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Gantenberg JR, van Aalst R, Bhuma MR, Limone B, Diakun D, Smith DM, Nelson CB, Bengtson AM, Chaves SS, La Via WV, Rizzo C, Savitz DA, Zullo AR. Risk Analysis of Respiratory Syncytial Virus Among Infants in the United States by Birth Month. J Pediatric Infect Dis Soc 2024; 13:317-327. [PMID: 38738450 PMCID: PMC11212365 DOI: 10.1093/jpids/piae042] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/09/2023] [Accepted: 05/10/2024] [Indexed: 05/14/2024]
Abstract
BACKGROUND Respiratory syncytial virus (RSV) is a major cause of morbidity and mortality among US infants. A child's calendar birth month determines their age at first exposure(s) to RSV. We estimated birth month-specific risk of medically attended (MA) RSV lower respiratory tract infection (LRTI) among infants during their first RSV season and first year of life (FYOL). METHODS We analyzed infants born in the USA between July 2016 and February 2020 using three insurance claims databases (two commercial, one Medicaid). We classified infants' first MA RSV LRTI episode by the highest level of care incurred (outpatient, emergency department, or inpatient), employing specific and sensitive diagnostic coding algorithms to define index RSV diagnoses. In our main analysis, we focused on infants' first RSV season. In our secondary analysis, we compared the risk of MA RSV LRTI during infants' first RSV season to that of their FYOL. RESULTS Infants born from May through September generally had the highest risk of first-season MA RSV LRTI-approximately 6-10% under the specific RSV index diagnosis definition and 16-26% under the sensitive. Infants born between October and December had the highest risk of RSV-related hospitalization during their first season. The proportion of MA RSV LRTI events classified as inpatient ranged from 9% to 54% (specific) and 5% to 33% (sensitive) across birth month and comorbidity group. Through the FYOL, the overall risk of MA RSV LRTI is comparable across birth months within each claims database (6-11% under the specific definition, 17-30% under the sensitive), with additional cases progressing to care at outpatient or ED settings. CONCLUSIONS Our data support recent national recommendations for the use of nirsevimab in the USA. For infants born at the tail end of an RSV season who do not receive nirsevimab, a dose administered prior to the onset of their second RSV season could reduce the incidence of outpatient- and ED-related events.
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Affiliation(s)
- Jason R Gantenberg
- Department of Health Services, Policy and Practice, Brown University School of Public Health, Providence, Rhode Island, USA
- Department of Epidemiology, Brown University School of Public Health, Providence, Rhode Island, USA
| | - Robertus van Aalst
- Department of Health Services, Policy and Practice, Brown University School of Public Health, Providence, Rhode Island, USA
- Department of Modeling, Epidemiology, and Data Science, Vaccines Medical Affairs, Sanofi, Lyon, France
- Department of Health Sciences, University Medical Center Groningen, University of Groningen, Groningen, the Netherlands
| | - Monika Reddy Bhuma
- Department of Health Services, Policy and Practice, Brown University School of Public Health, Providence, Rhode Island, USA
| | | | | | | | | | | | - Sandra S Chaves
- Department of Modeling, Epidemiology, and Data Science, Vaccines Medical Affairs, Sanofi, Lyon, France
| | | | | | - David A Savitz
- Department of Epidemiology, Brown University School of Public Health, Providence, Rhode Island, USA
| | - Andrew R Zullo
- Department of Health Services, Policy and Practice, Brown University School of Public Health, Providence, Rhode Island, USA
- Department of Epidemiology, Brown University School of Public Health, Providence, Rhode Island, USA
- Providence VA Medical Center, Providence, Rhode Island, USA
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Shi C, Wu MH, Zuo A, Yang MM, Jiang RR. Clinical analysis of 114 cases of bronchiolitis in infants. World J Clin Cases 2023; 11:8284-8290. [PMID: 38130614 PMCID: PMC10731204 DOI: 10.12998/wjcc.v11.i35.8284] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/22/2023] [Revised: 10/12/2023] [Accepted: 12/04/2023] [Indexed: 12/14/2023] Open
Abstract
BACKGROUND Bronchiolitis is a common lower respiratory tract infection in infants and young children. Severe cases may be accompanied by obvious dyspnea and oxygen saturation decline. AIM To summarize the clinical features, standard diagnosis, and treatment of bronchiolitis. METHODS This is a retrospective analysis of 114 pediatric patients (74 males, 40 females) who were first diagnosed as having bronchioles at the Department of Pediatrics of Tongling Maternal and Child Health Hospital from January 2019 to December 2019. The clinical features, imaging features, treatment, and other clinical data were recorded and analyzed. RESULTS The age of onset of the disease was mainly from 1 mo to 6 mo (75.4%), and the time to hospital visit was mostly from the 2nd day to the 4th day of the course of the disease (75.4%). Lung imaging examination showed increase in lung texture, fuzzy (93.8%). The main treatment was atomization therapy: Budesonide combined with terbutaline (45.6%) and budesonide combined with salbutamol (38.5%). The average hospitalization time was 7.1 ± 2.4 d, and the overall cure rate was 94.7%. In patients without bacterial infection, the use of antibiotics significantly prolonged the length of hospital stay (7.8 ± 2.5 d vs 5.7 ± 1.8 d) and improved the cure rate (98.3% vs 87.9%, P < 0.05). CONCLUSION Infants with bronchiolitis are mainly male and tend to have a good prognosis. However, the unneeded use of antibiotics may prolong the length of hospital stay significantly, which imposes the burden both on the patients and hospital system.
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Affiliation(s)
- Cheng Shi
- Department of Pediatrics, Tongling Maternal and Child Health Hospital, Tongling 244000, Anhui Province, China
| | - Meng-Hua Wu
- Department of Pediatrics, Tongling Maternal and Child Health Hospital, Tongling 244000, Anhui Province, China
| | - An Zuo
- Department of Pediatrics, Tongling Maternal and Child Health Hospital, Tongling 244000, Anhui Province, China
| | - Mi-Mi Yang
- Department of Pediatrics, Tongling Maternal and Child Health Hospital, Tongling 244000, Anhui Province, China
| | - Rong-Rong Jiang
- Department of Pediatrics, Tongling Maternal and Child Health Hospital, Tongling 244000, Anhui Province, China
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The role of microRNAs in COVID-19 with a focus on miR-200c. J Circ Biomark 2022; 11:14-23. [PMID: 35356072 PMCID: PMC8939267 DOI: 10.33393/jcb.2022.2356] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2021] [Accepted: 02/22/2022] [Indexed: 12/11/2022] Open
Abstract
Objective: Epigenetics is a quickly spreading scientific field, and the study of epigenetic regulation in various diseases such as infectious diseases is emerging. The microribonucleic acids (miRNAs) as one of the types of epigenetic processes bind to their target messenger RNAs (mRNAs) and regulate their stability and/or translation. This study aims to evaluate non-coding RNAs (ncRNAs) with a focus on miR-200c in COVID-19. In this review, we first define the epigenetics and miRNAs, and then the role of miRNAs in diseases focusing on lung diseases is explained. Finally, in this study, we will investigate the role and position of miRNAs with a focus on miR-200c in viral and severe acute respiratory syndrome–related coronavirus (SARS-CoV2) infections. Methods: Systematic search of MEDLINE, PubMed, Web of Science, Embase, and Cochrane Library was conducted for all relative papers from 2000 to 2021 with the limitations of the English language. Finally, we selected 128 articles which fit the best to our objective of study, among which 5 articles focused on the impact of miR-200c. Results: Due to the therapeutic results of various drugs in different races and populations, epigenetic processes, especially miRNAs, are important. The overall results showed that different types of miRNAs can be effective on the process of various lung diseases through different target pathways and genes. It is likely that amplified levels of miR-200c may lead to decreased angiotensin-converting enzyme-2 (ACE2) expression, which in turn may increase the potential of infection, inflammation, and the complications of coronavirus disease. Conclusion: miR-200c and its correlation with ACE2 can be used as early prognostic and diagnostic markers.
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Komoyo GF, Yambiyo BM, Manirakiza A, Gody JC, Muller CP, Hübschen JM, Nakoune E, Snoeck CJ. Epidemiology and genetic characterization of respiratory syncytial virus in children with acute respiratory infections: Findings from the influenza sentinel surveillance network in Central African Republic, 2015 to 2018. Health Sci Rep 2021; 4:e298. [PMID: 34013070 PMCID: PMC8112815 DOI: 10.1002/hsr2.298] [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: 08/20/2020] [Revised: 03/21/2021] [Accepted: 04/15/2021] [Indexed: 11/25/2022] Open
Abstract
BACKGROUND AND AIMS Respiratory syncytial virus (RSV) is one of the main viral pathogens causing acute respiratory infections in children under 5 years of age but has seldom been studied in Central African Republic (CAF). Taking advantage of the national influenza surveillance network in CAF, this study aimed at providing the first insights into RSV prevalence and seasonality over 4 years of surveillance and the clinical manifestations of RSV in this population in CAF. METHODS A total of 3903 children under 5 years matching the influenza-like illness (ILI, 68.5%) or severe acute respiratory infection (SARI, 31.5%) case definitions were recruited from January 2015 to December 2018. The presence of RSV viral RNA in nasopharyngeal samples was assessed by RT-PCR, followed by RSV-A and RSV-B typing and Sanger sequencing on a subset of samples. Phylogenetic analyses were carried on partial G protein sequences. Associations between RSV and demographic or clinical manifestations were investigated by statistical analyses. RESULTS RSV prevalence was significantly higher in infants <6 months (13.4%), in hospitalized children (13.3% vs 5.5%) and in male patients (9.5% vs 6.4%). An overall prevalence of RSV of 8.0% in the period of 2015 to 2018 was shown, with significant annual (6.4%-10.6%) and seasonal (12.7% in rainy season vs 3.0% in dry season) fluctuations. While RSV seasons in 2015, 2016, and 2018 were relatively similar, 2017 showed deviations from the overall patterns with significantly higher RSV circulation and an outbreak peak 3 to 5 months earlier. Concomitant circulation of RSV-A and RSV-B with an alternating predominance of RSV-A and RSV-B strains and temporal RSV-A genotype replacement from NA1 to ON1 was observed. CONCLUSION This study represents the first in-depth epidemiological analysis of RSV in CAF and provides first insights into RSV genetic diversity and seasonality in the country.
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Affiliation(s)
- Giscard F. Komoyo
- Laboratoire des arbovirus, des fièvres hémorragiques virales, des virus émergents et des zoonosesInstitut Pasteur de BanguiBanguiCentral African Republic
- Ecole Doctorale d'Infectiologie Tropicale de Franceville, GabonFrancevilleGabon
| | - Brice M. Yambiyo
- Service d'épidémiologieInstitut Pasteur de BanguiBanguiCentral African Republic
| | | | - Jean C. Gody
- Complexe pédiatrique de BanguiCentre National Hospitalier Universitaire de BanguiBanguiCentral African Republic
| | - Claude P. Muller
- Clinical and Applied Virology group, Department of Infection and ImmunityLuxembourg Institute of HealthEsch‐sur‐AlzetteLuxembourg
| | - Judith M. Hübschen
- Clinical and Applied Virology group, Department of Infection and ImmunityLuxembourg Institute of HealthEsch‐sur‐AlzetteLuxembourg
| | - Emmanuel Nakoune
- Laboratoire des arbovirus, des fièvres hémorragiques virales, des virus émergents et des zoonosesInstitut Pasteur de BanguiBanguiCentral African Republic
| | - Chantal J. Snoeck
- Clinical and Applied Virology group, Department of Infection and ImmunityLuxembourg Institute of HealthEsch‐sur‐AlzetteLuxembourg
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Brini I, Bhiri S, Ijaz M, Bouguila J, Nouri-Merchaoui S, Boughammoura L, Sboui H, Hannachi N, Boukadida J. Temporal and climate characteristics of respiratory syncytial virus bronchiolitis in neonates and children in Sousse, Tunisia, during a 13-year surveillance. ENVIRONMENTAL SCIENCE AND POLLUTION RESEARCH INTERNATIONAL 2020; 27:23379-23389. [PMID: 30569350 DOI: 10.1007/s11356-018-3922-x] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/23/2018] [Accepted: 12/04/2018] [Indexed: 06/09/2023]
Abstract
This study established the correlation between respiratory syncytial virus (RSV) bronchiolitis and climate factors in the area of Sousse, Tunisia, during 13 years (2003-2015), from neonates and children <= 5 years old and hospitalized in Farhat Hached University-Hospital of Sousse. The meteorological data of Sousse including temperature, rainfall, and humidity were obtained. RSV detection was carried out with the direct immunofluorescence assay. The impact of climate factors on viral circulation was statistically analyzed. From 2003 to 2015, the total rate of RSV bronchiolitis accounted for 34.5% and peaked in 2007 and 2013. RSV infection was higher in male cases and pediatric environment (p<0.001) and was detected in 47.3% of hospitalizations in intensive care units. The epidemic of this pathogen started in October and peaked in January (41.6%). When the infectivity of RSV was at its maximum, the monthly average rainfall was high (31 mm) and the monthly average temperature and the monthly average humidity were at their minimum (11 °C and 66%, respectively). RSV activity was negatively correlated with temperature (r = - 0.78, p = 0.003) and humidity (r = - 0.62, p = 0.03). Regression analysis showed that the monthly average temperature fits into a linear model (R2 = 61%, p < 0.01). No correlation between RSV activity and rainfall was observed (p = 0.48). The meteorological predictions of RSV outbreaks with specific Tunisian climate parameters will help in determining the optimal timing of appropriate preventive strategies. In the area of Sousse, preventive measures should be enhanced since October especially, when the temperature is around 11 °C and humidity is above 60%.
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Affiliation(s)
- Ines Brini
- Faculty of Pharmacy of Monastir, University of Monastir, Monastir, Tunisia.
- Laboratory of Microbiology, Sousse Medical University, Farhat Hached University-Hospital of Sousse, Sousse, Tunisia.
- Unit Research for Genomic Characterization of Infectious Agents, UR12SP34, Farhat Hached University-Hospital of Sousse, Sousse, Tunisia.
| | - Sana Bhiri
- Department of Epidemiology and Medical Statistics, Farhat Hached University-Hospital of Sousse, Sousse, Tunisia
| | - Muhammad Ijaz
- Department of Pharmacy, COMSATS University Islamabad, Lahore CAMPUS, Lahore, Pakistan
| | - Jihene Bouguila
- Pediatric ward, Farhat Hached University-Hospital of Sousse, Sousse, Tunisia
| | | | - Lamia Boughammoura
- Pediatric ward, Farhat Hached University-Hospital of Sousse, Sousse, Tunisia
| | - Hassen Sboui
- Neonatology ward, Farhat Hached University-Hospital of Sousse, Sousse, Tunisia
| | - Naila Hannachi
- Laboratory of Microbiology, Sousse Medical University, Farhat Hached University-Hospital of Sousse, Sousse, Tunisia
- Unit Research for Genomic Characterization of Infectious Agents, UR12SP34, Farhat Hached University-Hospital of Sousse, Sousse, Tunisia
| | - Jalel Boukadida
- Laboratory of Microbiology, Sousse Medical University, Farhat Hached University-Hospital of Sousse, Sousse, Tunisia
- Unit Research for Genomic Characterization of Infectious Agents, UR12SP34, Farhat Hached University-Hospital of Sousse, Sousse, Tunisia
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Tahamtan A, Samadizadeh S, Rastegar M, Nakstad B, Salimi V. Respiratory syncytial virus infection: why does disease severity vary among individuals? Expert Rev Respir Med 2020; 14:415-423. [PMID: 31995408 DOI: 10.1080/17476348.2020.1724095] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
Introduction: Respiratory syncytial virus (RSV) is the most common cause of acute lower respiratory tract infections in infancy. While many infants are infected with RSV, the nature and severity of the disease vary among individuals. RSV causes bronchiolitis, pneumonia, and asthma exacerbation. However, most children infected with RSV have only mild upper airways disease and may be asymptomatic.Areas covered: Despite efforts to elucidate mechanisms for the various clinical responses to RSV infection, they remain largely unknown, suggesting that susceptibility and disease are influenced by multiple intrinsic and extrinsic factors. This article reviews the available literature on the field of RSV disease severity and discusses important factors associated to susceptibility and different disease outcome.Expert opinion: The severity of RSV-induced illness is a phenomenon that depends on a variety of graded mechanisms of interaction between the host, virus, and environment. This may lead to differences in the intensity of immune response in the lung and different courses of the disease. By characterizing, classifying, and grading the affecting factors in high-risk patients versus those who do not fall ill by RSV, we may find therapies or point to disease-limiting medications.
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Affiliation(s)
- Alireza Tahamtan
- Infectious Diseases Research Centre, Golestan University of Medical Sciences, Gorgan, Iran.,Department of Microbiology, School of Medicine, Golestan University of Medical Sciences, Gorgan, Iran
| | - Saeed Samadizadeh
- Department of Microbiology, School of Medicine, Golestan University of Medical Sciences, Gorgan, Iran
| | - Mostafa Rastegar
- Department of Microbiology, School of Medicine, Golestan University of Medical Sciences, Gorgan, Iran
| | - Britt Nakstad
- Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Vahid Salimi
- Department of Virology, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
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Birth Season and Infection Risk Among Children Under 5 Years Old: A Study of Hospital Admissions and Short Message Service-reported Symptoms at Home. Pediatr Infect Dis J 2020; 39:23-29. [PMID: 31815837 DOI: 10.1097/inf.0000000000002506] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND The season in which a child is born may affect the immune system development and thereby influence the risk of infections. In this study, we examined the associations between birth season and the risk of hospital admission or symptoms associated with a wide range of infections. METHODS This study is a prospective cohort study of 2434 children with an average follow-up of 3.5 years. Admission data were obtained from the Danish National Patient Registry. Via short message service (SMS) questionnaires, 1279 families reported symptoms of infections in a 1-year period. RESULTS Of the 2434 children, 639 (26.3%) were admitted to the hospital, and the children experienced on average 64.4 days with symptoms of infection within 1 year. There was no association between birth season and hospital admissions due to all infectious causes [incidence rate ratio (IRR) = 0.89; 95% confidence interval (CI), 0.65-1.22; P = 0.471]. However, children born in the fall had a higher IRR for admission due to all infectious causes when excluding admissions within the first year of life. Winter- and spring-born children had lower IRRs for admission due to gastrointestinal infections than summer-born children, but this association was alone present when admissions within the first year of life were included. The short message service-survey showed significantly lower IRRs for any symptom of infection among winter-born (IRR = 0.85; 95% CI, 0.75-0.96; P = 0.009) and fall-born children (IRR = 0.88; 95% CI, 0.78-0.99; P = 0.033) in comparison with summer-born children. CONCLUSIONS Birth season was not associated with hospital admission due to all infectious causes within the first 5 years of age; however, fall-birth was associated with a higher IRR for admissions due to all infectious causes after the first year of life. The association between birth season and admissions due to gastrointestinal infections was only seen when including children admitted under the age of one. Being born in fall or winter was associated with a decreased IRR for number of days with any symptom of infection registered at home.
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Groves HE, Guo-Parke H, Broadbent L, Shields MD, Power UF. Characterisation of morphological differences in well-differentiated nasal epithelial cell cultures from preterm and term infants at birth and one-year. PLoS One 2018; 13:e0201328. [PMID: 30517096 PMCID: PMC6281239 DOI: 10.1371/journal.pone.0201328] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2018] [Accepted: 11/13/2018] [Indexed: 11/30/2022] Open
Abstract
BACKGROUND Innate immune responses of airway epithelium are important defences against respiratory pathogens and allergens. Newborn infants are at greater risk of severe respiratory infections compared to older infants, while premature infants are at greater risk than full term infants. However, very little is known regarding human neonatal airway epithelium immune responses and whether age-related morphological and/or innate immune changes contribute to the development of airway disease. METHODS We collected nasal epithelial cells from 41 newborn infants (23 term, 18 preterm) within 5 days of birth. Repeat sampling was achieved for 24 infants (13 term, 11 preterm) at a median age of 12.5 months. Morphologically- and physiologically-authentic well-differentiated primary paediatric nasal epithelial cell (WD-PNEC) cultures were generated and characterised using light microscopy and immunofluorescence. RESULTS WD-PNEC cultures were established for 15/23 (65%) term and 13/18 (72%) preterm samples at birth, and 9/13 (69%) term and 8/11 (73%) preterm samples at one-year. Newborn and infant WD-PNEC cultures demonstrated extensive cilia coverage, mucous production and tight junction integrity. Newborn WD-PNECs took significantly longer to reach full differentiation and were noted to have much greater proportions of goblet cells compared to one-year repeat WD-PNECs. No differences were evident in ciliated/goblet cell proportions between term- and preterm-derived WD-PNECs at birth or one-year old. CONCLUSION We describe the successful generation of newborn-derived WD-PNEC cultures and their revival from frozen. We also compared the characteristics of WD-PNECs derived from infants born at term with those born prematurely at birth and at one-year-old. The development of WD-PNEC cultures from newborn infants provides a powerful and exciting opportunity to study the development of airway epithelium morphology, physiology, and innate immune responses to environmental or infectious insults from birth.
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Affiliation(s)
- Helen E. Groves
- Wellcome Wolfson Institute for Experimental Medicine, School of Medicine, Dentistry & Biomedical Sciences, The Queen’s University of Belfast, Belfast, Northern Ireland, United Kingdom
| | - Hong Guo-Parke
- Wellcome Wolfson Institute for Experimental Medicine, School of Medicine, Dentistry & Biomedical Sciences, The Queen’s University of Belfast, Belfast, Northern Ireland, United Kingdom
| | - Lindsay Broadbent
- Wellcome Wolfson Institute for Experimental Medicine, School of Medicine, Dentistry & Biomedical Sciences, The Queen’s University of Belfast, Belfast, Northern Ireland, United Kingdom
| | - Michael D. Shields
- Wellcome Wolfson Institute for Experimental Medicine, School of Medicine, Dentistry & Biomedical Sciences, The Queen’s University of Belfast, Belfast, Northern Ireland, United Kingdom
- Department of Paediatric Respiratory Medicine, Royal Belfast Hospital for Sick Children, Belfast, Northern Ireland, United Kingdom
| | - Ultan F. Power
- Wellcome Wolfson Institute for Experimental Medicine, School of Medicine, Dentistry & Biomedical Sciences, The Queen’s University of Belfast, Belfast, Northern Ireland, United Kingdom
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Viguria N, Martínez-Baz I, Moreno-Galarraga L, Sierrasesúmaga L, Salcedo B, Castilla J. Respiratory syncytial virus hospitalization in children in northern Spain. PLoS One 2018; 13:e0206474. [PMID: 30439987 PMCID: PMC6237306 DOI: 10.1371/journal.pone.0206474] [Citation(s) in RCA: 30] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2018] [Accepted: 10/12/2018] [Indexed: 11/21/2022] Open
Abstract
OBJECTIVES Understanding respiratory syncytial virus (RSV) morbidity may help to plan health care and future vaccine recommendations. We aim to describe the characteristics and temporal distribution of children diagnosed with RSV admitted in a Spanish hospital. METHODS Descriptive study for which the hospital discharges of children < 5 years of age with RSV infection were analyzed. The information was extracted from the hospital discharge database of a reference pediatric hospital in northern Spain for the 2010-2011 to 2014-2015 RSV seasons. RESULTS Six hundred and forty-seven hospitalizations of children with RSV infection were analyzed, 94% of which occurred between the second week of November and the last week of March. Most children (72%) were under one year of age and 95% were previously healthy infants. Infants born from October to December had the highest risk of hospitalization in the first year of life. The median length of hospital stay of children with and without comorbidities was six and three days, respectively. 6.5% of the hospitalized cases were admitted to the pediatric intensive care unit; this percentage was higher among children < 2 months (adjusted odds ratio 4.15; 95% confidence interval: 1.37-12.61) or with comorbidities (adjusted odds ratio 4.15; 95% confidence interval: 1.53-11.28). The case lethality was 0.3%. CONCLUSIONS The risk of hospitalizations for RSV is high during the first year of life and increases among infants born in the fall. Being under two months of age and presenting comorbidities are the main risk factors associated to pediatric intensive care unit admission.
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Affiliation(s)
- Natividad Viguria
- Department of Pediatrics, Complejo Hospitalario de Navarra, Pamplona, Spain
- Instituto de Investigación Sanitaria de Navarra, IdiSNA, Pamplona, Spain
| | - Iván Martínez-Baz
- Instituto de Investigación Sanitaria de Navarra, IdiSNA, Pamplona, Spain
- Instituto de Salud Pública de Navarra, Pamplona, Spain
- CIBER Epidemiología y Salud Pública, Pamplona, Spain
| | - Laura Moreno-Galarraga
- Department of Pediatrics, Complejo Hospitalario de Navarra, Pamplona, Spain
- Instituto de Investigación Sanitaria de Navarra, IdiSNA, Pamplona, Spain
| | | | - Blanca Salcedo
- Servicio de Gestión, Información y Evaluación, Complejo Hospitalario de Navarra, Pamplona, Spain
| | - Jesús Castilla
- Instituto de Investigación Sanitaria de Navarra, IdiSNA, Pamplona, Spain
- Instituto de Salud Pública de Navarra, Pamplona, Spain
- CIBER Epidemiología y Salud Pública, Pamplona, Spain
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Characteristics of children admitted to intensive care with acute bronchiolitis. Eur J Pediatr 2018; 177:913-920. [PMID: 29654399 PMCID: PMC5958152 DOI: 10.1007/s00431-018-3138-6] [Citation(s) in RCA: 80] [Impact Index Per Article: 13.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/28/2017] [Revised: 03/27/2018] [Accepted: 03/28/2018] [Indexed: 10/25/2022]
Abstract
UNLABELLED To assess factors associated with outcome in children admitted to paediatric intensive care (PIC) with bronchiolitis. A retrospective study of children admitted to the PICU at St Mary's Hospital, London with bronchiolitis over a 6-year period (2011-2016). All bronchiolitis admissions < 2 years were included. Data collected particularly noted risk factors for severity, demographics, microbiology and outcome. We compared respiratory syncytial virus (RSV) with non-RSV status. Multivariate analysis was performed. Two hundred seventy-four patients were identified. Median age was 60 days (IQR 28-150 days), 63% were male, 90% were invasively ventilated and 42% were previously healthy. Pre-existing co-morbidities were present in 38%. The most frequently isolated pathogens were RSV (60%) and rhinovirus (26%). Co-infection was present in 45%, most commonly with RSV, rhinovirus and bacterial pathogens. Median length of stay (LOS) was 6 days (IQR 4.75-10). Younger age, prematurity, RSV, co-infection and co-morbidity were identified as significant risk factors for prolonged LOS. Six children died. Five of these had documented co-morbidities. CONCLUSION RSV causes more severe bronchiolitis than other viruses. Nearly half of children admitted to PICU with RSV were previously healthy. Current guidelines for immunoprophylaxis of RSV bronchiolitis should be re-considered. What is Known: • Bronchiolitis is one of the most common reasons for unplanned PICU admission. The most common virus causing bronchiolitis is RSV • Bronchiolitis severe enough to require admission to PICU is associated with frequent morbidity but has low mortality. What is New: • RSV causes more severe bronchiolitis than other viruses. • Nearly half of all children admitted to PICU with RSV were previously healthy.
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Tahamtan A, Inchley CS, Marzban M, Tavakoli‐Yaraki M, Teymoori‐Rad M, Nakstad B, Salimi V. The role of microRNAs in respiratory viral infection: friend or foe? Rev Med Virol 2016; 26:389-407. [PMID: 27373545 PMCID: PMC7169129 DOI: 10.1002/rmv.1894] [Citation(s) in RCA: 34] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2016] [Revised: 06/06/2016] [Accepted: 06/08/2016] [Indexed: 12/20/2022]
Abstract
MicroRNAs (miRNAs) have emerged as a class of regulatory RNAs in host-pathogen interactions. Aberrant miRNA expression seems to play a central role in the pathology of several respiratory viruses, promoting development and progression of infection. miRNAs may thus serve as therapeutic and prognostic factors for respiratory viral infectious disease caused by a variety of agents. We present a comprehensive review of recent findings related to the role of miRNAs in different respiratory viral infections and discuss possible therapeutic opportunities aiming to attenuate the burden of viral infections. Our review supports the emerging concept that cellular and viral-encoded miRNAs might be broadly implicated in human respiratory viral infections, with either positive or negative effects on virus life cycle. Copyright © 2016 John Wiley & Sons, Ltd.
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Affiliation(s)
- Alireza Tahamtan
- Department of Virology, School of Public HealthTehran University of Medical SciencesTehranIran
| | - Christopher S. Inchley
- Department of Pediatric and Adolescent MedicineAkershus University HospitalLørenskogNorway
| | - Mona Marzban
- Department of Virology, School of Public HealthTehran University of Medical SciencesTehranIran
| | | | - Majid Teymoori‐Rad
- Department of Virology, School of Public HealthTehran University of Medical SciencesTehranIran
| | - Britt Nakstad
- Department of Pediatric and Adolescent MedicineAkershus University HospitalLørenskogNorway
- Institute of Clinical MedicineUniversity of OsloOsloNorway
| | - Vahid Salimi
- Department of Virology, School of Public HealthTehran University of Medical SciencesTehranIran
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Lu L, Yan Y, Yang B, Xiao Z, Feng X, Wang Y, Ji W, Mize M, Hao C, Chen Z. Epidemiological and clinical profiles of respiratory syncytial virus infection in hospitalized neonates in Suzhou, China. BMC Infect Dis 2015; 15:431. [PMID: 26470889 PMCID: PMC4608146 DOI: 10.1186/s12879-015-1155-x] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2015] [Accepted: 09/28/2015] [Indexed: 01/08/2023] Open
Abstract
BACKGROUND This study was designed to explore the epidemiological and clinical profiles of respiratory syncytial virus (RSV) infection in neonates from the Suzhou area of China, taking into consideration how climate factors influence disease. METHODS From 2010 to 2014, nasopharyngeal aspirates (NPA) collected from hospitalized neonates with lower respiratory tract infections (LRIs) were screened for seven common respiratory viruses including RSV by direct immunofluorescence assay. Human bocavirus, human metapneumovirus, and mycoplasma pneumoniae were detected by polymerase chain reaction. RESULTS Of the 1803 hospitalized neonates analyzed, 20.74 % were found to be infected with RSV. Interestingly, 30 subjects were identified as being coinfected with other viruses. The rate of RSV infection was highestduring thewinter and early spring seasons; however, infection was negatively associated with monthly mean temperature (rs = -0.821, P < 0.0001), total rainfall (rs = -0.406, P = 0.002), and sum of sunshine (rs = -0.386, P = 0.001). Monthly mean temperature was the only independent factor associated with RSV activity, as determined using multivariate regression analysis. Compared with non-RSV neonates, neonates with RSV infection presented more frequently with tachypnea,moist rales, and abnormal chest X-rays requiring supplemental oxygen and extended hospitalization postpartum. Neonatal admittance into the NICU was determined based on prematurity and coinfection with other viruses; two independent risk factors for RSV disease, as determined by multivariate logistic analysis. CONCLUSIONS Important as a major cause of LRIs in hospitalized neonate, we found that the subtropical climate of the Suzhou area was associated with RSV activity. The identified risk factors ofsevere disease in neonates with RSV infection should be taken into consideration when implementing disease health interventions.
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Affiliation(s)
- Lianghua Lu
- Department of Neonatology, Children's Hospital of Soochow University, Suzhou, 215003, China.
| | - Yongdong Yan
- Department of Respiratory Disease, Children's Hospital of Soochow University, Suzhou, 215003, China.
| | - Bin Yang
- Department of Clinical Lab, Children's Hospital of Soochow University, Suzhou, 215003, China.
| | - Zhihui Xiao
- Department of Neonatology, Children's Hospital of Soochow University, Suzhou, 215003, China.
| | - Xing Feng
- Department of Neonatology, Children's Hospital of Soochow University, Suzhou, 215003, China.
| | - Yuqing Wang
- Department of Respiratory Disease, Children's Hospital of Soochow University, Suzhou, 215003, China.
| | - Wei Ji
- Department of Respiratory Disease, Children's Hospital of Soochow University, Suzhou, 215003, China.
| | - Maximillion Mize
- Department of Cell Biology and Immunology, UNT Health Science Center at Fort Worth, Fort Worth, TX, 76107, USA.
| | - Chuangli Hao
- Department of Respiratory Disease, Children's Hospital of Soochow University, Suzhou, 215003, China.
| | - Zhengrong Chen
- Department of Respiratory Disease, Children's Hospital of Soochow University, Suzhou, 215003, China.
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Ravaglia C, Poletti V. Recent advances in the management of acute bronchiolitis. F1000PRIME REPORTS 2014; 6:103. [PMID: 25580257 PMCID: PMC4229723 DOI: 10.12703/p6-103] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Acute bronchiolitis is characterized by acute wheezing in infants or children and is associated with signs or symptoms of respiratory infection; it is rarely symptomatic in adults and the most common etiologic agent is respiratory syncytial virus (RSV). Usually it does not require investigation, treatment is merely supportive and a conservative approach seems adequate in the majority of children, especially for the youngest ones (<3 months); however, clinical scoring systems have been proposed and admission in hospital should be arranged in case of severe disease or a very young age or important comorbidities. Apnea is a very important aspect of the management of young infants with bronchiolitis. This review focuses on the clinical, radiographic, and pathologic characteristics, as well as the recent advances in management of acute bronchiolitis.
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Affiliation(s)
- Claudia Ravaglia
- Pulmonology Unit, Department of Thoracic DiseasesGB Pierantoni - L Morgagni Hospital, via C. Forlanini 34, 47100 ForlìItaly
| | - Venerino Poletti
- Pulmonology Unit, Department of Thoracic DiseasesGB Pierantoni - L Morgagni Hospital, via C. Forlanini 34, 47100 ForlìItaly
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14
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A systematic review of predictive modeling for bronchiolitis. Int J Med Inform 2014; 83:691-714. [PMID: 25106933 DOI: 10.1016/j.ijmedinf.2014.07.005] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2014] [Revised: 06/20/2014] [Accepted: 07/16/2014] [Indexed: 12/14/2022]
Abstract
PURPOSE Bronchiolitis is the most common cause of illness leading to hospitalization in young children. At present, many bronchiolitis management decisions are made subjectively, leading to significant practice variation among hospitals and physicians caring for children with bronchiolitis. To standardize care for bronchiolitis, researchers have proposed various models to predict the disease course to help determine a proper management plan. This paper reviews the existing state of the art of predictive modeling for bronchiolitis. Predictive modeling for respiratory syncytial virus (RSV) infection is covered whenever appropriate, as RSV accounts for about 70% of bronchiolitis cases. METHODS A systematic review was conducted through a PubMed search up to April 25, 2014. The literature on predictive modeling for bronchiolitis was retrieved using a comprehensive search query, which was developed through an iterative process. Search results were limited to human subjects, the English language, and children (birth to 18 years). RESULTS The literature search returned 2312 references in total. After manual review, 168 of these references were determined to be relevant and are discussed in this paper. We identify several limitations and open problems in predictive modeling for bronchiolitis, and provide some preliminary thoughts on how to address them, with the hope to stimulate future research in this domain. CONCLUSIONS Many problems remain open in predictive modeling for bronchiolitis. Future studies will need to address them to achieve optimal predictive models.
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Øymar K, Skjerven HO, Mikalsen IB. Acute bronchiolitis in infants, a review. Scand J Trauma Resusc Emerg Med 2014; 22:23. [PMID: 24694087 PMCID: PMC4230018 DOI: 10.1186/1757-7241-22-23] [Citation(s) in RCA: 65] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2013] [Accepted: 03/28/2014] [Indexed: 12/26/2022] Open
Abstract
Acute viral bronchiolitis is one of the most common medical emergency situations in infancy, and physicians caring for acutely ill children will regularly be faced with this condition. In this article we present a summary of the epidemiology, pathophysiology and diagnosis, and focus on guidelines for the treatment of bronchiolitis in infants. The cornerstones of the management of viral bronchiolitis are the administration of oxygen and appropriate fluid therapy, and overall a “minimal handling approach” is recommended. Inhaled adrenaline is commonly used in some countries, but the evidences are sparse. Recently, inhalation with hypertonic saline has been suggested as an optional treatment. When medical treatment fails to stabilize the infants, non-invasive and invasive ventilation may be necessary to prevent and support respiratory failure. It is important that relevant treatment algorithms exist, applicable to all levels of the treatment chain and reflecting local considerations and circumstances.
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Affiliation(s)
- Knut Øymar
- Department of Paediatrics, Stavanger University Hospital, PO Box 8100, N-4068 Stavanger, Norway.
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