1
|
Woelke S, Szelenyi A, Dreßler M, Trischler J, Donath H, Hutter M, Blümchen K, Zielen S. Methacholine and FeNO Measurement in Patients with Habit Cough. KLINISCHE PADIATRIE 2023; 235:84-89. [PMID: 36720225 DOI: 10.1055/a-2004-3477] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
BACKGROUND Chronic cough is one of the most common symptoms in childhood. Making a definite diagnosis is a challenge for all pediatricians especially in patients when cough is without an organic cause like in habit cough. PATIENTS AND METHODS In this retrospective analysis, all electronic outpatient charts of the Division of Allergology and Pneumology, between January 1, 2010 and December 31, 2019 were reviewed in order to study all children with potential habit cough. All children underwent the following diagnostic algorithms, skin prick test (SPT), measurement of fractional exhaled nitric oxide (FeNO), spirometry and methacholine challenge test (MCT). The value of a normal MCT and FeNO measurement for diagnosing habit cough was investigated. RESULTS The chart review revealed 482 patients with chronic cough>4 weeks. Of these, 99 (20.5%) with suspected habit cough were collected. 13 patients had to be excluded for other diagnosis and a complete data set was available in 55 patients. 33 (60.0%) of 55 patients were SPT negative and 22 (40.0%) had sensitization to common allergens. Five patients had elevated FeNO≥20 ppb and three showed severe bronchial hyperresponsiveness<0.1 mg methacholine, challenging the diagnosis of habit cough. CONCLUSION A normal FeNO and MCT can help confirm the clinical diagnosis of habit cough. However, in patients with positive MCT and/or elevated FeNO habit cough can be present. Especially in patients with elevated FeNO and severe BHR cough variant asthma and eosinophilic bronchitis have to be ruled out.
Collapse
Affiliation(s)
- Sandra Woelke
- Department for Children and Adolescence, Division of Allergy, Pulmonology and Cystic fibrosis, University Hospital Frankfurt, Goethe University, Frankfurt, Germany
| | - Alexandra Szelenyi
- Department for Children and Adolescence, Division of Allergy, Pulmonology and Cystic fibrosis, University Hospital Frankfurt, Goethe University, Frankfurt, Germany
| | - Melanie Dreßler
- Department for Children and Adolescence, Division of Allergy, Pulmonology and Cystic fibrosis, University Hospital Frankfurt, Goethe University, Frankfurt, Germany
| | - Jordis Trischler
- Department for Children and Adolescence, Division of Allergy, Pulmonology and Cystic fibrosis, University Hospital Frankfurt, Goethe University, Frankfurt, Germany
| | - Helena Donath
- Department for Children and Adolescence, Division of Allergy, Pulmonology and Cystic fibrosis, University Hospital Frankfurt, Goethe University, Frankfurt, Germany
| | - Martin Hutter
- Department for Children and Adolescence, Division of Allergy, Pulmonology and Cystic fibrosis, University Hospital Frankfurt, Goethe University, Frankfurt, Germany
| | - Katharina Blümchen
- Department for Children and Adolescence, Division of Allergy, Pulmonology and Cystic fibrosis, University Hospital Frankfurt, Goethe University, Frankfurt, Germany
| | - Stefan Zielen
- Department for Children and Adolescence, Division of Allergy, Pulmonology and Cystic fibrosis, University Hospital Frankfurt, Goethe University, Frankfurt, Germany
| |
Collapse
|
2
|
Berdah L, Romain AS, Rivière S, Schnuriger A, Perrier M, Carbajal R, Lorrot M, Guedj R, Corvol H. Retrospective observational study of the influence of the COVID-19 outbreak on infants' hospitalisation for acute bronchiolitis. BMJ Open 2022; 12:e059626. [PMID: 36316083 PMCID: PMC9627576 DOI: 10.1136/bmjopen-2021-059626] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Abstract
OBJECTIVES Acute bronchiolitis is a major public health issue with high number of infants hospitalised worldwide each year. In France, hospitalisations mostly occur between October and March and peak in December. A reduction of emergency visits for bronchiolitis has been observed at onset of the COVID-19 outbreak. We aimed to assess the pandemic effects on the hospitalisations for bronchiolitis during the 2020-2021 winter (COVID-19 period) compared with three previous winters (pre-COVID-19). DESIGN Retrospective, observational and cross-sectional study. SETTING Tertiary university paediatric hospital in Paris (France). PARTICIPANTS All infants aged under 12 months who were hospitalised for acute bronchiolitis during the autumn/winter seasons (1 October to 31 March) from 2017 to 2021 were included. Clinical and laboratory data were collected using standardised forms. RESULTS During the COVID-19 period was observed, a 54.3% reduction in hospitalisations for bronchiolitis associated with a delayed peak (February instead of November-December). Clinical characteristics and hospitalisation courses were substantially similar. The differences during the COVID-19 period were: smaller proportion of infants with comorbidities (8% vs 14% p=0.02), lower need for oxygen (45% vs 55%, p=0.01), higher proportions of metapneumovirus, parainfluenzae 3, bocavirus, coronavirus NL63 and OC43 (all p≤0.01) and no influenza. The three infants positive for SARS-CoV-2 were also positive for respiratory syncytial virus, suggesting that SARS-CoV-2 alone does not cause bronchiolitis, despite previous assumptions. CONCLUSION The dramatic reduction in infants' hospitalisations for acute bronchiolitis is an opportunity to change our future habits such as advising the population to wear masks and apply additional hygiene measures in case of respiratory tract infections. This may change the worldwide bronchiolitis burden and improve children respiratory outcomes.
Collapse
Affiliation(s)
- Laura Berdah
- Sorbonne Université, Assistance Publique - Hôpitaux de Paris, Trousseau Hospital, Paediatric Pulmonology Department, Paris, France
- Sorbonne Université, Inserm, Centre de Recherche Saint Antoine, Paris, France
| | - Anne-Sophie Romain
- Sorbonne Université, Assistance Publique - Hôpitaux de Paris, Trousseau Hospital, General Paediatrics Department, Paris, France
| | - Simon Rivière
- Sorbonne Université, Assistance Publique - Hôpitaux de Paris, Trousseau Hospital, Paediatric Emergency Department, Paris, France
| | - Aurélie Schnuriger
- Sorbonne Université, Inserm, Centre de Recherche Saint Antoine, Paris, France
- Sorbonne Université, Assistance Publique - Hôpitaux de Paris, Trousseau Hospital, Virology Department, Paris, France
| | - Marine Perrier
- Sorbonne Université, Assistance Publique - Hôpitaux de Paris, Trousseau Hospital, Virology Department, Paris, France
| | - Ricardo Carbajal
- Sorbonne Université, Assistance Publique - Hôpitaux de Paris, Trousseau Hospital, Paediatric Emergency Department, Paris, France
| | - Mathie Lorrot
- Sorbonne Université, Assistance Publique - Hôpitaux de Paris, Trousseau Hospital, General Paediatrics Department, Paris, France
| | - Romain Guedj
- Sorbonne Université, Assistance Publique - Hôpitaux de Paris, Trousseau Hospital, Paediatric Emergency Department, Paris, France
| | - Harriet Corvol
- Sorbonne Université, Assistance Publique - Hôpitaux de Paris, Trousseau Hospital, Paediatric Pulmonology Department, Paris, France
- Sorbonne Université, Inserm, Centre de Recherche Saint Antoine, Paris, France
| |
Collapse
|
3
|
Yamada S, Fujisawa T, Nagao M, Matsuzaki H, Motomura C, Odajima H, Nakamura T, Imai T, Nagakura KI, Yanagida N, Mitomori M, Ebisawa M, Kabashima S, Ohya Y, Habukawa C, Tomiita M, Hirayama M. Risk Factors for Lung Function Decline in Pediatric Asthma under Treatment: A Retrospective, Multicenter, Observational Study. CHILDREN (BASEL, SWITZERLAND) 2022; 9:children9101516. [PMID: 36291452 PMCID: PMC9600699 DOI: 10.3390/children9101516] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/08/2022] [Revised: 09/27/2022] [Accepted: 09/30/2022] [Indexed: 11/17/2022]
Abstract
Background: Childhood asthma is a major risk for low lung function in later adulthood, but what factors in asthma are associated with the poor lung function during childhood is not known. Objective: To identify clinical factors in children with asthma associated with low or declining lung function during the treatment. Methods: We enrolled children with asthma who had been treated throughout three age periods, i.e., 6−9, 10−12, and 13−15 years old, at seven specialized hospitals in Japan. Clinical information and lung function measurements were retrieved from the electronic chart systems. To characterize the lung function trajectories during each age period, we evaluated the forced expiratory volume 1 (FEV1) with % predicted values and individual changes by the slope (S) from linear regression. We defined four trajectory patterns: normal (Group N) and low (Group L), showing %FEV1 ≥80% or <80% throughout all three periods; upward (Group U) and downward (Group D), showing S ≥ 0 or S < 0%. Logistic regression analysis was performed to compare factors associated with the unfavorable (D/L) versus favorable (N/U) groups. Results: Among 273 eligible patients, 197 (72%) were classified into Group N (n = 150)/U (n = 47), while 76 (28%) were in Group D (n = 66)/L (n = 10). A history of poor asthma control, long-acting beta2 agonist use, and a lower height Z-score during 13−15 years were associated with an unfavorable outcome (Group D/L). Conversely, inhaled corticosteroid (ICS) use during 10−12 years and high-dose ICS use during 13−15 years were associated with a favorable outcome (Group N/U). Conclusion: We identified several factors that are associated with unfavorable lung function changes in pediatric asthma. Attention should be paid to the possible relationship between yearly changes in lung function and poor asthma control, use of ICS (and its dose) and use of LABA.
Collapse
Affiliation(s)
- Shingo Yamada
- Allergy Center, National Hospital Organization Mie National Hospital, Tsu 514-0125, Japan
| | - Takao Fujisawa
- Allergy Center, National Hospital Organization Mie National Hospital, 357 Ozato-kubota, Tsu 514-0125, Japan
- Correspondence: ; Tel.: +81-59-232-2531
| | - Mizuho Nagao
- Allergy Center, National Hospital Organization Mie National Hospital, Tsu 514-0125, Japan
| | - Hiroshi Matsuzaki
- Department of Pediatrics, National Hospital Organization Fukuoka National Hospital, Fukuoka 811-1394, Japan
| | - Chikako Motomura
- Department of Pediatrics, National Hospital Organization Fukuoka National Hospital, Fukuoka 811-1394, Japan
| | - Hiroshi Odajima
- Department of Pediatrics, National Hospital Organization Fukuoka National Hospital, Fukuoka 811-1394, Japan
| | - Toshinori Nakamura
- Department of Pediatrics, Showa University School of Medicine, Tokyo 142-8666, Japan
| | - Takanori Imai
- Department of Pediatrics, Showa University School of Medicine, Tokyo 142-8666, Japan
| | - Ken-ichi Nagakura
- Department of Pediatrics, National Hospital Organization Sagamihara National Hospital, Sagamihara 252-0392, Japan
| | - Noriyuki Yanagida
- Department of Pediatrics, National Hospital Organization Sagamihara National Hospital, Sagamihara 252-0392, Japan
| | - Masatoshi Mitomori
- Department of Pediatrics, National Hospital Organization Sagamihara National Hospital, Sagamihara 252-0392, Japan
| | - Motohiro Ebisawa
- Department of Pediatrics, National Hospital Organization Sagamihara National Hospital, Sagamihara 252-0392, Japan
| | - Shigenori Kabashima
- Allergy Center, National Center for Child Health and Development, Tokyo 157-8535, Japan
| | - Yukihiro Ohya
- Allergy Center, National Center for Child Health and Development, Tokyo 157-8535, Japan
| | - Chizu Habukawa
- Department of Pediatric Allergy, National Hospital Organization Minami Wakayama Medical Center, Tanabe 656-8558, Japan
| | - Minako Tomiita
- Center of Pediatric Allergy and Rheumatology, National Hospital Organization Shimoshizu National Hospital, Yotsukaido 284-0003, Japan
| | - Masahiro Hirayama
- Department of Pediatrics, Mie University Graduate School of Medicine, Tsu 514-8507, Japan
| |
Collapse
|
4
|
Preliminary Evidence on Pulmonary Function after Asymptomatic and Mild COVID-19 in Children. CHILDREN 2022; 9:children9070952. [PMID: 35883936 PMCID: PMC9317526 DOI: 10.3390/children9070952] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 05/31/2022] [Revised: 06/09/2022] [Accepted: 06/24/2022] [Indexed: 11/17/2022]
Abstract
Background: While it has been described that adults can develop long-lasting deterioration in pulmonary function (PF) after coronavirus disease 19 (COVID-19), regardless of disease severity, data on the long-term pneumological impact of SARS-CoV-2 infection in children are lacking. Methods: Performing a single-center, prospective, observational study on children aged 6–18 years with a previous diagnosis of asymptomatic/mild COVID-19, we evaluated the long-term impact of mild severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection in children. Results: A total of 61 subjects underwent spirometry after a mean time of 10 ± 4 months from asymptomatic or mild infection. None of the children reported any respiratory symptoms, needed any inhaled therapy, or had abnormal lung function. Conclusions: In our study, we observed that children and adolescents did not develop chronic respiratory symptoms and did not present lung function impairment after asymptomatic or mild SARS-CoV-2 infection.
Collapse
|
5
|
Knoke L, Schlegtendal A, Maier C, Eitner L, Lücke T, Brinkmann F. Pulmonary Function and Long-Term Respiratory Symptoms in Children and Adolescents After COVID-19. Front Pediatr 2022; 10:851008. [PMID: 35547532 PMCID: PMC9081758 DOI: 10.3389/fped.2022.851008] [Citation(s) in RCA: 25] [Impact Index Per Article: 12.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/08/2022] [Accepted: 03/29/2022] [Indexed: 12/31/2022] Open
Abstract
Background Persistent respiratory symptoms after severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in adults are frequent, and there can be long-term impairment of pulmonary function. To date, only preliminary evidence is available on persistent respiratory sequelae of SARS-CoV-2 in children and adolescents. Our objective was to examine the long-term effects of symptomatic and asymptomatic SARS-CoV-2 infections on pulmonary function in this age group in a single-center, controlled, prospective study. Methods Participants with serological or polymerase chain reaction-based evidence of SARS-CoV-2 infection were recruited from a population-based study of seroconversion rates. Multiple-breath washout (MBW), body plethysmography, and diffusion capacity testing were performed for children and adolescents. Participants were interviewed about their symptoms during the acute phase of infection and long-lasting symptoms. Cases were compared with SARS-CoV-2 seronegative controls from the same population-based study with and without history of respiratory infection within 6 months prior to assessment. Primary endpoints were differences in pulmonary function, including diffusion capacity and MBW, between participants with and without evidence of SARS-CoV-2 infection. Secondary endpoints included correlation between lung function and long-lasting symptoms as well as disease severity. Findings In total, 73 seropositive children and adolescents (5-18 years) were recruited after an average of 2.6 months (range 0.4-6.0) following SARS-CoV-2 infection. Among 19 patients (27.1%) who complained of persistent or newly emerged symptoms since SARS-CoV-2, 8 (11.4%) reported respiratory symptoms. No significant differences were detected in frequency of abnormal pulmonary function when comparing cases with 45 controls, including 14 (31.1%) with a history of previous infection (SARS-CoV-2: 12, 16.4%; controls: 12, 27.7%; odds ratio 0.54, 95% confidence interval 0.22-1.34). Only two patients with persistent respiratory symptoms showed abnormal pulmonary function. Multivariate analysis revealed reduced forced vital capacity (p = 0.012) in patients with severe SARS-CoV-2 infection. Interpretation Pulmonary function is rarely impaired in children and adolescents after SARS-CoV-2 infection, except from those with severe infection, and did not differ between SARS-CoV-2 and other previous infections, suggesting that SARS-CoV-2 is not more likely to cause pulmonary sequelae than other infections. The discrepancy between persisting respiratory symptoms and normal pulmonary function suggests a different underlying pathology such as dysfunctional breathing.
Collapse
Affiliation(s)
| | | | | | | | | | - Folke Brinkmann
- University Children’s Hospital, Ruhr University Bochum, Bochum, Germany
| |
Collapse
|
6
|
Zhang D, Yang J, Zhao Y, Shan J, Wang L, Yang G, He S, Li E. RSV Infection in Neonatal Mice Induces Pulmonary Eosinophilia Responsible for Asthmatic Reaction. Front Immunol 2022; 13:817113. [PMID: 35185908 PMCID: PMC8847141 DOI: 10.3389/fimmu.2022.817113] [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: 11/17/2021] [Accepted: 01/11/2022] [Indexed: 11/13/2022] Open
Abstract
Respiratory syncytial virus (RSV) is a leading cause of lower respiratory tract infections in infants and young children. Severe respiratory viral infection in early life is intimately associated with childhood recurrent wheezing and is a risk factor for asthma later in life. Although eosinophilic airway inflammation is an important trait in asthma of children, the roles of pulmonary eosinophils in the disease have been inadequately understood. Here, we show that RSV infection in neonatal mice causes eosinophilia after allergen stimulation. We showed that RSV infection in neonatal mice exacerbated allergic asthma to allergen stimulation that was accompanied with increased detection of eosinophils in the lungs. In addition, we also detected accumulation of ILC2, CD4+ T cells, and macrophages. Importantly, adoptive transfer of eosinophils from asthmatic mice with early-life RSV infection exacerbated pulmonary pathologies associated with allergic respiratory inflammation in naive mice in response to foreign antigen. The induction of asthmatic symptoms including AHR, tracheal wall thickening, and mucus production became more severe after further stimulation in those mice. The expression of antigen presentation-related molecules like CD80, CD86, and especially MHC II was markedly induced in eosinophils from OVA-stimulated asthmatic mice. The accumulation of CD4+ T cells in the lungs was also significantly increased as a result of adoptive transfer of eosinophils. Importantly, the deterioration of lung pathology caused by adoptive transfer could be effectively attenuated by treatment with indomethacin, a nonsteroidal anti-inflammatory drug. Our findings highlight the significance of eosinophil-mediated proinflammatory response in allergic disease associated with early-life infection of the respiratory tract.
Collapse
Affiliation(s)
- Dan Zhang
- State Key Laboratory of Pharmaceutical Biotechnology, Medical School, Nanjing University, Nanjing, China.,Jiangsu Key Laboratory of Molecular Medicine, Medical School, Nanjing University, Nanjing, China.,Yancheng Medical Research Centre, Medical School, Nanjing University, Yancheng, China
| | - Jie Yang
- Jiangsu Key Laboratory of Molecular Medicine, Medical School, Nanjing University, Nanjing, China
| | - Yuanhui Zhao
- Jiangsu Key Laboratory of Molecular Medicine, Medical School, Nanjing University, Nanjing, China.,Institute of Medical Virology, Drum Tower Hospital, Medical School, Nanjing University, Nanjing, China
| | - Jinjun Shan
- Centre of Pediatric Diseases, College of Clinical Medicine, Nanjing University of Chinese Medicine, Nanjing, China
| | - Lingling Wang
- State Key Laboratory of Pharmaceutical Biotechnology, Medical School, Nanjing University, Nanjing, China.,Jiangsu Key Laboratory of Molecular Medicine, Medical School, Nanjing University, Nanjing, China
| | - Guang Yang
- Nanjing Children's Hospital, Nanjing Medical University, Nanjing, China
| | - Susu He
- State Key Laboratory of Pharmaceutical Biotechnology, Medical School, Nanjing University, Nanjing, China.,Jiangsu Key Laboratory of Molecular Medicine, Medical School, Nanjing University, Nanjing, China.,Yancheng Medical Research Centre, Medical School, Nanjing University, Yancheng, China
| | - Erguang Li
- State Key Laboratory of Pharmaceutical Biotechnology, Medical School, Nanjing University, Nanjing, China.,Jiangsu Key Laboratory of Molecular Medicine, Medical School, Nanjing University, Nanjing, China.,Institute of Medical Virology, Drum Tower Hospital, Medical School, Nanjing University, Nanjing, China
| |
Collapse
|
7
|
Eigenmann P. Comments on vitamin D and sensitization, asthma treatment, and lung function development. Pediatr Allergy Immunol 2021; 32:1137-1140. [PMID: 34333802 DOI: 10.1111/pai.13575] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/02/2021] [Accepted: 06/03/2021] [Indexed: 11/26/2022]
Affiliation(s)
- Philippe Eigenmann
- Department of Pediatrics Gynecology and Obstetrics, University Hospital of Geneva, Geneva, Switzerland
| |
Collapse
|
8
|
Riikonen R, Korppi M, Törmänen S, Koponen P, Nuolivirta K, Helminen M, He Q, Lauhkonen E. Risk factors for irreversible airway obstruction after infant bronchiolitis. Respir Med 2021; 187:106545. [PMID: 34332337 DOI: 10.1016/j.rmed.2021.106545] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/18/2020] [Revised: 06/03/2021] [Accepted: 07/21/2021] [Indexed: 10/20/2022]
Abstract
BACKGROUND Increasing evidence shows that environmental factors in childhood play a role in development of irreversible airway obstruction. We evaluated early-life and preschool-age risk factors for irreversible airway obstruction in adolescence after bronchiolitis in infancy. METHODS This study is a secondary analysis of data collected during prospective long-term follow-up of our post-bronchiolitis cohort. Risk factor data were collected during hospitalisation and on follow-up visits at 5-7 and 10-13 years of ages. Lung function was measured from 103 participants with impulse oscillometry at 5-7 years of age and from 89 participants with flow-volume spirometry at 10-13 years of age. RESULTS Asthma diagnosis at <12 months of age showed a significant association with irreversible airway obstruction at 10-13 years of age independently from current asthma. Irreversible airway obstruction was less frequent in children with variant than wild genotype of the Toll-like receptor 4(TLR4) rs4986790, but the significance was lost in logistic regression adjusted for current asthma and weight status. Higher post-bronchodilator respiratory system resistance at 5 Hz and lower baseline and post-bronchodilator reactance at 5 Hz by impulse oscillometry at 5-7 years of age were associated with irreversible airway obstruction at 10-13 years of age. CONCLUSION Asthma diagnosis during the first living year and worse lung function at preschool age increased the risk for irreversible airway obstruction at 10-13 years of age after bronchiolitis. TLR4 rs4986790 polymorphism may be protective for development of irreversible airway obstruction after bronchiolitis.
Collapse
Affiliation(s)
- Riikka Riikonen
- Center for Child Health Research, Tampere University and University Hospital, Tampere, Finland.
| | - Matti Korppi
- Center for Child Health Research, Tampere University and University Hospital, Tampere, Finland
| | - Sari Törmänen
- Center for Child Health Research, Tampere University and University Hospital, Tampere, Finland
| | - Petri Koponen
- Center for Child Health Research, Tampere University and University Hospital, Tampere, Finland
| | - Kirsi Nuolivirta
- Department of Paediatrics, Seinäjoki Central Hospital, Seinäjoki, Finland
| | - Merja Helminen
- Department of Paediatrics, Tampere University Hospital, Tampere, Finland
| | - Qiushui He
- Institute of Biomedicine, University of Turku, Turku, Finland; Department of Medical Microbiology, Capital Medical University, Beijing, China
| | - Eero Lauhkonen
- Center for Child Health Research, Tampere University and University Hospital, Tampere, Finland; Department of Paediatrics, Tampere University Hospital, Tampere, Finland
| |
Collapse
|
9
|
Bianchini S, Silvestri E, Argentiero A, Fainardi V, Pisi G, Esposito S. Role of Respiratory Syncytial Virus in Pediatric Pneumonia. Microorganisms 2020; 8:microorganisms8122048. [PMID: 33371276 PMCID: PMC7766387 DOI: 10.3390/microorganisms8122048] [Citation(s) in RCA: 26] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2020] [Revised: 12/15/2020] [Accepted: 12/17/2020] [Indexed: 12/12/2022] Open
Abstract
Respiratory viral infections represent the leading cause of hospitalization in infants and young children worldwide and the second leading cause of infant mortality. Among these, Respiratory Syncytial Virus (RSV) represents the main cause of lower respiratory tract infections (LRTIs) in young children worldwide. RSV manifestation can range widely from mild upper respiratory infections to severe respiratory infections, mainly bronchiolitis and pneumonia, leading to hospitalization, serious complications (such as respiratory failure), and relevant sequalae in childhood and adulthood (wheezing, asthma, and hyperreactive airways). There are no specific clinical signs or symptoms that can distinguish RSV infection from other respiratory pathogens. New multiplex platforms offer the possibility to simultaneously identify different pathogens, including RSV, with an accuracy similar to that of single polymerase chain reaction (PCR) in the majority of cases. At present, the treatment of RSV infection relies on supportive therapy, mainly consisting of oxygen and hydration. Palivizumab is the only prophylactic method available for RSV infection. Advances in technology and scientific knowledge have led to the creation of different kinds of vaccines and drugs to treat RSV infection. Despite the good level of these studies, there are currently few registered strategies to prevent or treat RSV due to difficulties related to the unpredictable nature of the disease and to the specific target population.
Collapse
Affiliation(s)
- Sonia Bianchini
- Department of Medicine and Surgery, University of Perugia, 06123 Perugia, Italy; (S.B.); (E.S.)
- Pediatric Unit, ASST Santi Carlo e Paolo, 20142 Milan, Italy
| | - Ettore Silvestri
- Department of Medicine and Surgery, University of Perugia, 06123 Perugia, Italy; (S.B.); (E.S.)
| | - Alberto Argentiero
- Pediatric Clinic, Pietro Barilla Children’s Hospital, Department of Medicine and Surgery, University of Parma, 43126 Parma, Italy; (A.A.); (V.F.); (G.P.)
| | - Valentina Fainardi
- Pediatric Clinic, Pietro Barilla Children’s Hospital, Department of Medicine and Surgery, University of Parma, 43126 Parma, Italy; (A.A.); (V.F.); (G.P.)
| | - Giovanna Pisi
- Pediatric Clinic, Pietro Barilla Children’s Hospital, Department of Medicine and Surgery, University of Parma, 43126 Parma, Italy; (A.A.); (V.F.); (G.P.)
| | - Susanna Esposito
- Pediatric Clinic, Pietro Barilla Children’s Hospital, Department of Medicine and Surgery, University of Parma, 43126 Parma, Italy; (A.A.); (V.F.); (G.P.)
- Correspondence: ; Tel.: +39-0521-704790
| |
Collapse
|