro Cuore-Don Calabria Hospital, 37024 Negrar di Valpolicella, Verona, Italy; (F.F.); (F.P.)
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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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Souquette A, Allen EK, Oshansky CM, Tang L, Wong SS, Jeevan T, Shi L, Pounds S, Elias G, Kuan G, Balmaseda A, Zapata R, Shaw-Saliba K, Damme PV, Tendeloo VV, Dib JC, Ogunjimi B, Webby R, Schultz-Cherry S, Pekosz A, Rothman R, Gordon A, Thomas PG. Integrated Drivers of Basal and Acute Immunity in Diverse Human Populations. BIORXIV : THE PREPRINT SERVER FOR BIOLOGY 2023:2023.03.25.534227. [PMID: 36993205 PMCID: PMC10055315 DOI: 10.1101/2023.03.25.534227] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/19/2023]
Abstract
Prior studies have identified genetic, infectious, and biological associations with immune competence and disease severity; however, there have been few integrative analyses of these factors and study populations are often limited in demographic diversity. Utilizing samples from 1,705 individuals in 5 countries, we examined putative determinants of immunity, including: single nucleotide polymorphisms, ancestry informative markers, herpesvirus status, age, and sex. In healthy subjects, we found significant differences in cytokine levels, leukocyte phenotypes, and gene expression. Transcriptional responses also varied by cohort, and the most significant determinant was ancestry. In influenza infected subjects, we found two disease severity immunophenotypes, largely driven by age. Additionally, cytokine regression models show each determinant differentially contributes to acute immune variation, with unique and interactive, location-specific herpesvirus effects. These results provide novel insight into the scope of immune heterogeneity across diverse populations, the integrative effects of factors which drive it, and the consequences for illness outcomes.
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Gsenger J, Bruckner T, Ihling CM, Rehbein RM, Schnee SV, Hoos J, Manuel B, Pfeil J, Schnitzler P, Tabatabai J. RSV-CLASS -Clinical Assessment Severity Score: An easy-to-use clinical disease severity score for respiratory syncytial virus infection in hospitalized children. J Med Virol 2023; 95:e28541. [PMID: 36727642 DOI: 10.1002/jmv.28541] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2022] [Revised: 01/24/2023] [Accepted: 01/30/2023] [Indexed: 02/03/2023]
Abstract
Respiratory syncytial virus (RSV) is the most common cause of acute respiratory tract infection in infants and young children often leading to severe disease requiring hospitalization. However, validated tools for systematic assessment of disease severity are lacking. This study aimed at creating and validating a standardized, simple-to-use disease severity score for RSV infection in children-the RSV-CLASS (Clinical Assessment Severity Score). Therefore, data from over 700 RSV-infected children over six winter seasons (2014-2020) was analyzed using univariate and multiple regression analyses for the prediction of lower respiratory tract infection (LRTI) as a proxy for a severe course of the disease. Testing a broad range of respiratory symptoms, they eventually yielded seven items. Performing stepwise selection, these were reduced to the final four items: cough, tachypnea, rales, and wheezing, each receiving one point in the proposed score named RSV-CLASS. The score was calculated for children in two cohorts A and B, one for development and one for validation, with an area under the curve of 0.90 and 0.87, respectively. With a score value of 3 or 4, 97.8% and 100% of the children, respectively, were admitted with LRTI and classified correctly. The RSV-CLASS is a disease severity score based on a neutral, analytical approach using prospective data from a large study cohort. It will contribute to systematically assessing the disease severity of RSV infection and can be used for evidence-based clinical decision-making as well as for research settings.
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Affiliation(s)
- Julia Gsenger
- Center for Infectious Diseases, Virology, University Hospital Heidelberg, Heidelberg, Germany
- German Center for Infectious Diseases (DZIF), Heidelberg, Germany
| | - Thomas Bruckner
- Institute for Medical Biometry and Informatics, University of Heidelberg, Heidelberg, Germany
| | - Clara Marlene Ihling
- Center for Infectious Diseases, Virology, University Hospital Heidelberg, Heidelberg, Germany
- German Center for Infectious Diseases (DZIF), Heidelberg, Germany
- Dr. von Haunersches Kinderspital, University Hospital of the LMU Munich, Munich, Germany
| | - Rebecca Marie Rehbein
- Center for Infectious Diseases, Virology, University Hospital Heidelberg, Heidelberg, Germany
- German Center for Infectious Diseases (DZIF), Heidelberg, Germany
- Center for Child and Adolescent Medicine, University Hospital Heidelberg, Heidelberg, Germany
| | - Sarah Valerie Schnee
- Center for Infectious Diseases, Virology, University Hospital Heidelberg, Heidelberg, Germany
- German Center for Infectious Diseases (DZIF), Heidelberg, Germany
| | - Johannes Hoos
- Center for Infectious Diseases, Virology, University Hospital Heidelberg, Heidelberg, Germany
- German Center for Infectious Diseases (DZIF), Heidelberg, Germany
- Center for Child and Adolescent Medicine, University Hospital Heidelberg, Heidelberg, Germany
| | | | | | - Paul Schnitzler
- Center for Infectious Diseases, Virology, University Hospital Heidelberg, Heidelberg, Germany
| | - Julia Tabatabai
- Center for Infectious Diseases, Virology, University Hospital Heidelberg, Heidelberg, Germany
- German Center for Infectious Diseases (DZIF), Heidelberg, Germany
- Center for Child and Adolescent Medicine, University Hospital Heidelberg, Heidelberg, Germany
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7
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Taveras J, Garcia-Maurino C, Moore-Clingenpeel M, Xu Z, Mertz S, Ye F, Chen P, Cohen SH, Cohen D, Peeples ME, Ramilo O, Mejias A. Type III Interferons, Viral Loads, Age, and Disease Severity in Young Children With Respiratory Syncytial Virus Infection. J Infect Dis 2022; 227:61-70. [PMID: 36200173 PMCID: PMC10205614 DOI: 10.1093/infdis/jiac404] [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: 07/04/2022] [Revised: 09/27/2022] [Accepted: 10/03/2022] [Indexed: 01/19/2023] Open
Abstract
BACKGROUND The interplay among respiratory syncytial virus (RSV) loads, mucosal interferons (IFN), and disease severity in RSV-infected children is poorly understood. METHODS Children <2 years of age with mild (outpatients) or severe (inpatients) RSV infection and healthy controls were enrolled, and nasopharyngeal samples obtained for RSV loads and innate cytokines quantification. Patients were stratified by age (0-6 and >6-24 months) and multivariable analyses performed to identify predictors of disease severity. RESULTS In 2015-2019 we enrolled 219 RSV-infected children (78 outpatients; 141 inpatients) and 34 healthy controls. Type I, II, and III IFN concentrations were higher in children aged >6 versus 0-6 months and, like CXCL10, they were higher in outpatients than inpatients and correlated with RSV loads (P < .05). Higher IL6 concentrations increased the odds of hospitalization (odds ratio [OR], 2.30; 95% confidence interval [CI], 1.07-5.36) only in children >6 months, while higher IFN-λ2/3 concentrations had the opposite effect irrespective of age (OR, 0.38; 95% CI, .15-.86). Likewise, higher CXCL10 concentrations decreased the odds of hospitalization (OR, 0.21; 95% CI, .08-.48), oxygen administration (OR, 0.42; 95% CI, .21-.80),PICU admission (OR, 0.39; 95% CI, .20-.73), and prolonged hospitalization (OR, 0.57; 95% CI, .32-.98) irrespective of age. CONCLUSIONS Children with milder RSV infection and those aged >6 months had higher concentrations of mucosal IFNs, suggesting that maturation of mucosal IFN responses are associated with protection against severe RSV disease.
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Affiliation(s)
- Jeanette Taveras
- Department of Pediatrics, Division of Infectious Diseases, Nationwide Children's Hospital and The Ohio State College of Medicine, Columbus, Ohio, USA
| | - Cristina Garcia-Maurino
- Center for Vaccines and Immunity, Abigail Wexner Research Institute at Nationwide Children's Hospital, The Ohio State College of Medicine, Columbus, Ohio, USA
| | - Melissa Moore-Clingenpeel
- Biostatistics Core, Abigail Wexner Research Institute at Nationwide Children's Hospital, Columbus, Ohio, USA
| | - Zhaohui Xu
- Center for Vaccines and Immunity, Abigail Wexner Research Institute at Nationwide Children's Hospital, The Ohio State College of Medicine, Columbus, Ohio, USA
| | - Sara Mertz
- Center for Vaccines and Immunity, Abigail Wexner Research Institute at Nationwide Children's Hospital, The Ohio State College of Medicine, Columbus, Ohio, USA
| | - Fang Ye
- Center for Vaccines and Immunity, Abigail Wexner Research Institute at Nationwide Children's Hospital, The Ohio State College of Medicine, Columbus, Ohio, USA
| | - Phyl Chen
- Center for Vaccines and Immunity, Abigail Wexner Research Institute at Nationwide Children's Hospital, The Ohio State College of Medicine, Columbus, Ohio, USA
| | - Shira H Cohen
- Center for Vaccines and Immunity, Abigail Wexner Research Institute at Nationwide Children's Hospital, The Ohio State College of Medicine, Columbus, Ohio, USA
| | - Daniel Cohen
- Department of Pediatrics, Division of Emergency Medicine at Nationwide Children's Hospital and The Ohio State University College of Medicine, Columbus, Ohio, USA
| | - Mark E Peeples
- Center for Vaccines and Immunity, Abigail Wexner Research Institute at Nationwide Children's Hospital, The Ohio State College of Medicine, Columbus, Ohio, USA
| | - Octavio Ramilo
- Department of Pediatrics, Division of Infectious Diseases, Nationwide Children's Hospital and The Ohio State College of Medicine, Columbus, Ohio, USA
- Center for Vaccines and Immunity, Abigail Wexner Research Institute at Nationwide Children's Hospital, The Ohio State College of Medicine, Columbus, Ohio, USA
| | - Asuncion Mejias
- Department of Pediatrics, Division of Infectious Diseases, Nationwide Children's Hospital and The Ohio State College of Medicine, Columbus, Ohio, USA
- Center for Vaccines and Immunity, Abigail Wexner Research Institute at Nationwide Children's Hospital, The Ohio State College of Medicine, Columbus, Ohio, USA
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8
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Halabi KC, Wang H, Leber AL, Sánchez PJ, Ramilo O, Mejias A. Respiratory syncytial virus and SARS-CoV-2 coinfections in children. Pediatr Pulmonol 2022; 57:3158-3160. [PMID: 35997032 PMCID: PMC9538042 DOI: 10.1002/ppul.26127] [Citation(s) in RCA: 14] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/26/2022] [Revised: 08/09/2022] [Accepted: 08/21/2022] [Indexed: 01/11/2023]
Affiliation(s)
- Katia C Halabi
- Department of Pediatrics, Division of Infectious Diseases, Nationwide Children's Hospital, The Ohio State University College of Medicine, Columbus, Ohio, USA
| | - Huanyu Wang
- Department of Laboratory Medicine, Nationwide Children's Hospital, Columbus, Ohio, USA
| | - Amy L Leber
- Department of Laboratory Medicine, Nationwide Children's Hospital, Columbus, Ohio, USA
| | - Pablo J Sánchez
- Department of Pediatrics, Division of Infectious Diseases, Nationwide Children's Hospital, The Ohio State University College of Medicine, Columbus, Ohio, USA.,Center for Perinatal Research, Abigail Wexner Research Institute at Nationwide Children's Hospital, Columbus, Ohio, USA.,Department of Pediatrics, Division of Neonatology, Nationwide Children's Hospital, The Ohio State University College of Medicine, Columbus, Ohio, USA
| | - Octavio Ramilo
- Department of Pediatrics, Division of Infectious Diseases, Nationwide Children's Hospital, The Ohio State University College of Medicine, Columbus, Ohio, USA.,Center for Vaccines and Immunity, Abigail Wexner Research Institute at Nationwide Children's Hospital, Columbus, Ohio, USA
| | - Asuncion Mejias
- Department of Pediatrics, Division of Infectious Diseases, Nationwide Children's Hospital, The Ohio State University College of Medicine, Columbus, Ohio, USA.,Center for Vaccines and Immunity, Abigail Wexner Research Institute at Nationwide Children's Hospital, Columbus, Ohio, USA
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9
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Hurme P, Komulainen M, Tulkki M, Leino A, Rückert B, Turunen R, Vuorinen T, Akdis M, Akdis CA, Jartti T. Cytokine expression in rhinovirus- vs. respiratory syncytial virus-induced first wheezing episode and its relation to clinical course. Front Immunol 2022; 13:1044621. [PMID: 36451824 PMCID: PMC9702984 DOI: 10.3389/fimmu.2022.1044621] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2022] [Accepted: 10/14/2022] [Indexed: 09/26/2023] Open
Abstract
Rhinovirus (RV) and respiratory syncytial virus (RSV) are common causes of bronchiolitis. Unlike an RSV etiology, an RV etiology is associated with a markedly increased risk of asthma. We investigated the cytokine profiles of RV- and RSV-induced first wheezing episode and their correlation with prognosis. We recruited 52 sole RV- and 11 sole RSV-affected children with a severe first wheezing episode. Peripheral blood mononuclear cells (PBMCs) were isolated during acute illness and 2 weeks later and stimulated in vitro with anti-CD3/anti-CD28. Culture medium samples were analyzed for 56 different cytokines by multiplex ELISA. Recurrences were prospectively followed for 4 years. In adjusted analyses, the cytokine response from PBMCs in the RV group was characterized by decreased expression of interleukin 1 receptor antagonist (IL-1RA), interleukin 1 beta (IL-1β), and monocyte chemoattractant protein-1 (MCP-1) and increased expression of eosinophil chemotactic protein 2 (eotaxin-2), thymus- and activation-regulated chemokine (TARC), and epithelial-derived neutrophil-activating peptide 78 (ENA-78) in the acute phase and increased expression of fractalkine in the convalescent phase compared to those in the RSV group. An analysis of the change in cytokine expression between study points revealed an increased expression of fractalkine and IL-1β and decreased expression of I-309 (CCL1) and TARC in the RV group compared to those in the RSV group.. Considering hospitalization time, a significant non-adjusted group × cytokine interaction was observed in the levels of interferon gamma (IFN-γ), macrophage-derived chemokine (MDC), IL-1RA, and vascular endothelial growth factor (VEGF), indicating that a higher expression of cytokine was associated with shorter hospitalization time in the RSV group but not in the RV group. A significant interaction was also found in interleukin 6 (IL-6), but the cytokine response was not associated with hospitalization time in the RSV or RV group. In the RV group, increased expression of I-309 (CCL1) and TARC was associated with fewer relapses within 2 months, and decreased expression of interleukin 13 (IL-13) and increased expression of I-309 (CCL1) were associated with less relapses within 12 months. Differences in cytokine response from PBMCs were observed between RV- and RSV-induced first severe wheezing episode. Our findings also reveal new biomarkers for short- and medium-term prognosis in first-time wheezing children infected with RV or RSV.
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Affiliation(s)
- Pekka Hurme
- Department of Pediatrics and Adolescent Medicine, Turku University Hospital and University of Turku, Turku, Finland
| | - Miisa Komulainen
- Department of Pediatrics and Adolescent Medicine, Turku University Hospital and University of Turku, Turku, Finland
| | - Marleena Tulkki
- Department of Pediatrics and Adolescent Medicine, Turku University Hospital and University of Turku, Turku, Finland
| | - Annamari Leino
- Department of Pediatrics and Adolescent Medicine, Turku University Hospital and University of Turku, Turku, Finland
| | - Beate Rückert
- Swiss Institute of Allergy and Asthma Research (SIAF), University of Zürich, Christine Kühne-Center for Allergy Research and Education (CK-CARE), Davos, Switzerland
| | - Riitta Turunen
- Department of Pediatrics and Adolescent Medicine, Turku University Hospital and University of Turku, Turku, Finland
- New Children’s Hospital, Helsinki University Hospital and University of Helsinki, Helsinki, Finland
| | - Tytti Vuorinen
- Institute of Biomedicine, University of Turku, Turku, Finland
- Department of Clinical Microbiology, Turku University Hospital, Turku, Finland
| | - Mübeccel Akdis
- Swiss Institute of Allergy and Asthma Research (SIAF), University of Zürich, Christine Kühne-Center for Allergy Research and Education (CK-CARE), Davos, Switzerland
| | - Cezmi A. Akdis
- Swiss Institute of Allergy and Asthma Research (SIAF), University of Zürich, Christine Kühne-Center for Allergy Research and Education (CK-CARE), Davos, Switzerland
| | - Tuomas Jartti
- Department of Pediatrics and Adolescent Medicine, Turku University Hospital and University of Turku, Turku, Finland
- PEDEGO Research Unit, Medical Research Center, University of Oulu, Oulu, Finland
- Department of Pediatrics and Adolescent Medicine, Oulu University Hospital, Oulu, Finland
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10
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Colazo Salbetti MB, Boggio GA, Abbiatti G, Montañez Sandoz A, Villarreal V, Torres E, Pedranti M, Zalazar JA, Moreno L, Adamo MP. Diagnosis and clinical significance of Human bocavirus 1 in children hospitalized for lower acute respiratory infection: molecular detection in respiratory secretions and serum. J Med Microbiol 2022; 71. [DOI: 10.1099/jmm.0.001595] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
Introduction. Human bocavirus 1 (HBoV1) infection occurs with viral genome presence in respiratory secretions (RS) and serum, and therefore both samples can be used for diagnosis.
Gap statement. The diagnostic sensitivity of HBoV1 DNA detection in serum and the duration of DNAaemia in severe clinical cases have not been elucidated.
Aim. To determine HBoV1 DNA in serum and RS of paediatric patients hospitalized for lower acute respiratory infection (LARI) and to analyse the clinical–epidemiological features of positive cases.
Methodology. This was a prospective, transverse study. Physicians selected the clinical situations and obtained paired clinical samples (RS and serum) that were tested by PCR/qPCR for HBoV1. Positive cases were analysed considering time of specimen collection, co-detection, clinical manifestations and viral load; statistical significant level was set at α=0.05.
Results. HBoV1 was detected in 98 of 402 cases included (24 %); 18/98 (18 %) patients had the virus detectable in serum and 91/98 (93 %) in RS (P<0.001). Positivity rates were not significantly different in patients with RS and serum collected within or beyond 24 h of admission. Single HBoV1 infection was identified in 39/98 patients (40 %), three patients had HBoV1 in both clinical samples (3/39, 8 %) and 32 (32/39, 82 %) only in RS, 22 of them (69 %) with both clinical samples within 24 h of admission. Cough (P=0.001) and rhinitis (P=0.003) were significantly frequent among them and most patients were diagnosed with bronchiolitis (22/39, 56 %) and pneumonia (9/39, 23 %), which was more frequent compared to cases with co-infection (P=0.04). No significant differences were identified among patients with high, medium or low viral load of HBoV1 regarding rate of positivity in both clinical samples, the time of collection of RS and serum, co-detection, first episode of LARI, clinical manifestations, comorbidity or requirement for assisted ventilation. Intensive care unit (ICU) patients had a significantly higher frequency of detection (P<0.001) and co-detection (P=0.001) compared to patients on standard care.
Conclusions. HBoV1 is prevalent among infant patients hospitalized for LARI and including it in the standard testing can add to the aetiological diagnosis in these cases, especially for patients admitted to the ICU. HBoV1 detection in serum did not contribute significantly to the diagnosis as compared to detection in respiratory secretions.
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Affiliation(s)
- Maria Belen Colazo Salbetti
- Instituto de Virología “Dr. J. M. Vanella”, Facultad de Ciencias Médicas, Universidad Nacional de Córdoba, Córdoba, Argentina
| | - Gabriel Amilcar Boggio
- Clínica Privada Vélez Sársfield, Córdoba, Argentina
- Hospital de Niños de la Santísima Trinidad de Córdoba, Argentina
- Cátedra de Clínica Pediátrica, Facultad de Ciencias Médicas, Universidad Nacional de Córdoba, Argentina
| | | | | | | | - Erika Torres
- Hospital de Niños de la Santísima Trinidad de Córdoba, Argentina
| | - Mauro Pedranti
- Instituto de Virología “Dr. J. M. Vanella”, Facultad de Ciencias Médicas, Universidad Nacional de Córdoba, Córdoba, Argentina
| | | | - Laura Moreno
- Cátedra de Clínica Pediátrica, Facultad de Ciencias Médicas, Universidad Nacional de Córdoba, Argentina
| | - Maria Pilar Adamo
- Instituto de Virología “Dr. J. M. Vanella”, Facultad de Ciencias Médicas, Universidad Nacional de Córdoba, Córdoba, Argentina
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11
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Rodriguez-Fernandez R, González-Sánchez MI, Perez-Moreno J, González-Martínez F, de la Mata Navazo S, Mejias A, Ramilo O. Age and respiratory syncytial virus etiology in bronchiolitis clinical outcomes. THE JOURNAL OF ALLERGY AND CLINICAL IMMUNOLOGY. GLOBAL 2022; 1:91-98. [PMID: 37781264 PMCID: PMC10509905 DOI: 10.1016/j.jacig.2022.05.005] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/20/2021] [Revised: 03/25/2022] [Accepted: 05/13/2022] [Indexed: 10/03/2023]
Abstract
Background Respiratory syncytial virus (RSV) is the most frequent cause of bronchiolitis. Precise and updated information about demographic characteristics, clinical manifestations, and risk factors for severe disease are needed for optimal implementation of upcoming new therapeutic and preventive interventions. Objectives The main goals of this study were to define the epidemiology of acute bronchiolitis in hospitalized young children during 5 calendar years in Spain; evaluate the differences in clinical manifestations between children hospitalized with RSV infection and those hospitalized with non-RSV infection; and identify demographic characteristics, clinical parameters, and risk factors associated with disease severity. Methods We performed a retrospective review of the medical records of children younger than 2 years who were hospitalized with bronchiolitis between January 2015 and December 2019. We constructed multivariable models to identify independent predictors of disease severity defined as length of hospital stay (LOS), pediatric intensive care unit (PICU) admission, and need for a high-flow-nasal canula (HFNC). Results From January 2015 to December 2019, 1437 children were hospitalized with bronchiolitis and met the inclusion criteria. The proportion of children hospitalized with bronchiolitis caused by RSV increased significantly during the study period, from 60% to 65% (P = .03). The children with RSV bronchiolitis were younger than those with non-RSV bronchiolitis (median age = 3 months [interquartile range = 1.5-6.5 months] vs 4 months [interquartile range = 2-7.5 months], respectively (P < .01). The children younger than 6 months with RSV bronchiolitis had enhanced disease severity compared with those with non-RSV bronchiolitis, as defined by an LOS of more than 4 days, severity scores, need for an HFNC, intravenous fluids, enteral feeding, and PICU admissions (P < .01). Age younger than 6 months and RSV-positive etiology were independently associated with greater odds of PICU admission, need for an HFNC, and longer LOS. Conclusion This study identified differences in disease severity between young children with RSV bronchiolitis and those with non-RSV bronchiolitis. These differences are particularly significant in children younger than 6 months, who comprise a group of infants with suboptimal innate immunity to RSV and may benefit from new preventive strategies.
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Affiliation(s)
- Rosa Rodriguez-Fernandez
- Department of Pediatrics, Hospital Infantil Gregorio Marañón, Madrid, Spain
- Instituto de Investigación Sanitaria Gregorio Marañón, Madrid, Spain
| | - María Isabel González-Sánchez
- Department of Pediatrics, Hospital Infantil Gregorio Marañón, Madrid, Spain
- Instituto de Investigación Sanitaria Gregorio Marañón, Madrid, Spain
| | - Jimena Perez-Moreno
- Department of Pediatrics, Hospital Infantil Gregorio Marañón, Madrid, Spain
- Instituto de Investigación Sanitaria Gregorio Marañón, Madrid, Spain
| | - Felipe González-Martínez
- Department of Pediatrics, Hospital Infantil Gregorio Marañón, Madrid, Spain
- Instituto de Investigación Sanitaria Gregorio Marañón, Madrid, Spain
| | - Sara de la Mata Navazo
- Department of Pediatrics, Hospital Infantil Gregorio Marañón, Madrid, Spain
- Instituto de Investigación Sanitaria Gregorio Marañón, Madrid, Spain
| | - Asuncion Mejias
- Division of Pediatric Infectious Diseases and Center for Vaccines and Immunity, Abigail Wexner Research Institute at Nationwide Children’s Hospital, The Ohio State University College of Medicine, Columbus, Ohio
| | - Octavio Ramilo
- Division of Pediatric Infectious Diseases and Center for Vaccines and Immunity, Abigail Wexner Research Institute at Nationwide Children’s Hospital, The Ohio State University College of Medicine, Columbus, Ohio
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12
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Chirkova T, Rosas-Salazar C, Gebretsadik T, Jadhao SJ, Chappell JD, Peebles RS, Dupont WD, Newcomb DC, Berdnikovs S, Gergen PJ, Hartert TV, Anderson LJ. Effect of Infant RSV Infection on Memory T Cell Responses at Age 2-3 Years. Front Immunol 2022; 13:826666. [PMID: 35371035 PMCID: PMC8967987 DOI: 10.3389/fimmu.2022.826666] [Citation(s) in RCA: 14] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2021] [Accepted: 02/23/2022] [Indexed: 11/13/2022] Open
Abstract
Background It is unknown whether RSV infection in infancy alters subsequent RSV immune responses. Methods In a nested cohort of healthy, term children, peripheral blood mononuclear cells (PBMCs) were collected at ages 2-3 years to examine RSV memory T cell responses among children previously RSV infected during infancy (first year of life) compared to those RSV-uninfected during infancy. The presence vs. absence of infant RSV infection was determined through a combination of RSV molecular and serologic testing. Memory responses were measured in RSV stimulated PBMCs. Results Compared to children not infected with RSV during the first year of life, children infected with RSV during infancy had lower memory T cell responses at ages 2-3 years to in vitro stimulation with RSV for most tested type-1 and type-17 markers for a number of memory T cell subsets. Conclusions RSV infection in infancy has long-term effects on memory T cell responses. This is the first study to show the potential for RSV infection in infancy to have long-term effects on the immune memory irrespective of the severity of the infection. Our results suggest a possible mechanism through which infant RSV infection may result in greater risk of subsequent childhood respiratory viral morbidity, findings also relevant to vaccine development.
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Affiliation(s)
- Tatiana Chirkova
- Department of Pediatrics, Emory University School of Medicine and Children’s Healthcare of Atlanta, Atlanta, GA, United States
| | - Christian Rosas-Salazar
- Department of Pediatrics, Vanderbilt University Medical Center, Nashville, TN, United States
| | - Tebeb Gebretsadik
- Department of Biostatistics, Vanderbilt University Medical Center, Nashville, TN, United States
| | - Samadhan J. Jadhao
- Department of Pediatrics, Emory University School of Medicine and Children’s Healthcare of Atlanta, Atlanta, GA, United States
| | - James D. Chappell
- Department of Pediatrics, Vanderbilt University Medical Center, Nashville, TN, United States
| | - R. Stokes Peebles
- Department of Medicine, Vanderbilt University Medical Center, Nashville, TN, United States
| | - William D. Dupont
- Department of Biostatistics, Vanderbilt University Medical Center, Nashville, TN, United States
| | - Dawn C. Newcomb
- Department of Medicine, Vanderbilt University Medical Center, Nashville, TN, United States
| | - Sergejs Berdnikovs
- Department of Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL, United States
| | - Peter J. Gergen
- Division of Allergy, Immunology and Transplantation, National Institute of Allergy and Infectious Diseases, Rockville, MD, United States
| | - Tina V. Hartert
- Department of Pediatrics, Vanderbilt University Medical Center, Nashville, TN, United States
- Department of Medicine, Vanderbilt University Medical Center, Nashville, TN, United States
| | - Larry J. Anderson
- Department of Pediatrics, Emory University School of Medicine and Children’s Healthcare of Atlanta, Atlanta, GA, United States
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13
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Li YC, Ma Z, Zhong HY, You HL. Clinical characteristics of children with omicron SARS-CoV-2 infection in Changchun, China from march to april 2022: A retrospective study. Front Pediatr 2022; 10:990944. [PMID: 36458144 PMCID: PMC9705729 DOI: 10.3389/fped.2022.990944] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/11/2022] [Accepted: 10/31/2022] [Indexed: 11/17/2022] Open
Abstract
BACKGROUND Recently, there was an outbreak in China of the Omicron (B.1.1.529) variant, the corresponding clinical characteristics of Chinese children with the Omicron variant of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection were then reviewed and summarized retrospectively. METHODS From March to April 2022, a total of 134 children infected with the Omicron variant were included in the study. Data such as sex, age, clinical symptoms, laboratory examinations, and imaging features were collected for further analyses. RESULTS Half of the children were male and the median age was 5.67 years. The most SARS-CoV-2 Omicron variant was identified in mild (122, 91%), and the most three frequent symptoms were as cough (108, 80.6%), fever (75, 56%), and sore throat (38, 28.4%). Among age groups, no significant difference was observed in the distribution of symptoms, and no statistical difference was found in different clinical types among sex or age groups. Laboratory examinations revealed that white blood cells, neutrophils, and hemoglobin decreased; and monocytes, C-reactive protein (CRP), and aspartate aminotransferase (AST) increased. Further analyses showed that neutrophils, hemoglobin, CRP, and AST exhibited significant differences among age groups. Radiological abnormalities were found in nine cases, with small patchy high-density shadows. Of the 76 cured cases discharged from the hospital, the median hospital stay was 13 days (mean, 12 days). CONCLUSIONS In China, most children with Omicron SARS-CoV-2 infection have mild presentation. The findings of this study may help other districts improve the management of children with Omicron SARS-CoV-2 infection in China.
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Affiliation(s)
- Yan-Chun Li
- Department of Pediatrics, The First Hospital of Jilin University, Changchun, China
| | - Zhen Ma
- Department of Pediatrics, The First Hospital of Jilin University, Changchun, China
| | - Hua-Ying Zhong
- Department of Pediatrics, The First Hospital of Jilin University, Changchun, China
| | - Hai-Long You
- Department of Pediatrics, The First Hospital of Jilin University, Changchun, China
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14
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Diaz-Diaz A, Bunsow E, Garcia-Maurino C, Moore-Clingenpeel M, Naples J, Juergensen A, Mertz S, Wang H, Leber AL, Gern J, Hall MW, Cohen DM, Ramilo O, Mejias A. Nasopharyngeal Codetection of H. influenzae and S. pneumoniae and Respiratory Syncytial Virus Disease Outcomes in Children. J Infect Dis 2021; 225:912-923. [PMID: 34543409 DOI: 10.1093/infdis/jiab481] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2021] [Accepted: 09/16/2021] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND The role of nasopharyngeal bacteria on RSV disease has been underestimated. We measured the frequency and quantitative detection of potentially pathogenic bacteria in the upper respiratory tract of infants with RSV infection over seven respiratory seasons, and their impact on clinical outcomes. METHODS Children <2 years old with mild (outpatients; n=115) or severe (inpatients; n=566) RSV infection, and matched healthy controls (n=161) were prospectively enrolled. Nasopharyngeal samples were obtained for RSV, S. pneumoniae, S. aureus, M. catarrhalis, and H. influenzae detection and quantitation by PCR. Multivariable models were constructed to identify variables predictive of severe disease. RESULTS S. pneumoniae, H. influenzae, and M. catarrhalis, but not S. aureus, were detected more frequently in RSV-infected children (84%) than healthy controls (46%; p<0.001). Detection of S. pneumoniae and/or H. influenzae was associated with fever, more frequent antibiotic treatment, worse radiologic findings, and higher neutrophil counts (p<0.01). In adjusted analyses S. pneumoniae/H. influenzae co-detection was associated with greater odds (OR; 95% CI) of hospitalization (2.25 [1.07-4.74), higher disease severity scores (1.93 [1.14-3.26]), prolonged oxygen administration (2.23 [1.01-4.91]), and longer hospitalization (2.53 [1.33-4.79]). CONCLUSIONS Nasopharyngeal co-detection of S. pneumoniae and H. influenzae in infants with RSV infection is associated with increased disease severity.
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Affiliation(s)
- Alejandro Diaz-Diaz
- Division of Infectious Diseases, Department of Pediatrics, Nationwide Children's Hospital-The Ohio State University College of Medicine, Columbus, OH, USA
| | - Eleonora Bunsow
- Center for Vaccines & Immunity, Abigail Wexner Research Institute at Nationwide Children's Hospital, Columbus, OH, USA
| | - Cristina Garcia-Maurino
- Center for Vaccines & Immunity, Abigail Wexner Research Institute at Nationwide Children's Hospital, Columbus, OH, USA
| | - Melissa Moore-Clingenpeel
- Biostatistics Resource Core, Abigail Wexner Research Institute at Nationwide Children's Hospital, Columbus, OH, USA
| | - Jeffrey Naples
- Division of Critical Care Medicine, Department of Pediatrics, Nationwide Children's Hospital, Columbus, OH, USA
| | - Alexis Juergensen
- Center for Vaccines & Immunity, Abigail Wexner Research Institute at Nationwide Children's Hospital, Columbus, OH, USA
| | - Sara Mertz
- Center for Vaccines & Immunity, Abigail Wexner Research Institute at Nationwide Children's Hospital, Columbus, OH, USA
| | - Huanyu Wang
- Department of Laboratory Medicine, Nationwide Children's Hospital, Columbus, OH, USA
| | - Amy L Leber
- Department of Laboratory Medicine, Nationwide Children's Hospital, Columbus, OH, USA
| | - James Gern
- Department of Pediatrics. University of Wisconsin, School of Medicine and Public Health. Madison WI, USA
| | - Mark W Hall
- Division of Critical Care Medicine, Department of Pediatrics, Nationwide Children's Hospital, Columbus, OH, USA
| | - Daniel M Cohen
- Division of Emergency Medicine, Department of Pediatrics, Nationwide Children's Hospital, Columbus, OH, USA
| | - Octavio Ramilo
- Division of Infectious Diseases, Department of Pediatrics, Nationwide Children's Hospital-The Ohio State University College of Medicine, Columbus, OH, USA.,Center for Vaccines & Immunity, Abigail Wexner Research Institute at Nationwide Children's Hospital, Columbus, OH, USA
| | - Asuncion Mejias
- Division of Infectious Diseases, Department of Pediatrics, Nationwide Children's Hospital-The Ohio State University College of Medicine, Columbus, OH, USA.,Center for Vaccines & Immunity, Abigail Wexner Research Institute at Nationwide Children's Hospital, Columbus, OH, USA
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15
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Khan S, Dobrovolny HM. A study of the effects of age on the dynamics of RSV in animal models. Virus Res 2021; 304:198524. [PMID: 34329697 DOI: 10.1016/j.virusres.2021.198524] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2021] [Revised: 06/24/2021] [Accepted: 07/17/2021] [Indexed: 01/18/2023]
Abstract
Respiratory syncytial virus can cause severe illness and even death, particularly in infants. The increased severity of disease in young children is thought to be due to a lack of previous exposure to the virus as well as the limited immune response in infants. While studies have examined the clinical differences in disease between infants and adults, there has been limited examination of how the viral dynamics differ as infants develop. In this study, we apply a mathematical model to data from cotton rats and ferrets of different ages to assess how viral kinetics parameters change as the animals age. We find no clear trend in the viral decay rate, infecting time, and basic reproduction number as the animals age. We discuss possible reasons for the null result including the limited data, lack of detail of the mathematical model, and the limitations of animal models.
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Affiliation(s)
- Shaheer Khan
- Department of Physics and Astronomy, Texas Christian University, Fort Worth, TX USA
| | - Hana M Dobrovolny
- Department of Physics and Astronomy, Texas Christian University, Fort Worth, TX USA.
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16
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Takashima MD, Grimwood K, Sly PD, Lambert SB, Chappell KJ, Watterson D, Ware RS. Epidemiology of respiratory syncytial virus in a community birth cohort of infants in the first 2 years of life. Eur J Pediatr 2021; 180:2125-2135. [PMID: 33634335 DOI: 10.1007/s00431-021-03998-0] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/22/2020] [Revised: 02/01/2021] [Accepted: 02/17/2021] [Indexed: 02/07/2023]
Abstract
Respiratory syncytial virus (RSV) is the most common virus identified in children hospitalised with acute respiratory infections. However, less is known about RSV in community settings. This report describes RSV epidemiology in the community, including acute illness episodes, healthcare burden, and risk factors in Australian children during the first 2-years of life. A community-based, birth cohort from Brisbane, Australia, followed children until their second birthday. Parents completed daily respiratory symptom and illness-burden diaries. Weekly parent-collected nasal swabs were analysed for RSV by real-time polymerase chain reaction assays. Serum RSV-neutralising antibodies were assayed at age 3 years. Overall, 158 children provided 11,216 swabs, of which 104 were RSV-positive (85 incident episodes). RSV incidence in the first 2 years of life was 0.46 (95% CI = 0.37-0.58) episodes per child-year. Incidence increased with age and formal childcare attendance and was highest in autumn. Of 82 episodes linked with symptom data, 60 (73.2%) were symptomatic, 28 (34.1%) received community-based medical care, and 2 (2.4%) led to hospitalisation. Viral load was higher in symptomatic than asymptomatic infections. In 72 children, RSV-specific antibody seroprevalence was 94.4% at age 3 years.Conclusion: RSV incidence increased after age 6-months with approximately three-quarters of infections symptomatic and most infections treated in the community. What is known •RSV is a major cause of hospitalisation for acute lower respiratory infections in infants and young children, especially in the first 6 months of life. •However, limited data exist on the overall burden in young children at the community level. What is new •RSV incidence in the community increases after age 6 months, and by 3 years, most children have been infected. •About one-quarter of RSV infections were asymptomatic in children aged < 2 years, and approximately 60% of children with RSV-related symptoms had a healthcare contact of any kind with most managed within the community.
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Affiliation(s)
- Mari D Takashima
- Menzies Health Institute Queensland and School of Medicine, Griffith University, Gold Coast, Queensland, 4222, Australia.
- School of Medicine, Griffith University Nathan Campus, QLD, Nathan, 4111, Australia.
| | - Keith Grimwood
- Menzies Health Institute Queensland and School of Medicine, Griffith University, Gold Coast, Queensland, 4222, Australia
- Departments of Infectious Diseases and Paediatrics, Gold Coast Health, Gold Coast, Queensland, 4215, Australia
| | - Peter D Sly
- Children's Health and Environment Program, Child Health Research Centre, The University of Queensland, South Brisbane, Queensland, 4101, Australia
- Australian Infectious Diseases Research Centre, The University of Queensland, St Lucia, Queensland, 4072, Australia
| | - Stephen B Lambert
- The Australian National University, Canberra, Australian Capital Territory, 2600, Australia
| | - Keith J Chappell
- Australian Infectious Diseases Research Centre, The University of Queensland, St Lucia, Queensland, 4072, Australia
- School of Chemistry and Molecular Biosciences, The University of Queensland, St Lucia, Queensland, 4072, Australia
| | - Daniel Watterson
- Australian Infectious Diseases Research Centre, The University of Queensland, St Lucia, Queensland, 4072, Australia
- School of Chemistry and Molecular Biosciences, The University of Queensland, St Lucia, Queensland, 4072, Australia
| | - Robert S Ware
- Menzies Health Institute Queensland and School of Medicine, Griffith University, Gold Coast, Queensland, 4222, Australia
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17
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Mejias A, Brenes-Chacon H, Garcia-Mauriño C, Moore-Clingenpeel M, Ramilo O. Clinical Disease Severity Scores and Viral Loads in Children With Respiratory Syncytial Virus Infection. Clin Infect Dis 2021; 72:e1160-e1162. [PMID: 33215632 DOI: 10.1093/cid/ciaa1752] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Affiliation(s)
- Asuncion Mejias
- Center for Vaccines and Immunity Abigail Wexner Research Institute, Department of Pediatrics at Nationwide Children's Hospital, Columbus, OH, USA.,Division of nfectious Diseases, Department of Pediatrics, Nationwide Children's Hospital and The Ohio State University College of Medicine, Columbus, OH, USA.,Departamento de Farmacologia y Pediatria, Facultad de Medicina, Universidad de Malaga, Malaga, Spain
| | - Helena Brenes-Chacon
- Center for Vaccines and Immunity Abigail Wexner Research Institute, Department of Pediatrics at Nationwide Children's Hospital, Columbus, OH, USA
| | - Cristina Garcia-Mauriño
- Center for Vaccines and Immunity Abigail Wexner Research Institute, Department of Pediatrics at Nationwide Children's Hospital, Columbus, OH, USA
| | - Melissa Moore-Clingenpeel
- Biostatistics Core, Abigail Wexner Research Institute at Nationwide Children's Hospital, Columbus, OH, USA
| | - Octavio Ramilo
- Center for Vaccines and Immunity Abigail Wexner Research Institute, Department of Pediatrics at Nationwide Children's Hospital, Columbus, OH, USA.,Division of nfectious Diseases, Department of Pediatrics, Nationwide Children's Hospital and The Ohio State University College of Medicine, Columbus, OH, USA
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