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Colosia A, Costello J, McQuarrie K, Kato K, Bertzos K. Systematic literature review of the signs and symptoms of respiratory syncytial virus. Influenza Other Respir Viruses 2023; 17:e13100. [PMID: 36824394 PMCID: PMC9899685 DOI: 10.1111/irv.13100] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2022] [Accepted: 01/08/2023] [Indexed: 02/07/2023] Open
Abstract
Respiratory syncytial virus (RSV) is responsible for over 30 million lower respiratory tract infections (LRTIs) and 3 million hospitalizations worldwide each year. Despite the risk RSV poses to young children, older adults, and individuals with comorbidities or suppressed immunity, there is limited understanding of RSV symptom presentation across these at-risk groups, and there is no vaccine for RSV. We conducted two systematic literature reviews (SLRs) of studies that document signs and symptoms (S&S) of RSV in (1) children aged ≤5 years and (2) immunocompromised adolescents and adults, and adults at high risk for severe RSV due to age or comorbidities. Symptom duration and hospital length of stay (LOS) were explored. Electronic database searches were performed following PRISMA guidelines. Studies captured RSV S&S across community and hospital settings. Clinicians and caregivers reported (n = 25 studies) nasal discharge/congestion, cough, shortness of breath, feeding abnormalities, and fever in ≥40% of children across studies and settings. Median hospital stays for children ranged from 2 days in the United States to 7.5 days in China. High-risk adults with RSV (n = 6 studies) commonly (≥40% of adults) reported cough, sputum, dyspnea, and fever/feverishness. Median length of hospital stay in adults ranged from 6 to 15 days across studies. Caregivers and clinicians reported similar RSV S&S in young children, including upper and lower respiratory and systemic symptoms. In high-risk and immunocompromised adults, the most frequent (in multiple publications) and commonly reported RSV S&S were primarily LRTI symptoms. RSV symptoms could last for weeks and are variable based on geography.
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Affiliation(s)
- Ann Colosia
- RTI Health SolutionsResearch Triangle ParkNorth CarolinaUSA
| | | | - Kelly McQuarrie
- Janssen Global ServicesHorshamPennsylvaniaUSA,Present address:
Merck & CompanyRahwayNew JerseyUSA
| | - Kelly Kato
- Janssen Global ServicesRaritanNew JerseyUSA
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I G Giamberardino H, O Pacheco AP, Pereira LA, Debur MDC, Genehold G, Raboni SM. Respiratory syncytial virus: host genetic susceptibility and factors associated with disease severity in a cohort of pediatric patients. J Trop Pediatr 2022; 68:6794268. [PMID: 36323460 DOI: 10.1093/tropej/fmac091] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
BACKGROUND Respiratory syncytial virus (RSV) infections are the leading cause of hospitalization in young children. We assessed the epidemiology, severity, clinical characteristics, molecular profile and genetic factors of RSV infections compared to acute respiratory illness (ARI) caused by other respiratory viruses. METHODS Prospective cohort study was conducted from 2017 to 2018 with children under 2 years old hospitalized with ARI. Detection of respiratory viruses was carried out using RT-PCR. RSVs were genotyped via nucleotide sequencing, and host interleukin 28B (IL28B) single nucleotide polymorphisms (SNPs) were determined using SNP TaqMan® Genotyping Assays. RESULTS A total of 468 children were included; 288 (61.5%) had an infection by a single virus: 202 (70.1%) cases by RSV followed by rhinovirus 36 (12.5%) and influenza 16 (5.6%). Of the RSV cases, 36% were genotyped with a higher prevalence of RSV B (62.1%). The RSV group presented median age of 2.7 months (1.6-6.8), higher frequency in: intensive care unit admission (p = 0.004), mechanical ventilation use (p = 0.018), wheezing (p < 0.001), antimicrobial use (p < 0.001) and low oxygen saturation (p < 0.001). Prematurity (27.2%) was the most frequent comorbidity. RSV patients without comorbidities demonstrated a higher frequency in the combination of IL28B rs12979860 CT/IL28B rs8099917 TG and IL28B rs12979860 TT/IL28B rs8099917 TT genotypes. Viral coinfection was detected in 27 (5.7%) children, with the most frequent being RSV and rhinovirus (14.2%). CONCLUSIONS This study highlighted the burden of RSV infection in children under 2 years of age, without comorbidities, with a higher need for pediatric ICU admission. Some IL28B allele combinations had a significant association with RSV frequency of infections.
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Affiliation(s)
- Heloisa I G Giamberardino
- Graduate Program in Internal Medicine and Health Science, Universidade Federal do Paraná, Curitiba, Paraná 80060-900, Brazil.,Epidemiology, Immunization and Infection Control Department, Hospital Pequeno Principe, Curitiba, Paraná 80250-060, Brazil
| | - Ana P O Pacheco
- Epidemiology, Immunization and Infection Control Department, Hospital Pequeno Principe, Curitiba, Paraná 80250-060, Brazil
| | - Luciane A Pereira
- Graduate Program in Internal Medicine and Health Science, Universidade Federal do Paraná, Curitiba, Paraná 80060-900, Brazil.,Research and Molecular Biology of Microorganisms Laboratory, Infectious Diseases Department, Universidade Federal do Paraná, Curitiba, Paraná 80060-900, Brazil
| | - Maria do Carmo Debur
- Health Public Laboratory, Health State Secretary, Curitiba, Paraná 80045-155, Brazil
| | - Gustavo Genehold
- Research and Molecular Biology of Microorganisms Laboratory, Infectious Diseases Department, Universidade Federal do Paraná, Curitiba, Paraná 80060-900, Brazil
| | - Sonia M Raboni
- Research and Molecular Biology of Microorganisms Laboratory, Infectious Diseases Department, Universidade Federal do Paraná, Curitiba, Paraná 80060-900, Brazil.,Infectious Diseases Department, Universidade Federal do Paraná, Curitiba, Paraná 80060-900, Brazil
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Soysal B, Özdemir SA, Gönüllü A, Kalkanlı OH, Ayhan FY, Çalkavur Ş, Yıldırım TG. Evaluation of Newborns with Non-COVID-19 Pneumonia Hospitalized in the Neonatal Intensive Care Unit during the COVID-19 Pandemic, Turkey, Izmir 2020–2021. J PEDIAT INF DIS-GER 2022. [DOI: 10.1055/s-0042-1755212] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/14/2022]
Abstract
Abstract
Objective In this study, we aimed to compare the clinical, laboratory, and radiological findings of noncoronavirus disease 2019 (COVID-19) viral agents in newborn infants hospitalized for lower respiratory tract infection during the COVID-19 pandemic.
Methods This prospective cross-sectional study conducted between 11 March 2020 and 31 July 2021 included neonates with lower respiratory tract infections admitted to the neonatal intensive care unit of the Dr. Behcet Uz Children's Hospital. Nasopharyngeal swab samples were taken from all hospitalized patients for multiplex respiratory polymerase chain reaction (PCR) and severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) PCR. The detection of respiratory viral pathogens was performed by multiplex real-time PCR assay (Bosphore Respiratory Pathogens Panel Kit V4, Anatolia Geneworks, Turkey). Infants with SARS-CoV-2 PCR positivity were excluded from the study. Patients' data were obtained from the electronic medical registry system. The non-COVID-19 viruses of the cases were analyzed according to seasonal variation (in/off-season). The pulmonary findings of the cases were classified as normal, infiltration, air bronchogram, and reticulogranular appearance at the time of admission.
Results A total of 80 infants were included during the study period. A multiplex PCR test was performed to identify viral agents affecting the lower respiratory tract of infants; it was determined that 31% (25 out of 80) were respiratory syncytial virus (RSV), 41% (33 out of 80) were rhinovirus (Rhino), and the remaining portion (28%, 22 out of 80) were other viral agents (enterovirus, bocavirus, adenovirus, influenza, and parainfluenza). Compared with Rhino and other viral agents, RSV was detected most frequently in seasonal hospitalizations (p < 0.05). When chest radiography and laboratory findings were evaluated, the rate of “infiltration” /“lymphopenia” was significantly associated with infants with RSV lower respiratory tract infections (p < 0.05).
Conclusion During the pandemic period, RSV affected the prognosis in intensive care unit admissions due to lower respiratory tract infection in newborns.
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Affiliation(s)
- Buse Soysal
- Newborn Intensive Care Unit, The University of Health Sciences, Dr Behçet Uz Children's Hospital, İzmir, Turkey
| | - Senem Alkan Özdemir
- Newborn Intensive Care Unit, The University of Health Sciences, Dr Behçet Uz Children's Hospital, İzmir, Turkey
- Stem Cell Department, Institute of Health Science, Ege University, Izmir, Turkey
| | - Ahmet Gönüllü
- Department of Pediatrics, The University of Health Sciences, Dr Behçet Uz Children's Hospital, Izmir, Turkey
| | - Oğuz Han Kalkanlı
- Newborn Intensive Care Unit, The University of Health Sciences, Dr Behçet Uz Children's Hospital, İzmir, Turkey
| | - Fahri Yüce Ayhan
- Department of Medical Microbiology, The University of Health Sciences, Dr Behçet Uz Children's Hospital, Izmir, Turkey
| | - Şebnem Çalkavur
- Newborn Intensive Care Unit, The University of Health Sciences, Dr Behçet Uz Children's Hospital, İzmir, Turkey
| | - Tülin Gökmen Yıldırım
- Newborn Intensive Care Unit, The University of Health Sciences, Dr Behçet Uz Children's Hospital, İzmir, Turkey
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Stefanidis K, Konstantelou E, Yusuf GT, Oikonomou A, Tavernaraki K, Karakitsos D, Loukides S, Vlahos I. Radiological, epidemiological and clinical patterns of pulmonary viral infections. Eur J Radiol 2021; 136:109548. [PMID: 33485125 PMCID: PMC7808729 DOI: 10.1016/j.ejrad.2021.109548] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2020] [Revised: 01/08/2021] [Accepted: 01/11/2021] [Indexed: 01/07/2023]
Abstract
Respiratory viruses are the most common causes of acute respiratory infections. However, identification of the underlying viral pathogen may not always be easy. Clinical presentations of respiratory viral infections usually overlap and may mimic those of diseases caused by bacteria. However, certain imaging morphologic patterns may suggest a particular viral pathogen as the cause of the infection. Although definitive diagnosis cannot be made on the basis of clinical or imaging features alone, the use of a combination of clinical and radiographic findings can substantially improve the accuracy of diagnosis. The purpose of this review is to present the clinical, epidemiological and radiological patterns of lower respiratory tract viral pathogens providing a comprehensive approach for their diagnosis and identification in hospitals and community outbreaks.
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Affiliation(s)
| | - Elissavet Konstantelou
- 1st Respiratory Department of the National and Kapodistrian University of Athens, “Sotiria” General and Chest Diseases’ Hospital, Athens, Greece
| | | | - Anastasia Oikonomou
- Department of Medical Imaging, Sunnybrook Health Sciences Centre, University of Toronto, Canada
| | - Kyriaki Tavernaraki
- Imaging and Interventional Radiology, Sotiria General and Chest Diseases Hospital, Athens, Greece
| | | | - Stylianos Loukides
- 2nd Respiratory Department of the National and Kapodistrian University of Athens, “Attikon” General Hospital, Athens, Greece
| | - Ioannis Vlahos
- Department of Thoracic Radiology, Division of Diagnostic Imaging. University of Texas MD Anderson Cancer Center, Houston, TX, USA
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Tan J, Wu J, Jiang W, Huang L, Ji W, Yan Y, Wang M, Shao X. Etiology, clinical characteristics and coinfection status of bronchiolitis in Suzhou. BMC Infect Dis 2021; 21:135. [PMID: 33522910 PMCID: PMC7851904 DOI: 10.1186/s12879-021-05772-x] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2020] [Accepted: 01/06/2021] [Indexed: 01/21/2023] Open
Abstract
Background Bronchiolitis is a clinical syndrome commonly encountered in practice, particularly among infants and young children. To investigate the prevalence of pathogens in hospitalized children with bronchiolitis and study the clinical characteristics of bronchiolitis with or without coinfections. Methods We investigated the respiratory specimens and clinical data of 1012 children with bronchiolitis who were treated at the Children’s Hospital of Soochow University between November 2011 and December 2018. The nasopharyngeal aspirates were examined to detect viruses by direct immunofluorescence assay or polymerase chain reaction (PCR). Mycoplasma pneumoniae (MP) was tested by PCR and enzyme-linked immunosorbent assay. Results Of the 1134 children less than 2 years with bronchiolitis, 122 were excluded by exclusion criteria. Causative pathogen was detected in 83.2% (842 of 1012). The majority of these (614 [72.9%] of 842) were single virus infection. The most common pathogens detected were respiratory syncytial virus (RSV) (44.4%), MP (15.6%), and human rhinovirus (HRV) (14.4%). Coinfection was identified in 13.5% (137 of 1012) of the patients. Coinfection included mixed virus infection and virus infection with MP infection. Children with single virus infection had a higher rate of oxygen therapy compared with single MP infection. Conclusions The most common pathogen detected in children with bronchiolitis is RSV, followed by MP and HRV. Coinfection leads to a longer period of illness, increased severity of the symptoms and increased risk of hypoxemia.
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Affiliation(s)
- Jiahong Tan
- Department of Respiratory Medicine, Children's Hospital of Soochow University, Suzhou, China
| | - Jinfeng Wu
- 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. .,Children's Hospital of Wujiang District, Suzhou, China.
| | - Li Huang
- Department of Respiratory Medicine, Children's Hospital of Soochow University, Suzhou, China.
| | - Wei Ji
- Department of Respiratory Medicine, Children's Hospital of Soochow University, Suzhou, China
| | - Yongdong Yan
- Department of Respiratory Medicine, Children's Hospital of Soochow University, Suzhou, China
| | - Meijuan Wang
- Department of Respiratory Medicine, Children's Hospital of Soochow University, Suzhou, China
| | - Xuejun Shao
- Department of Clinical Laboratory, Children's Hospital of Soochow University, Suzhou, China
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Alkan Ozdemir S, Soysal B, Calkavur S, Gökmen Yıldırım T, Kıymet E, Kalkanlı O, Çolak R, Devrim İ. Is respiratory syncytial virus infection more dangerous than COVID 19 in the neonatal period? J Matern Fetal Neonatal Med 2020; 35:4398-4403. [PMID: 33225779 DOI: 10.1080/14767058.2020.1849125] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
OBJECTIVE We aimed to compare the clinical features, laboratory findings and primary outcomes of the neonates with RSV and neonates with SARS-CoV-2 infections. MATERIALS AND METHODS This nested case-control study included the neonates who were administered in the neonatal intensive care unit (NICU) of the University of Health Sciences, Dr Behçet Uz Children's Hospital during the period of 01 March-30 April 2020. Respiratory PCR samples and COVID-19 samples were taken simultaneously. Only RSV positive and COVID-19 positive infants were compared. Demographic, epidemiological and clinical data were obtained from hospital electronic information system medical records. The chest radiographs at the admission were evaluated by using standard definitions for normal chest X-ray, atelectasis, bronchopenumonia, peribronchial thickening and hyperinflation in various lung volumes. RESULTS A total of 30 infants were enrolled in the study and RSV was identified in 20/30 infants (66%). No significant differences were observed between the two groups in terms of general characteristics. Comparing to the infants with Covid-19 infections, infants with RSV infections had significantly higher rates of having oxygen support (p = .03). Total NICU duration time was 6.7 ± 1.6 days in COVID positive group and 11.1 ± 5.1 days in the RSV group (p = .01). Infants with COVID-19 had more normal chest X-rays. Infants with RSV-positive had a significantly higher proportion of atelectasis than those with COVID-19 infants (p = .04). DISCUSSION This is the first study that compares RSV infection and COVID-19 infection. RSV infection can be more serious in the neonatal period. In cases with suspected COVID-19 infection, it should be kept in mind if atelectasis is seen on chest radiography. Respiratory failure may be more serious in RSV positive infants and RSV infection may be more dangerous for the neonatal period.
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Affiliation(s)
- Senem Alkan Ozdemir
- Division of Neonatology, Dr. Behçet Uz Child Disease and Pediatric Surgery Training and Research Hospital, Izmir Health Science University, Izmir, Turkey.,Division of Stem Cell, Aegean University School of Health Sciences Institute, Izmir, Turkey
| | - Buse Soysal
- Division of Neonatology, Dr. Behçet Uz Child Disease and Pediatric Surgery Training and Research Hospital, Izmir Health Science University, Izmir, Turkey
| | - Sebnem Calkavur
- Division of Neonatology, Dr. Behçet Uz Child Disease and Pediatric Surgery Training and Research Hospital, Izmir Health Science University, Izmir, Turkey
| | - Tülin Gökmen Yıldırım
- Division of Neonatology, Dr. Behçet Uz Child Disease and Pediatric Surgery Training and Research Hospital, Izmir Health Science University, Izmir, Turkey
| | - Elif Kıymet
- Division of Pediatric Infection Diseases, Dr. Behçet Uz Child Disease and Pediatric Surgery Training and Research Hospital, Izmir Health Science University, Izmir, Turkey
| | - Oguzhan Kalkanlı
- Division of Neonatology, Dr. Behçet Uz Child Disease and Pediatric Surgery Training and Research Hospital, Izmir Health Science University, Izmir, Turkey
| | - Rüya Çolak
- Division of Neonatology, Dr. Behçet Uz Child Disease and Pediatric Surgery Training and Research Hospital, Izmir Health Science University, Izmir, Turkey
| | - İlker Devrim
- Division of Pediatric Infection Diseases, Dr. Behçet Uz Child Disease and Pediatric Surgery Training and Research Hospital, Izmir Health Science University, Izmir, Turkey
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