Epidemiological and etiological characteristics of 1266 patients with severe acute respiratory infection in central China, 2018-2020: a retrospective survey

Retrospective study on the epidemiological characteristics of multi-pathogen infections of hospitalized severe acute respiratory tract infection and influenza-like illness in Xinjiang from January to May 2024

BACKGROUND

Acute respiratory tract infections are very common and can be caused by many pathogens. The aim of this study was to understand the characteristics of multi-pathogen infections of respiratory tract infections during the seasonal changes in winter and spring in Xinjiang.

METHODS

Throat swab samples were collected from 2791 patients with influenza-like illness (ILI) and hospitalized severe acute respiratory tract infection (SARI) in Xinjiang from January 2024 to May 2024 for multi-pathogen detection. Then, the infection frequency of pathogens and their distribution characteristics in different months, genders, regions and case classifications were analyzed.

RESULTS

The positive infection rate of pathogens in 2791 patients was 48.30% (1348/2791). The proportion of patients infected with respiratory pathogens in the 0-9 age group was the highest. Of all pathogens detected, MP was most common in positive patients (22.03%). The highest frequency of multiple infections was SPn. RSV, FluA and FluB were the main infectious pathogens in January and February. The number of RV, HPIV and MP infections showed an increasing trend from January to May. Compared to female patients, male patients are more likely to be infected with ADV and SPn. Compared with hospitalized SARI patients, outpatient and emergency ILI patients were more susceptible to infection with ADV and FluB. However, hospitalized SARI patients were more susceptible to infection with RSV and MP. The positive infected patients mainly came from northern Xinjiang (60.83%). Compared with other regions, the proportion of ADV positive patients in northern Xinjiang was higher.

CONCLUSION

This study revealed the distribution characteristics of pathogen infection in patients with respiratory tract infections in different months, genders, regions and case classifications during the seasonal changes of winter and spring in Xinjiang for the first time, which is helpful to formulate more effective treatment strategies and preventive measures.

CLINICAL TRIAL NUMBER

not applicable.

The global burden of human metapneumovirus-associated acute respiratory infections in older adults: a systematic review and meta-analysis

BACKGROUND

The human metapneumovirus (hMPV)-associated disease burden in older adults remains under-researched. We aimed to systematically estimate the global burden of hMPV-associated disease in older adults.

METHODS

We searched MEDLINE, Embase, Global Health, CINAHL, Web of Science, and Global Index Medicus in February, 2023, November, 2023, and October, 2024; and CNKI, Wanfang, and CQVip, in April, 2024, and October, 2024. We included studies conducted over at least 12 consecutive months, reporting on adults aged 60 years or older, and with laboratory-confirmed hMPV infections. Critical appraisal of included studies was conducted using the Joanna Briggs Institute critical appraisal tools. To estimate the hMPV pooled proportions positive in acute respiratory infections (ARIs), random effects meta-analyses were conducted. Using Monte Carlo simulation, we estimated the hMPV-associated hospitalisations globally and separately in high-income countries, low-income and middle-income countries, and the USA in individuals aged 65 years or older in 2019, as most studies reported on this age group. The hMPV-associated ARI incidence in countries other than the USA and in outpatient or community settings in the USA was summarised narratively due to scarcity of data. The review protocol was registered on PROSPERO (CRD42023422325).

FINDINGS

46 studies conducted between 2005 and 2023, and reporting on hMPV proportion positive estimates (n=36, with 29 866 laboratory tests), hospitalisation rates in the USA (n=4), and hMPV incidence (n=6) were included. We estimated 473 000 (95% CI 396 000-777 000) hMPV-associated hospitalisations globally, of which 185 000 (105 000-340 000) were in high-income countries (n=6 studies), and 288 000 (193 000-436 000) in low-income and middle-income countries (n=10 studies) in people aged 65 years or older in 2019. In the USA, the pooled hMPV-associated hospitalisation rate was 231 (95% CI 41-421) per 100 000 people in adults aged 65 years or older, representing approximately 122 000 (41 000-398 000) hospital admissions in this population in 2019.

INTERPRETATION

hMPV-associated ARIs contribute to a substantial disease and hospitalisation burden in older adults. However, more large-scale surveillance studies and greater investment in research and diagnostic methods are required to develop reliable estimates.

FUNDING

Icosavax, a member of the AstraZeneca group.

Molecular detection of respiratory viruses: an observational study on respiratory co-infections in children and adults

Respiratory tract infection (RTI) is the most important cause of visiting both public and private medical care services. During the decade preceding Covid-19, in developing countries, there was a gap in the epidemiology of respiratory viral infections, probably due to the difficulty of detecting viral agents in clinical microbiology laboratories routine, at that time. In this context, the aim of this study was to describe the occurrence of virus, demographic factors associated and the likelihood of coinfections detection by multiplex PCR methods. The target also was to determine the involvement of respiratory viruses other than SARS-CoV-2 as agents of upper respiratory tract infections (URTIs) using rapid respiratory panels by multiplex real time PCR with flow chip methodology. Samples of SARSs patients, 530 in total, were tested between 2022 and 2023, obtained from nasopharyngeal swabs, nasopharyngeal exudates or nasopharyngeal aspirates. Of 530 tests, 30% was human rhinovirus, the most prevalent, followed by respiratory syncytial virus B (21.5%) and human adenovirus (17.4%). Among the total of positive samples, 83.8% belonged to patients aged between 0 and 10 years, 62.6% of whom were aged between 1 and 10 years. Multiple virus detection was found in 50.4% of the samples tested, 93.1% of which were from patients under the age of 18. Viral co-infection was evident in the finding and was higher (88.7%) in patients under the age of 18 yeas.