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Salehi Z, Askari M, Jafari A, Ghosn B, Surkan PJ, Hosseinzadeh-Attar MJ, Pouraram H, Azadbakht L. Dietary patterns and micronutrients in respiratory infections including COVID-19: a narrative review. BMC Public Health 2024; 24:1661. [PMID: 38907196 PMCID: PMC11193220 DOI: 10.1186/s12889-024-18760-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2023] [Accepted: 05/02/2024] [Indexed: 06/23/2024] Open
Abstract
BACKGROUND COVID-19 is a pandemic caused by nCoV-2019, a new beta-coronavirus from Wuhan, China, that mainly affects the respiratory system and can be modulated by nutrition. METHODS This review aims to summarize the current literature on the association between dietary intake and serum levels of micronutrients, malnutrition, and dietary patterns and respiratory infections, including flu, pneumonia, and acute respiratory syndrome, with a focus on COVID-19. We searched for relevant articles in various databases and selected those that met our inclusion criteria. RESULTS Some studies suggest that dietary patterns, malnutrition, and certain nutrients such as vitamins D, E, A, iron, zinc, selenium, magnesium, omega-3 fatty acids, and fiber may have a significant role in preventing respiratory diseases, alleviating symptoms, and lowering mortality rates. However, the evidence is not consistent and conclusive, and more research is needed to clarify the mechanisms and the optimal doses of these dietary components. The impact of omega-3 and fiber on respiratory diseases has been mainly studied in children and adults, respectively, and few studies have examined the effect of dietary components on COVID-19 prevention, with a greater focus on vitamin D. CONCLUSION This review highlights the potential of nutrition as a modifiable factor in the prevention and management of respiratory infections and suggests some directions for future research. However, it also acknowledges the limitations of the existing literature, such as the heterogeneity of the study designs, populations, interventions, and outcomes, and the difficulty of isolating the effects of single nutrients from the complex interactions of the whole diet.
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Affiliation(s)
- Zahra Salehi
- Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, Tehran, IR, Iran
| | - Mohammadreza Askari
- Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, Tehran, IR, Iran
| | - Alireza Jafari
- Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, Tehran, IR, Iran
| | - Batoul Ghosn
- Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, Tehran, IR, Iran
| | - Pamela J Surkan
- Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Mohammad Javad Hosseinzadeh-Attar
- Department of Clinical Nutrition, School of Nutritional Sciences and Dietetic, Tehran University of Medical Sciences, Tehran, Iran
- Department of Nutrition and Biochemistry, School of Public Health, Tehran University of Medical Sciences, Tehran, IR, Iran
| | - Hamed Pouraram
- Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, Tehran, IR, Iran
| | - Leila Azadbakht
- Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, Tehran, IR, Iran.
- Diabetes Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, IR, Iran.
- Department of Community Nutrition, School of Nutrition and Food Science, Isfahan University of Medical Sciences, Isfahan, IR, Iran.
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Yu M, Zhang Q, Yan H. Cytokines and refractory mycoplasma pneumoniae pneumonia in children: a systematic review. Minerva Pediatr (Torino) 2024; 76:259-267. [PMID: 37155205 DOI: 10.23736/s2724-5276.23.07158-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/10/2023]
Abstract
INTRODUCTION The relationship between cytokines and refractory mycoplasma pneumoniae pneumonia (RMPP) in children was conflicting. The aim of the current study was to perform a systematic review to determine the relationship between cytokines and RMPP in children. EVIDENCE ACQUISITION We searched PubMed, and the search was done on 21 November 2022. This search was limited to human studies, with language restriction of English. Studies were included if they reported the relationship between cytokines and RMPP. EVIDENCE SYNTHESIS A total of 22 relevant full articles were included in the review. TNF-α levels in the bronchoalveolar lavage fluid (BALF) and IL-18 levels in the blood samples were likely to be associated with RMPP. IL-2 and IL-4 lost significance regardless in the BALF or blood samples. Additionally, there was no significant difference in IFN-γ levels between RMPP patients and non-refractory mycoplasma pneumoniae pneumonia (NRMPP) patients in the BALF. Patients receiving different treatments had different levels of cytokines. CONCLUSIONS This analysis offers evidence linking abnormalities of cytokines with RMPP in children, which may be essential for identifying individuals with RMPP. Large prospective studies are needed for further clarification of roles of cytokines in RMPP.
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Affiliation(s)
- Ming Yu
- Medical School of Nantong University, Nantong, China
- Affiliated Hospital of Nantong University, Nantong, China
| | - Qin Zhang
- Department of Nursing, the First Affiliated Hospital of Soochow University, Suzhou, Jiangsu, China
| | - Haiou Yan
- Affiliated Hospital of Nantong University, Nantong, China -
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Liu C, Wang R, Ge S, Wang B, Li S, Yan B. Research status and challenges of Mycoplasma pneumoniae pneumonia in children: A bibliometric and visualization analysis from 2011 to 2023. Medicine (Baltimore) 2024; 103:e37521. [PMID: 38489686 PMCID: PMC10939570 DOI: 10.1097/md.0000000000037521] [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: 11/29/2023] [Revised: 02/14/2024] [Accepted: 02/15/2024] [Indexed: 03/17/2024] Open
Abstract
BACKGROUND Mycoplasma pneumoniae (MP) infections occur in regional outbreaks every 3 to 7 years, lasting up to 2 years. Since this fall, there has been a significant rise in MP infections among children in China, indicating a regional epidemiological trend that imposes an increased national public health burden. To date, bibliometric methods have not been applied to studies on MP infection in children. METHODS We searched for all relevant English publications on MP pneumonia in children published from 2011 to 2023 using Web of Science. Analytical software tools such as Citespace and VOSviewer were employed to analyze the collected literature. RESULTS 993 articles on MP pneumonia in children were published in 338 academic journals by 5062 authors affiliated with 1381 institutions across 75 countries/regions. China led in global productivity with 56.19%. Among the top 10 prolific organizations, 8 were Chinese institutions, with Soochow University being the most active, followed by Capital Medical University and Zhejiang University. Zhimin Chen from Zhejiang University School of Medicine exhibited the highest H-index of 32. Keyword co-occurrence network analysis revealed 7 highly relevant clusters. CONCLUSION The current research hotspots and frontiers in this field are primarily MP pneumonia, refractory MP pneumonia, lactate dehydrogenase, asthma, and biomarker. We anticipate that this work will provide novel insights for advancing scientific exploration and the clinical application of MP pneumonia in children.
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Affiliation(s)
- Congcong Liu
- Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Rui Wang
- Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Shuyi Ge
- Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Binding Wang
- Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Siman Li
- Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Bohua Yan
- Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu, China
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Chen Q, Hu T, Wu L, Chen L. Clinical Features and Biomarkers for Early Prediction of Refractory Mycoplasma Pneumoniae Pneumonia in Children. Emerg Med Int 2024; 2024:9328177. [PMID: 38222094 PMCID: PMC10787049 DOI: 10.1155/2024/9328177] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2023] [Revised: 10/23/2023] [Accepted: 11/24/2023] [Indexed: 01/16/2024] Open
Abstract
Objective The study aimed to analyze the clinical characteristics of children with RMPP and to explore the biomarkers for the early prediction of RMPP, thus providing references for the clinical diagnosis and treatment of RMPP in children. Methods Baseline clinical characteristics, clinical symptoms, physical examination, chest imaging, and laboratory indicators between children with RMPP and general refractory mycoplasma pneumoniae pneumonia (GMPP) were compared. Multiple logistic regression analysis was used to determine independent risk factors for RMPP. ROC curves were adopted to analyze the predictive values of biomarkers. Results The RMPP group had more severe clinical symptoms and manifestations on imaging (including pleural effusion, pulmonary consolidation, and pulmonary atelectasis), a higher incidence of extrapulmonary complications, and a longer duration of hospital stays. Results of multiple logistic regression analysis showed that serum D-dimer (OR = 8.169, P < 0.001), C-reactive protein (CRP) (OR = 1.146, P < 0.001), and lactate dehydrogenase (LDH) (OR = 1.025, P < 0.001) levels were independent risk factors for RMPP. The area under the receiver operating characteristic curve (AUROC) in RMPP prediction was 0.841, 0.870, and 0.893 for serum levels of D-dimer, CRP, and LDH, respectively (P < 0.001), with a cutoff value of 1.47 ng/ml, 39.34 mg/L, and 379 IU/L, respectively. Conclusions Serum D-dimer, CRP, and LDH levels were related to the severity of mycoplasma pneumoniae pneumonia in children and had potential as biomarkers for the early prediction of RMPP, suggesting great applicative values for the early diagnosis and timely intervention of children with RMPP in clinical practice.
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Affiliation(s)
- Qin Chen
- Department of Respiratory Medicine, College of Clinical Medicine for Obstetrics & Gynecology and Pediatrics, Fujian Medical University, Fujian Children's Hospital (Fujian Branch of Shanghai Children's Medical Center), Fuzhou 350014, China
| | - Tingting Hu
- Department of Cardiology, College of Clinical Medicine for Obstetrics & Gynecology and Pediatrics, Fujian Medical University, Fujian Children's Hospital (Fujian Branch of Shanghai Children's Medical Center), Fuzhou 350014, China
| | - Ling Wu
- Infectious Department, College of Clinical Medicine for Obstetrics & Gynecology and Pediatrics, Fujian Medical University, Fujian Children's Hospital (Fujian Branch of Shanghai Children's Medical Center), Fuzhou 350014, China
| | - Lumin Chen
- Department of Respiratory Medicine, College of Clinical Medicine for Obstetrics & Gynecology and Pediatrics, Fujian Medical University, Fujian Children's Hospital (Fujian Branch of Shanghai Children's Medical Center), Fuzhou 350014, China
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Mendes ADCL, De Souza AMG, Nunes ADDS, Jerez-Roig J, Barbosa IR. Frequency of Vitamin a Deficiency in Children Hospitalized for Pneumonia: An Integrative Review. Public Health Rev 2022; 43:1604500. [PMID: 36588988 PMCID: PMC9799238 DOI: 10.3389/phrs.2022.1604500] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2021] [Accepted: 11/29/2022] [Indexed: 12/15/2022] Open
Abstract
Objective: To identify the frequency of vitamin A deficiency in children aged 6 months to 5 years hospitalized for pneumonia. Methods: An integrative literature review was carried out, where searches were made by two independent researchers, with no language limits or publication time in the databases PubMed, LILACS, Web of Science, Scopus and CINAHL, and in the gray literature-OpenGrey, Proquest and Google Scholar. In the eligibility phase, the screened studies were read in full and those that did not answer the research question were excluded. Methodological quality was assessed using the Downs & Black (1998) checklist. Results: 1642 articles were identified, after all stages of screening and selection, 10 studies were included, of which 5 were longitudinal, 4 were intervention and 1 transversal. All studies identified subclinical vitamin A deficiency in children hospitalized with pneumonia; the highest frequency of subclinical vitamin A deficiency was 93.2%. All studies evaluated showed frequencies of subclinical vitamin A deficiency >20%. Conclusion: There is a high frequency of subclinical vitamin A deficiency in children with pneumonia; these data need to be further explored in terms of their associations. For this reason, new studies that evaluate this topic are of fundamental importance.
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Affiliation(s)
- Amanda De Conceição Leão Mendes
- Department of Collective Health, Federal University of Rio Grande do Norte, Natal, Brazil,*Correspondence: Amanda De Conceição Leão Mendes,
| | | | | | - Javier Jerez-Roig
- University of Vic-Central University of Catalonia (UVIC-UCC), Barcelona, Spain
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Li R, Zhao W, Wang H, Toshiyoshi M, Zhao Y, Bu H. Vitamin A in children's pneumonia for a COVID-19 perspective: A systematic review and meta-analysis of 15 trials. Medicine (Baltimore) 2022; 101:e31289. [PMID: 36281101 PMCID: PMC9592144 DOI: 10.1097/md.0000000000031289] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND To systematically review and meta-analyze the efficacy of vitamin A as an adjuvant therapy for pneumonia in children. METHODS We searched in PubMed, the Cochrane Library, Chinese National Knowledge Infrastructure, WanFang Database and Chongqing VIP information network from libraries building to March 2022, screening randomized controlled trials (RCT) about vitamin A combined with conventional therapy for pneumonia in children. Two researchers used the Cochrane risk of bias tool to assess the quality of included studies dependently. Data analysis was conducted in the RevMan 5.3. RESULTS 15 trials involving 3496 patients (treated group: 1898; control group: 1598) were analyzed in this study. The Meta-analysis showed that vitamin A combined with conventional therapy improved clinical efficacy (P < .05), shortened the duration of fever and cough, negative time of chest X-ray, and the hospitalization, lung rale disappearance, choking milk disappearance, shortness of breath disappearance and perilabial cyanosis disappearance (P < .05). However, vitamin A combined with conventional therapy did not reduce the mortality of pneumonia in children (P > .05). CONCLUSION Vitamin A contributes to relieve the clinical symptoms and signs, and also shorten the hospitalization.
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Affiliation(s)
- Ruoxi Li
- Graduate School, Shandong University of Traditional Chinese Medicine, Jinan, China
| | - Wenli Zhao
- Liver Center, Saga University Hospital, Saga University, Saga, Japan
| | - Hongwu Wang
- School of Health Science and Engineering, Tianjin University of Traditional Chinese Medicine, Tianjin, China
| | - Maeda Toshiyoshi
- International Education College, Shandong University of Traditional Chinese Medicine, Jinan, China
| | - Ye Zhao
- Department of Public Health, International College, Krirk University, Bangkok, Thailand
- *Correspondence: Ye Zhao, Department of Public Health, International College, Krirk University, Bangkok 10220, Thailand (e-mail: )
| | - Huaien Bu
- School of Health Science and Engineering, Tianjin University of Traditional Chinese Medicine, Tianjin, China
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Refractory Mycoplasma Pneumonia in Children: A Systematic Review and Meta-analysis of Laboratory Features and Predictors. J Immunol Res 2022; 2022:9227838. [PMID: 35795531 PMCID: PMC9251082 DOI: 10.1155/2022/9227838] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2022] [Revised: 05/16/2022] [Accepted: 05/28/2022] [Indexed: 11/17/2022] Open
Abstract
Background. Mycoplasma pneumoniae is a common pathogen of community-acquired pneumonia (CAP) in children. M. pneumoniae infection is usually regarded as a self-limiting disease, but in some special cases, it can also develop into refractory Mycoplasma pneumoniae pneumonia (RMPP). The aim of this study is to analyze the clinical characteristics of CRP (C-reactive protein), LDH (lactate dehydrogenase), ESR (erythrocyte sedimentation rate), D-dimer, neutrophils (%), lymphocytes (%), and lung consolidation in RMPP and explore their prediction results in the early stage of RMPP, which is important for early treatment. Methods. This systematic search was conducted in PubMed, Embase, Cochrane Library, Web of Science, CNKI, Wangfang, and Cqvip, and the date was set until February 23, 2021. For the continuous variables, mean difference (MD) with 95% CI was adopted to evaluate CRP, LDH, ESR, D-dimer, neutrophils (%), lymphocytes (%), and the correlation between lung consolidation and RMPP. Results. 20 studies including 5289 patients were included in the analysis, and the results showed that the CRP of the RMPP group (MD (95% CI): 22.29 (12.20, 32.38),
), LDH (MD (95% CI): 145.13 (78.62, 211.64),
), neutrophils (%) (MD (95% CI): 7.27 (0.31, 14.23),
), and D-dimer (MD (95% CI): 1.79 (-1.17, 4.74),
) was higher than that of the NRMPP group; the risk of lung consolidation in the RMPP group (OR (95% CI): 14.29 (4.52, 45.12),
) was higher than that in the NRMPP group, and there was no difference in ESR (MD (95% CI): 8.11 (-1.34, 17.56),
) and lymphocytes (%) (MD (95% CI): -6.27 (-12.81, 0.27),
) between the two groups. Conclusion. So, the available evidence indicates that CRP, LDH, neutrophils (%), D-dimer, and lung consolidation are predictive factors for RMPP.
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Jiang Y, Bao C, Zhao X, Chen Y, Song Y, Xiao Z. Intestinal bacteria flora changes in patients with Mycoplasma pneumoniae pneumonia with or without wheezing. Sci Rep 2022; 12:5683. [PMID: 35383237 PMCID: PMC8981890 DOI: 10.1038/s41598-022-09700-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2021] [Accepted: 03/28/2022] [Indexed: 12/05/2022] Open
Abstract
Mycoplasma pneumoniae (MP) infection is a common cause of community-acquired pneumonia in children. Furthermore, many children with Mycoplasma pneumoniae pneumonia (MPP) have recurrent wheezing and reduced small airway function after their clinical symptoms have resolved, eventually leading to asthma. MPP can trigger immune disorders and systemic inflammatory responses. Hence, the intestine is the largest immune organ of the body. Therefore, we sought to investigate whether the alteration of intestinal flora is correlated with the development of wheezing in children with MPP. We collected 30 healthy children as group A, 50 children with nonwheezing MPP as group B, and 50 children with wheezing MPP as group C. We found that the percentage of eosinophil cells (EC) was significantly higher in group C than that in group B for routine blood tests and serum inflammatory factors. The serum cytokines, including IL-4, IL-17, TNF-α, and TGF-β, were significantly higher in group C than in group B. In addition, the level of IL-10 was significantly lower in group C than in group B. The distribution characteristics of intestinal flora strains in children with MPP were detected by sequencing of 16S rRNA gene amplicon sequencing. There were differences in the abundance of intestinal flora between children with MPP and healthy children, with lower abundance of Ruminococcus flavefaciens, Clostridium butyricum, Lactobacillus, and Bifidobacterium in the intestine of children with MPP compared to healthy children. The abundance of Ruminococcus flavefaciens and Clostridium butyricum was significantly lower in the intestine of children with wheezing MPP compared to children without wheezing MPP. In the correlation analysis between children with MPP and inflammatory factors, Ruminococcus flavefaciens was found to be negatively correlated with IL-17. Clostridium butyricum was negatively correlated with L-4, IL-17, TNF-α, and TGF-β; however, it positively correlated with IL-10. Thus, it was concluded that alterations in intestinal flora play a crucial role in the immune response to MPP, where a significant decline in intestinal Ruminococcus flavefaciens and Clostridium butyricum leads to an exacerbation of the inflammatory responses, which may promote the development of children with wheezing MPP.
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Affiliation(s)
- Yonghong Jiang
- Department of Paediatrics, Longhua Hospital Affiliated to Shanghai University of Traditional Chinese Medicine, No.725 South Wanping Road, Xuhui District, Shanghai, 200032, China.
| | - Chunxiu Bao
- Department of Paediatrics, Longhua Hospital Affiliated to Shanghai University of Traditional Chinese Medicine, No.725 South Wanping Road, Xuhui District, Shanghai, 200032, China
| | - Xiaoyang Zhao
- Department of Paediatrics, Longhua Hospital Affiliated to Shanghai University of Traditional Chinese Medicine, No.725 South Wanping Road, Xuhui District, Shanghai, 200032, China
| | - Yiliu Chen
- Department of Paediatrics, Longhua Hospital Affiliated to Shanghai University of Traditional Chinese Medicine, No.725 South Wanping Road, Xuhui District, Shanghai, 200032, China
| | - Yao Song
- Department of Paediatrics, Longhua Hospital Affiliated to Shanghai University of Traditional Chinese Medicine, No.725 South Wanping Road, Xuhui District, Shanghai, 200032, China
| | - Zhen Xiao
- Department of Paediatrics, Longhua Hospital Affiliated to Shanghai University of Traditional Chinese Medicine, No.725 South Wanping Road, Xuhui District, Shanghai, 200032, China.
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