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Armero G, Guitart C, Soler-Garcia A, Melé M, Esteva C, Brotons P, Muñoz-Almagro C, Jordan I, Launes C. Non-Pharmacological Interventions During SARS-CoV-2 Pandemic: Effects on Pediatric Viral Respiratory Infections. Arch Bronconeumol 2024; 60:612-618. [PMID: 38853117 DOI: 10.1016/j.arbres.2024.05.019] [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: 02/19/2024] [Revised: 05/08/2024] [Accepted: 05/15/2024] [Indexed: 06/11/2024]
Abstract
INTRODUCTION Viral lower respiratory tract infections frequently cause morbidity and mortality in children. The Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) pandemic led to isolation and hygiene measures, resulting in decreased respiratory virus transmission and pediatric admissions. This study aimed to assess the impact of these measures and their uplifting on respiratory virus circulation in children before and during the SARS-CoV-2 pandemic (January 2017-December 2022). METHODS We conducted a weekly time series analysis of multiple virus molecular assays in children. This included those admitted to a university reference hospital's Pediatric Intensive Care Unit (PICU) and those with risk pathologies exhibiting fever and/or respiratory symptoms. We included patients aged 0-18 years residing in Catalonia and adjusted the positive results to account for diagnostic effort. RESULTS We performed a total of 2991 respiratory virus tests during the period. Confinement significantly decreased the detection of all viruses, especially Rhinovirus (RV). After the deconfinement of children, the viral detection trend remained stable for all viruses, with no short-term impact on virus transmission. The mandatory implementation of facemasks in those aged ≥6 years led to decreased viral circulation, but we observed an influenza virus rebound after facemask removal. At that time, we also noticed an interrupted drop in the detection rates of RV and respiratory syncytial virus (RSV). The reopening of schools led to a progressive increase in viral detections, especially of Rhinovirus. CONCLUSION Non-pharmacological interventions significantly impact the circulation of respiratory viruses among children. We observed these effects even when some measures did not specifically target preschool-aged children.
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Affiliation(s)
- Georgina Armero
- Pediatrics Department, Hospital Sant Joan de Déu, Barcelona, Spain; Infectious Diseases and Microbiome Research Group. Institut de Recerca Sant Joan de Déu, Esplugues de Llobregat, Spain
| | - Carmina Guitart
- Infectious Diseases and Microbiome Research Group. Institut de Recerca Sant Joan de Déu, Esplugues de Llobregat, Spain; Pediatrics Intensive Care Unit, Hospital Sant Joan de Déu, Barcelona, Spain
| | - Aleix Soler-Garcia
- Pediatrics Department, Hospital Sant Joan de Déu, Barcelona, Spain; Infectious Diseases and Microbiome Research Group. Institut de Recerca Sant Joan de Déu, Esplugues de Llobregat, Spain; Department of Surgery and Medical-Surgical Specialties, Facultat de Medicina i Ciències de la Salut, Universitat de Barcelona, Barcelona, Spain
| | - Maria Melé
- Pediatrics Department, Hospital Sant Joan de Déu, Barcelona, Spain; Infectious Diseases and Microbiome Research Group. Institut de Recerca Sant Joan de Déu, Esplugues de Llobregat, Spain
| | - Cristina Esteva
- Infectious Diseases and Microbiome Research Group. Institut de Recerca Sant Joan de Déu, Esplugues de Llobregat, Spain; Microbiology Department, Hospital Sant Joan de Déu, Barcelona, Spain; CIBER of Epidemiology and Public Health (CIBERESP), Instituto de Salud Carlos III, Madrid, Spain
| | - Pedro Brotons
- Infectious Diseases and Microbiome Research Group. Institut de Recerca Sant Joan de Déu, Esplugues de Llobregat, Spain; CIBER of Epidemiology and Public Health (CIBERESP), Instituto de Salud Carlos III, Madrid, Spain; Faculty of Medicine and Health Sciences, Universitat Internacional de Catalunya, Barcelona, Spain
| | - Carmen Muñoz-Almagro
- Infectious Diseases and Microbiome Research Group. Institut de Recerca Sant Joan de Déu, Esplugues de Llobregat, Spain; Microbiology Department, Hospital Sant Joan de Déu, Barcelona, Spain; CIBER of Epidemiology and Public Health (CIBERESP), Instituto de Salud Carlos III, Madrid, Spain; Faculty of Medicine and Health Sciences, Universitat Internacional de Catalunya, Barcelona, Spain
| | - Iolanda Jordan
- Infectious Diseases and Microbiome Research Group. Institut de Recerca Sant Joan de Déu, Esplugues de Llobregat, Spain; Pediatrics Intensive Care Unit, Hospital Sant Joan de Déu, Barcelona, Spain; Department of Surgery and Medical-Surgical Specialties, Facultat de Medicina i Ciències de la Salut, Universitat de Barcelona, Barcelona, Spain; CIBER of Epidemiology and Public Health (CIBERESP), Instituto de Salud Carlos III, Madrid, Spain
| | - Cristian Launes
- Pediatrics Department, Hospital Sant Joan de Déu, Barcelona, Spain; Infectious Diseases and Microbiome Research Group. Institut de Recerca Sant Joan de Déu, Esplugues de Llobregat, Spain; Department of Surgery and Medical-Surgical Specialties, Facultat de Medicina i Ciències de la Salut, Universitat de Barcelona, Barcelona, Spain; CIBER of Epidemiology and Public Health (CIBERESP), Instituto de Salud Carlos III, Madrid, Spain.
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da Silva Alves C, Baptista Pestana R, Morais-Almeida M. Recent insights into the impacts of COVID-19 on pediatric asthma. Expert Rev Clin Immunol 2024:1-20. [PMID: 39136081 DOI: 10.1080/1744666x.2024.2390641] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2024] [Revised: 07/31/2024] [Accepted: 08/06/2024] [Indexed: 08/28/2024]
Abstract
INTRODUCTION The emergence of Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) and the subsequent coronavirus disease 2019 (COVID-19) pandemic has raised questions about its impact on pediatric asthma. This review analyzes the latest research to offer a comprehensive understanding of the dynamics between COVID-19 and pediatric asthma. AREAS COVERED This narrative review examines the effects of COVID-19 on pediatric asthma, exploring clinical outcomes, immune responses, recommended treatments, the impact of SARS-CoV-2 strains, and COVID-19 vaccination. Data were sourced from databases (PubMed, Embase, and BioRxiv/MedRxiv) from January 2020 to November 2023. EXPERT OPINION In response to the COVID-19 pandemic, the international scientific community rapidly developed extensive knowledge, demonstrating unprecedented cooperation. Despite these advances, questions remain about SARS-CoV-2 infection and pediatric asthma. Most research consists of epidemiological studies with varying methods, sometimes yielding contradictory results. While asthma generally did not increase the risk of severe COVID-19 in children, uncontrolled asthma was a risk factor, highlighting the importance of maintaining asthma management. Telemedicine has proven effective for asthma control and will continue to grow, despite its limitations. Notably, allergic asthma may have a protective role against severe COVID-19. We recommend COVID-19 vaccination in the pediatric age group, including those with asthma.
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Affiliation(s)
- Carolina da Silva Alves
- Allergy Center, CUF Descobertas Hospital, Lisbon, Portugal
- Pulmonology Department, Doutor Fernando da Fonseca Hospital, Amadora, Portugal
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Fakih H, Abdulsater N, El Hajj Hussein Z. Epidemiology of Pediatric Respiratory Tract Infections During the COVID-19 Era: A Retrospective Multicentric Study of Hospitalized Children in Lebanon Between October 2018 and March 2021. Cureus 2024; 16:e61669. [PMID: 38966443 PMCID: PMC11223744 DOI: 10.7759/cureus.61669] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/04/2024] [Indexed: 07/06/2024] Open
Abstract
Background The identification of SARS-CoV-2 in December 2019 and its subsequent designation as the causative agent of COVID-19 marked the beginning of an unprecedented global health crisis. As the virus spread rapidly across continents, its impact on various demographic groups, including children, became a subject of intense research. While children were initially thought to be less susceptible to severe COVID-19 illness compared to adults, concerns emerged regarding their vulnerability to other respiratory infections amidst the pandemic. Understanding the epidemiological trends of pediatric respiratory tract infections (RTIs) during the COVID-19 era is crucial for informing public health strategies and clinical management protocols. This study aimed to compare the prevalence and characteristics of pediatric RTIs before and during the COVID-19 pandemic in Lebanon. Methodology A retrospective, observational study was conducted by reviewing medical records of children admitted to three tertiary care hospitals in Lebanon: Sheikh Ragheb Harb University Hospital, Al Sahel General University Hospital, and Rafik Al-Hariri University Hospital. Data were collected from October 2018 to March 2021, encompassing both the pre-COVID-19 and COVID-19 eras. A standardized data collection sheet was utilized to gather information on demographic characteristics, clinical presentations, duration of hospitalization, and antibiotic usage. Results Our analysis revealed significant shifts in the epidemiology of pediatric RTIs between the pre-COVID-19 and COVID-19 eras. There was a marked decline in the proportion of school-age children hospitalized with RTIs during the pandemic period. However, the overall percentage of Lebanese hospitalized children across different age groups increased significantly during the COVID-19 era. Furthermore, the prevalence of specific RTIs, such as pharyngitis, increased from 1.1% in the pre-COVID-19 to 5.5% during the COVID-19 period (p = 0.016), and the prevalence of bronchiolitis increased from 26.7% to 50.9% (p < 0.001) during the pre-COVID-19 and COVID-19 periods, respectively. This notable rise during the pandemic suggested potential changes in circulating pathogens or diagnostic practices. Importantly, the median length of hospital stays for pediatric RTIs decreased during the COVID-19 era compared to the pre-pandemic period, indicating possible improvements in clinical management or healthcare resource utilization. Analysis of antibiotic usage revealed ceftriaxone as the most frequently prescribed antibiotic in both periods, highlighting its continued relevance in the management of pediatric RTIs. Conclusions This study highlights significant epidemiological shifts in pediatric RTIs during the COVID-19 era in Lebanon. These findings underscore the importance of ongoing surveillance and research to adapt public health interventions and clinical practices to evolving infectious disease dynamics. Further investigation is warranted to elucidate the underlying factors driving these changes and optimize strategies for the prevention and management of pediatric RTIs in the context of the ongoing pandemic.
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Affiliation(s)
- Hadi Fakih
- Pediatrics, Faculty of Medical Sciences, Lebanese University, Beirut, LBN
- Pediatrics, Sheikh Ragheb Harb University Hospital, Toul, LBN
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Vargas‐Acevedo C, Botero Marín M, Jaime Trujillo C, Hernández LJ, Vanegas MN, Moreno SM, Rueda‐Guevara P, Baquero O, Bonilla C, Mesa ML, Restrepo S, Barrera P, Mejía LM, Piñeros JG, Ramírez Varela A. Severity and mortality of acute respiratory failure in pediatrics: A prospective multicenter cohort in Bogotá, Colombia. Health Sci Rep 2024; 7:e1994. [PMID: 38872789 PMCID: PMC11169278 DOI: 10.1002/hsr2.1994] [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: 06/25/2023] [Revised: 02/05/2024] [Accepted: 02/25/2024] [Indexed: 06/15/2024] Open
Abstract
Background and Aims Acute respiratory failure (ARF) is the most frequent cause of cardiorespiratory arrest and subsequent death in children worldwide. There have been limited studies regarding ARF in high altitude settings. The aim of this study was to calculate mortality and describe associated factors for severity and mortality in children with ARF. Methods The study was conducted within a prospective multicentric cohort that evaluated the natural history of pediatric ARF. For this analysis three primary outcomes were studied: mortality, invasive mechanical ventilation, and pediatric intensive care unit (PICU) length of stay. Eligible patients were children older than 1 month and younger than 18 years of age with respiratory difficulty at the time of admission. Patients who developed ARF were followed at the time of ARF, 48 h later, at the time of discharge, and at 30 and 60 days after discharge. It was conducted in the pediatric emergency, in-hospital, and critical-care services in three hospitals in Bogotá, Colombia, from April 2020 to June 2021. Results Out of a total of 685 eligible patients, 296 developed ARF for a calculated incidence of ARF of 43.2%. Of the ARF group, 90 patients (30.4%) needed orotracheal intubation, for a mean of 9.57 days of ventilation (interquartile range = 3.00-11.5). Incidence of mortality was 6.1% (n = 18). The associated factors for mortality in ARF were a history of a neurologic comorbidity and a higher fraction of inspired oxygen at ARF diagnosis. For PICU length of stay, the associated factors were age between 2 and 5 years of age, exposure to smokers, and respiratory comorbidity. Finally, for mechanical ventilation, the risk factors were obesity and being unstable at admission. Conclusions ARF is a common cause of morbidity and mortality in children. Understanding the factors associated with greater mortality and severity of ARF might allow earlier recognition and initiation of prompt treatment strategies.
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Affiliation(s)
- Catalina Vargas‐Acevedo
- Pediatrics Residency ProgramUniversidad de los AndesBogotáColombia
- Department of PediatricsHospital Universitario Fundación Santa Fe de BogotáBogotáColombia
| | - Mónica Botero Marín
- Pediatrics Residency ProgramUniversidad de los AndesBogotáColombia
- Department of PediatricsHospital Universitario Fundación Santa Fe de BogotáBogotáColombia
| | - Catalina Jaime Trujillo
- Pediatrics Residency ProgramUniversidad de los AndesBogotáColombia
- Department of PediatricsHospital Universitario Fundación Santa Fe de BogotáBogotáColombia
| | - Laura Jimena Hernández
- Pediatrics Residency ProgramUniversidad de los AndesBogotáColombia
- Department of PediatricsHospital Universitario Fundación Santa Fe de BogotáBogotáColombia
| | | | | | | | - Olga Baquero
- Department of PediatricsClínica Infantil ColsubsidioBogotáColombia
| | - Carolina Bonilla
- Pediatrics Residency ProgramUniversidad de los AndesBogotáColombia
- Department of PediatricsHospital Universitario Fundación Santa Fe de BogotáBogotáColombia
| | - María L. Mesa
- Pediatrics Residency ProgramUniversidad de los AndesBogotáColombia
- Department of PediatricsHospital Universitario Fundación Santa Fe de BogotáBogotáColombia
| | - Sonia Restrepo
- Pediatrics Residency ProgramUniversidad de los AndesBogotáColombia
- Department of PediatricsHospital Universitario Fundación Santa Fe de BogotáBogotáColombia
| | - Pedro Barrera
- Pediatrics Residency ProgramUniversidad de los AndesBogotáColombia
- Department of PediatricsHospital Universitario Fundación Santa Fe de BogotáBogotáColombia
| | - Luz M. Mejía
- Department of PediatricsInstituto RooseveltBogotáColombia
| | - Juan G. Piñeros
- Pediatrics Residency ProgramUniversidad de los AndesBogotáColombia
- Department of PediatricsHospital Universitario Fundación Santa Fe de BogotáBogotáColombia
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Klee B, Diexer S, Horn J, Langer S, Wende M, Ortiz D, Bielecka A, Strowig T, Mikolajczyk R, Gottschick C. The impact of non-pharmaceutical interventions on community non-SARS-CoV-2 respiratory infections in preschool children. BMC Pediatr 2024; 24:231. [PMID: 38561704 PMCID: PMC10985994 DOI: 10.1186/s12887-024-04686-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/21/2023] [Accepted: 03/02/2024] [Indexed: 04/04/2024] Open
Abstract
BACKGROUND Effects of non-pharmaceutical interventions during the pandemic were mainly studied for severe outcomes. Among children, most of the burden of respiratory infections is related to infections which are not medically attended. The perspective on infections in the community setting is necessary to understand the effects of the pandemic on non-pharmaceutical interventions. METHODS In the unique prospective LoewenKIDS cohort study, we compared the true monthly incidence of self-reported acute respiratory infections (ARI) in about 350 participants (aged 3-4 years old) between October 2019 to March 2020 (pre-pandemic period) and October 2020 to March 2021 (pandemic period). Parents reported children's symptoms using a diary. Parents were asked to take a nasal swab of their child during all respiratory symptoms. We analysed 718 swabs using Multiplex PCR for 25 common respiratory viruses and bacteria. RESULTS During the pre-pandemic period, on average 44.6% (95% CI: 39.5-49.8%) of children acquired at least one ARI per month compared to 19.9% (95% CI: 11.1-28.7%) during the pandemic period (Incidence Rate Ratio = 0.47; 95% CI: 0.41-0.54). The detection of influenza virus decreased absolute by 96%, respiratory syncytial virus by 65%, metapneumovirus by 95%, parainfluenza virus by 100%, human enterovirus by 96% and human bocavirus by 70% when comparing the pre-pandemic to the pandemic period. However, rhinoviruses were nearly unaffected by NPI. Co-detection (detection of more than one virus in a single symptomatic swab) was common in the pre-pandemic period (222 of 390 samples with viral detection; 56.9%) and substantially less common during the pandemic period (46 of 216 samples; 21.3%). CONCLUSION Non-pharmaceutical interventions strongly reduced the incidence of all respiratory infections in preschool children but did not affect rhinovirus.
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Affiliation(s)
- Bianca Klee
- Institute for Medical Epidemiology, Biometrics and Informatics, Interdisciplinary Centre for Health Sciences, Medical Faculty of the Martin Luther University Halle-Wittenberg, Halle (Saale), Germany
| | - Sophie Diexer
- Institute for Medical Epidemiology, Biometrics and Informatics, Interdisciplinary Centre for Health Sciences, Medical Faculty of the Martin Luther University Halle-Wittenberg, Halle (Saale), Germany
| | - Johannes Horn
- Institute for Medical Epidemiology, Biometrics and Informatics, Interdisciplinary Centre for Health Sciences, Medical Faculty of the Martin Luther University Halle-Wittenberg, Halle (Saale), Germany
| | - Susan Langer
- Institute for Medical Epidemiology, Biometrics and Informatics, Interdisciplinary Centre for Health Sciences, Medical Faculty of the Martin Luther University Halle-Wittenberg, Halle (Saale), Germany
| | - Marie Wende
- Helmholtz Centre for Infection Research, Braunschweig, Germany
- German Centre for Infection Research (DZIF), Partner Site Hannover-Braunschweig, Braunschweig, Germany
| | - Diego Ortiz
- Helmholtz Centre for Infection Research, Braunschweig, Germany
| | - Agata Bielecka
- Helmholtz Centre for Infection Research, Braunschweig, Germany
| | - Till Strowig
- Helmholtz Centre for Infection Research, Braunschweig, Germany
- German Centre for Infection Research (DZIF), Partner Site Hannover-Braunschweig, Braunschweig, Germany
- Hannover Medical School, Cluster of Excellence RESIST (EXC 2155), Hannover, Germany
| | - Rafael Mikolajczyk
- Institute for Medical Epidemiology, Biometrics and Informatics, Interdisciplinary Centre for Health Sciences, Medical Faculty of the Martin Luther University Halle-Wittenberg, Halle (Saale), Germany
- Helmholtz Centre for Infection Research, Braunschweig, Germany
| | - Cornelia Gottschick
- Institute for Medical Epidemiology, Biometrics and Informatics, Interdisciplinary Centre for Health Sciences, Medical Faculty of the Martin Luther University Halle-Wittenberg, Halle (Saale), Germany.
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Liu S, Pan J, Chen Y, Ye L, Chen E, Wen X, Wu W, Wu B, Qi X, Chan TC, Sun W, Yu Z, Zhang T, Yan J, Jiang J. Human respiratory syncytial virus subgroups A and B outbreak in a kindergarten in Zhejiang Province, China, 2023. Front Public Health 2024; 12:1368744. [PMID: 38435292 PMCID: PMC10904655 DOI: 10.3389/fpubh.2024.1368744] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2024] [Accepted: 02/05/2024] [Indexed: 03/05/2024] Open
Abstract
Background In May-June 2023, an unprecedented outbreak of human respiratory syncytial virus (HRSV) infections occurred in a kindergarten, Zhejiang Province, China. National, provincial, and local public health officials investigated the cause of the outbreak and instituted actions to control its spread. Methods We interviewed patients with the respiratory symptoms by questionnaire. Respiratory samples were screened for six respiratory pathogens by real-time quantitative polymerase chain reaction (RT-PCR). The confirmed cases were further sequenced of G gene to confirm the HRSV genotype. A phylogenetic tree was reconstructed by maximum likelihood method. Results Of the 103 children in the kindergarten, 45 were classified as suspected cases, and 25 cases were confirmed by RT-PCR. All confirmed cases were identified from half of classes. 36% (9/25) were admitted to hospital, none died. The attack rate was 53.19%. The median ages of suspected and confirmed cases were 32.7 months and 35.8 months, respectively. Nine of 27 confirmed cases lived in one community. Only two-family clusters among 88 household contacts were HRSV positive. A total of 18 of the G gene were obtained from the confirmed cases. Phylogenetic analyses revealed that 16 of the sequences belonged to the HRSV B/BA9 genotype, and the other 2 sequences belonged to the HRSV A/ON1 genotype. The school were closed on June 9 and the outbreak ended on June 15. Conclusion These findings suggest the need for an increased awareness of HRSV coinfections outbreak in the kindergarten, when HRSV resurges in the community after COVID-19 pandemic.
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Affiliation(s)
- Shelan Liu
- Department of Infectious Diseases, Zhejiang Provincial Centre for Disease Control and Prevention, Hangzhou, China
| | - Jinren Pan
- Department of Infectious Diseases, Zhejiang Provincial Centre for Disease Control and Prevention, Hangzhou, China
| | - Yin Chen
- Department of Microbiology, Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou, China
| | - Ling Ye
- Department of Infectious Diseases, Daishan Country Centre for Disease Control and Prevention, Zhoushan, China
| | - Enfu Chen
- Department of Infectious Diseases, Zhejiang Provincial Centre for Disease Control and Prevention, Hangzhou, China
| | - Xiaosha Wen
- Chinese Field Epidemiology Training Program, China Centre for Disease Control and Prevention, Beijing, China
| | - Wenjie Wu
- Department of Infectious Diseases, Zhoushan Municipal Centre for Disease Control and Prevention, Zhoushan, China
| | - Bing Wu
- Department of Microbiology, Zhoushan Municipal Center for Disease Control and Prevention, Zhoushan, China
| | - Xiaoqi Qi
- Chinese Field Epidemiology Training Program, China Centre for Disease Control and Prevention, Beijing, China
| | - Ta-Chien Chan
- Research Center for Humanities and Social Sciences, Academia Sinica, Taipei, Taiwan
| | - Wanwan Sun
- Department of Infectious Diseases, Zhejiang Provincial Centre for Disease Control and Prevention, Hangzhou, China
| | - Zhao Yu
- Department of Infectious Diseases, Zhejiang Provincial Centre for Disease Control and Prevention, Hangzhou, China
| | - Tongjie Zhang
- Department of Infectious Diseases, Daishan Country Centre for Disease Control and Prevention, Zhoushan, China
| | - Jianbo Yan
- Department of Infectious Diseases, Zhoushan Municipal Centre for Disease Control and Prevention, Zhoushan, China
| | - Jianmin Jiang
- Zhejiang Provincial Centre for Disease Control and Prevention, Hangzhou, China
- Key Lab of Vaccine, Prevention and Control of Infectious Disease of Zhejiang Province, Hangzhou, China
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Hu L, Yang Y, Lin J, Yan Q, Sun C, Li Z, Sun L, Xu J, Chen J, Bai G. Epidemiological characteristics of respiratory syncytial virus infection in pediatric patients before, during the COVID-19 pandemic and after easing of COVID-19 restrictive measures in China. J Med Virol 2024; 96:e29374. [PMID: 38197487 DOI: 10.1002/jmv.29374] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2023] [Revised: 12/07/2023] [Accepted: 12/25/2023] [Indexed: 01/11/2024]
Abstract
We aimed to assess the epidemiological characteristics of respiratory syncytial virus (RSV) infection in Chinese children at different phases of the coronavirus disease 2019 (COVID-19) pandemic, that is, before, during the pandemic and after easing of restrictive measures. We included 123 623 patients aged 0-18 years with respiratory infection symptoms who were suspected with RSV infection from January 1, 2019 to June 30, 2023 in Hangzhou Children's Hospital. Clinical information and RSV test result were extracted from the laboratory information system. We calculated the positive rate of RSV detection by age groups, gender, seasons, types of patients and phases of COVID-19 pandemic. Nonlinear associations between age and risk of RSV infection in three phases of pandemic were assessed by restricted cubic spline regression models. Among 123 623 patients, 3875 (3.13%) were tested as positive. The highest positive rate was observed in children aged 0-28 days (i.e., 12.28%). RSV infection was most prevalent in winter (6.04%), and followed by autumn (2.52%). Although there is no statistical significance regarding the positive rate at three phases of the pandemic, we observed that the rate was lowest during the pandemic and increased after easing the measures in certain age groups (p < 0.05), which was consisted with results from the nonlinear regression analyses. In addition, regression analyses suggested that the age range of children susceptible to RSV got wider, that is, 0-3.5 years, after easing all restrictive measures compared with that before (i.e., 0-3 years) and during the pandemic (i.e., 0-1 year). Based on our findings, we called for attention from health professionals and caregivers on the new epidemiological characteristics of RSV infection in the post-pandemic era after easing the restrictive measures.
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Affiliation(s)
- Lidan Hu
- Children's Hospital, Zhejiang University School of Medicine, National Clinical Research Center for Child Health, Hangzhou, Zhejiang, China
| | - Yang Yang
- Yunnan Provincial Key Laboratory of Public Health and Biosafety & School of Public Health, Kunming, China
| | - Jianyu Lin
- Children's Hospital, Zhejiang University School of Medicine, National Clinical Research Center for Child Health, Hangzhou, Zhejiang, China
| | - Qingtao Yan
- Children's Hospital, Zhejiang University School of Medicine, National Clinical Research Center for Child Health, Hangzhou, Zhejiang, China
| | - Changxuan Sun
- Dushu Lake Hospital Affiliated to Soochow University, Medical Center of Soochow University, Suzhou Dushu Lake Hospital, Suzhou, Jiangshu, China
| | - Ziqiao Li
- Department of Child Health Care, Children's Hospital, Zhejiang University School of Medicine, National Clinical Research Center for Child Health, Hangzhou, Zhejiang, China
| | - Lidan Sun
- Department of Child Health Care, Children's Hospital, Zhejiang University School of Medicine, National Clinical Research Center for Child Health, Hangzhou, Zhejiang, China
| | - Jingfang Xu
- Department of Orthopedics, Children's Hospital, Zhejiang University School of Medicine, National Clinical Research Center for Child Health, Hangzhou, Zhejiang, China
| | - Jie Chen
- Department of Respiratory, Hangzhou Children's Hospital, Hangzhou, Zhejiang, China
| | - Guannan Bai
- Department of Child Health Care, Children's Hospital, Zhejiang University School of Medicine, National Clinical Research Center for Child Health, Hangzhou, Zhejiang, China
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Wan L, Li L, Zhang H, Liu C, Li R, Wu X, Chen J. The changing pattern of common respiratory viruses among children from 2018 to 2021 in Wuhan, China. Arch Virol 2023; 168:291. [PMID: 37962775 PMCID: PMC10645662 DOI: 10.1007/s00705-023-05891-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2023] [Accepted: 08/18/2023] [Indexed: 11/15/2023]
Abstract
BACKGROUND Acute respiratory infections in children are a global public health challenge. Owing to the coronavirus disease (COVID-19) pandemic, non-pharmaceutical interventions, including patient isolation, social distancing, hand washing, and mask wearing, have been widely implemented, impacting the transmission of common respiratory viruses. The aim of this study was to clarify the epidemiological features of respiratory viruses in children less than 14 years of age in Wuhan before and after COVID-19. METHODS Respiratory specimens were collected from patients aged < 14 years at two hospitals in Wuhan, China, from January 2018 to December 2021. Seven respiratory viruses were identified using an immunofluorescence assay. Pathogen profiles and seasonality were analysed. RESULTS The number of visits and virus detection rate decreased dramatically after February 2020. The respiratory virus detection rate peaked in January and December and decreased dramatically in February and August. The detection rate was lower in 2021 than in 2018 and 2019. Respiratory syncytial virus (RSV) was identified as the leading pathogen in children aged < 1 year and 1-4 years before and after the COVID-19 pandemic. In children aged 5-14 years, influenza virus was detected at the highest rate before, and RSV after, the COVID-19 pandemic. RSV was the most common virus in coinfections. CONCLUSIONS This study revealed the epidemiological patterns of common respiratory viruses from 2018 to 2021. The spectrum of pathogens involved in paediatric respiratory infections had partly changed. Non-pharmaceutical interventions resulted in fewer opportunities for the spread of common viruses but also in an "immunity debt" that could have negative consequences when the pandemic is under control in Wuhan.
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Affiliation(s)
- Lu Wan
- Department of Pulmonary and Critical Care Medicine, Renmin Hospital of Wuhan University, Wuhan, Hubei, China
| | - Liangyu Li
- Department of Pulmonary and Critical Care Medicine, Renmin Hospital of Wuhan University, Wuhan, Hubei, China
| | - Haiyue Zhang
- Department of Pulmonary and Critical Care Medicine, Renmin Hospital of Wuhan University, Wuhan, Hubei, China
| | - Chan Liu
- Department of Pulmonary and Critical Care Medicine, Renmin Hospital of Wuhan University, Wuhan, Hubei, China
| | - Ruiyun Li
- Department of Pulmonary and Critical Care Medicine, Renmin Hospital of Wuhan University, Wuhan, Hubei, China
| | - Xiaojun Wu
- Department of Pulmonary and Critical Care Medicine, Renmin Hospital of Wuhan University, Wuhan, Hubei, China.
| | - Jianjun Chen
- CAS Key Laboratory of Special Pathogens, Center for Biosafety Mega Science, Wuhan Institute of Virology, Chinese Academy of Sciences, Wuhan, Hubei, China.
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Wu R, Zhang J, Mo L. Analysis of respiratory virus detection in hospitalized children with acute respiratory infection during the COVID-19 pandemic. Virol J 2023; 20:253. [PMID: 37919789 PMCID: PMC10623845 DOI: 10.1186/s12985-023-02218-5] [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: 05/09/2023] [Accepted: 10/27/2023] [Indexed: 11/04/2023] Open
Abstract
OBJECTIVE It is now understood that the Coronavirus disease 2019 (COVID-19) pandemic and its associated containment measures have influenced the epidemiology of other respiratory viruses. This study aimed to characterize respiratory virus infections in pediatric patients hospitalized for acute respiratory infections (ARIs) in East China both prior to and during the COVID-19 pandemic. METHODS We collected nasal secretions from 9782 pediatric ARI patients admitted to Shaoxing Maternal and Child Health Care Hospital between January 2018 and December 2022. We analyzed and compared changes in viral detection rates, epidemiological features, and clinical characteristics. RESULTS A total of 1633 strains from 7 common respiratory viruses were identified, with an overall positive rate of 16.35% (n = 821/5021) in 2018-2019 and 17.06% (n = 812/4761) in 2020-2022. Compared to 2018-2019, the positive rate for RSV significantly increased in 2020-2022, while detection rates for ADV, PIV-2, PIV-3, and flu-B showed reductions (P < 0.05). The RSV-positive rate experienced a more significant increase in winter compared to other seasons both before and during COVID-19 (P < 0.05), whereas PIV-3 predominantly circulated in spring and summer before COVID-19. CONCLUSION During the COVID-19 pandemic, marked variations in age distribution and seasonality of respiratory virus infections were observed among hospitalized children with ARIs in East China. Non-pharmaceutical interventions (NPIs) implemented during the pandemic yielded a limited impact on common respiratory viruses.
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Affiliation(s)
- Ruoya Wu
- Nursing department, Shaoxing Maternity and Child Health Care Hospital, 305 East Street, Yuecheng District, Shaoxing, Zhejiang, P. R. China
| | - Jianwei Zhang
- Department of Pediatrics, Shaoxing Maternity and Child Health Care Hospital, 305 East Street, Yuecheng District, Shaoxing, Zhejiang, P. R. China
| | - Liyan Mo
- Nursing department, Shaoxing Maternity and Child Health Care Hospital, 305 East Street, Yuecheng District, Shaoxing, Zhejiang, P. R. China.
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10
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Nguyen DD, Phung LT, Thanh Tran HT, Ly HTT, Vo AHM, Dinh NP, Doan PM, Nguyen AT, Dang LD, Doan TT, Pham KT, Pham HL, Hoang DX, Pham TN, Tran BT, Tran TTT, Le HTM, Pham AN, Antoniou A, Ho NT. Molecular subtypes of Adenovirus-associated acute respiratory infection outbreak in children in Northern Vietnam and risk factors of more severe cases. PLoS Negl Trop Dis 2023; 17:e0011311. [PMID: 37934746 PMCID: PMC10655982 DOI: 10.1371/journal.pntd.0011311] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2023] [Revised: 11/17/2023] [Accepted: 10/19/2023] [Indexed: 11/09/2023] Open
Abstract
BACKGROUND Under the pressure of Human Adenovirus (HAdV)-associated acute respiratory infection (ARI) outbreak in children in Northern Vietnam in the end of 2022, this study was initiated to identify the HAdV subtype(s) and examine the associated clinical features and risk factors of more severe cases. METHODS This study evaluated pediatric patients with ARI which had tested positive for HAdV between October and November 2022 using a multiplex real-time PCR panel. Nasopharyngeal aspirates or nasal swab samples were used for sequencing to identify HAdV subtypes. Clinical data were collected retrospectively. RESULTS Among 97 successfully sequenced samples, the predominant subtypes were HAdV-B3 (83%), HAdV-B7 (16%) and HAdV-C2 (1%). Lower respiratory manifestations were found in 25% of the patients of which 5% were diagnosed with severe pneumonia. There was no significant association between HAdV subtype and clinical features except higher white blood cell and neutrophil counts in those detected with HAdV-B3 (p<0.001). Co-detection of HAdV with ≥1 other respiratory viruses was found in 13/24(54%) of those with lower respiratory manifestations and 4/5(80%) of those with severe pneumonia (odds ratio (95% confidence interval) vs. those without = 10.74 (2.83, 48.17) and 19.44 (2.12, 492.73) respectively after adjusting for age, sex, birth delivery method, day of disease). CONCLUSION HAdV-B3 and HAdV-B7 were predominant in the outbreak. Co-detection of HAdV together with other respiratory viruses was a strong risk factor for lower respiratory tract illnesses and severe pneumonia. The findings advocate the advantages of multi-factor microbial panels for the diagnosis and prognosis of ARI in children.
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Affiliation(s)
- Dinh-Dung Nguyen
- Medical Genetics Department, Vinmec High Tech Center, Vinmec Healthcare System, Hanoi, Vietnam
| | - Lan Tuyet Phung
- Pediatric Center, Vinmec Times City International General Hospital, Vinmec Healthcare System, Hanoi, Vietnam
- VinUniversity, Hanoi, Vietnam
| | - Huyen Thi Thanh Tran
- Medical Genetics Department, Vinmec High Tech Center, Vinmec Healthcare System, Hanoi, Vietnam
| | - Ha Thi Thanh Ly
- Medical Genetics Department, Vinmec High Tech Center, Vinmec Healthcare System, Hanoi, Vietnam
| | - Anh Hang Mai Vo
- Medical Genetics Department, Vinmec High Tech Center, Vinmec Healthcare System, Hanoi, Vietnam
| | - Nhung Phuong Dinh
- Medical Genetics Department, Vinmec High Tech Center, Vinmec Healthcare System, Hanoi, Vietnam
| | - Phuong Mai Doan
- Microbiology Lab, Laboratory Department, Vinmec Times City International General Hospital, Vinmec Healthcare System, Hanoi, Vietnam
| | - Anh Thi Nguyen
- Microbiology Lab, Laboratory Department, Vinmec Times City International General Hospital, Vinmec Healthcare System, Hanoi, Vietnam
| | - Luc Danh Dang
- Microbiology Lab, Laboratory Department, Vinmec Times City International General Hospital, Vinmec Healthcare System, Hanoi, Vietnam
| | - Thia Thi Doan
- Microbiology Lab, Laboratory Department, Vinmec Times City International General Hospital, Vinmec Healthcare System, Hanoi, Vietnam
| | - Khuong Thi Pham
- Pediatric Center, Vinmec Times City International General Hospital, Vinmec Healthcare System, Hanoi, Vietnam
| | - Huong Lan Pham
- Pediatric Center, Vinmec Times City International General Hospital, Vinmec Healthcare System, Hanoi, Vietnam
| | - Dai Xuan Hoang
- Pediatric Center, Vinmec Times City International General Hospital, Vinmec Healthcare System, Hanoi, Vietnam
| | | | | | | | - Huong Thi Minh Le
- Pediatric Center, Vinmec Times City International General Hospital, Vinmec Healthcare System, Hanoi, Vietnam
| | - An Nhat Pham
- Pediatric Center, Vinmec Times City International General Hospital, Vinmec Healthcare System, Hanoi, Vietnam
| | - Antony Antoniou
- Department of Applied Sciences, Faculty of Health and Life Sciences, Northumbria University, Newcastle upon Tyne, United Kingdom
| | - Nhan Thi Ho
- Research & Development Department, Vinmec High Tech Center, Vinmec Healthcare System, Hanoi, Vietnam
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Wanlapakorn N, Thongpan I, Sarawanangkoor N, Vichaiwattana P, Auphimai C, Srimuan D, Thatsanathorn T, Kongkiattikul L, Kerr SJ, Poovorawan Y. Epidemiology and clinical characteristics of severe acute respiratory infections among hospitalized children under 5 years of age in a tertiary care center in Bangkok, Thailand, 2019-2020. Heliyon 2023; 9:e22300. [PMID: 38045212 PMCID: PMC10692904 DOI: 10.1016/j.heliyon.2023.e22300] [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: 06/01/2023] [Revised: 11/07/2023] [Accepted: 11/09/2023] [Indexed: 12/05/2023] Open
Abstract
Background Acute respiratory infections (ARIs) are common in children and can range in severity from mild self-limiting illnesses to more severe conditions such as pneumonia and respiratory failure. Data on the epidemiology of viral and bacterial pathogens causing ARIs in children are scarce in this region. This study aimed to investigate the epidemiology and clinical manifestations of pathogens in children aged ≤5 years presenting with severe acute respiratory infection (SARI) in Bangkok, Thailand. The impact of rapid multiplex PCR-based testing on clinical management is also explored. Methods This cross-sectional study enrolled consecutive children aged ≤5 years presenting with SARI at a tertiary care centre in Bangkok, Thailand, between 2019 and 2020. Nasopharyngeal swabs were collected once at admission, and viral and bacterial pathogens were tested using the QIAstat-Dx respiratory panel. Results A total of 169 children were enrolled in this study. At least one pathogenic virus was detected in 91.7 % of participants. Based on the final diagnoses made upon discharge, 30.2 % had upper respiratory tract infection, whereas 66.3 % had lower respiratory tract infection. Pneumonia was the most common diagnosis (59.2 %). The most common pathogen identified was rhino/enterovirus (45.2 %), followed by respiratory syncytial virus (31.6 %) and parainfluenza virus (14.2 %). Co-infection was found in 15.4 % and was not associated with increased disease severity. Conclusions This study provides additional insights into the pathogen profiles, clinical diagnosis, and co-infection combinations of ARIs in hospitalized children. This information is useful for diagnosis and treatment of ARIs, as well as implementation of appropriate infection control measures and guidance for future vaccine policy development.
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Affiliation(s)
- Nasamon Wanlapakorn
- Center of Excellence in Clinical Virology, Department of Pediatrics, Faculty of Medicine, Chulalongkorn University, Bangkok, 10330, Thailand
| | - Ilada Thongpan
- Center of Excellence in Clinical Virology, Department of Pediatrics, Faculty of Medicine, Chulalongkorn University, Bangkok, 10330, Thailand
- Abigail Wexner Research Institute at Nationwide Children's Hospital, Center for Vaccines and Immunity, Columbus, OH 43205, USA
| | - Nasiri Sarawanangkoor
- Center of Excellence in Clinical Virology, Department of Pediatrics, Faculty of Medicine, Chulalongkorn University, Bangkok, 10330, Thailand
| | - Preeyaporn Vichaiwattana
- Center of Excellence in Clinical Virology, Department of Pediatrics, Faculty of Medicine, Chulalongkorn University, Bangkok, 10330, Thailand
| | - Chompoonut Auphimai
- Center of Excellence in Clinical Virology, Department of Pediatrics, Faculty of Medicine, Chulalongkorn University, Bangkok, 10330, Thailand
| | - Donchida Srimuan
- Center of Excellence in Clinical Virology, Department of Pediatrics, Faculty of Medicine, Chulalongkorn University, Bangkok, 10330, Thailand
| | - Thaksaporn Thatsanathorn
- Center of Excellence in Clinical Virology, Department of Pediatrics, Faculty of Medicine, Chulalongkorn University, Bangkok, 10330, Thailand
| | - Lalida Kongkiattikul
- Division of pulmonology and critical care, Department of Pediatrics, Faculty of Medicine, Chulalongkorn University, Bangkok, 10330, Thailand
| | - Stephen J. Kerr
- Biostatistics Excellence Center, Faculty of Medicine, Chulalongkorn University, Bangkok, 10330, Thailand
| | - Yong Poovorawan
- Center of Excellence in Clinical Virology, Department of Pediatrics, Faculty of Medicine, Chulalongkorn University, Bangkok, 10330, Thailand
- FRS(T), the Royal Society of Thailand, Sanam Sueapa, Dusit, Bangkok, 10300, Thailand
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Xavier MO, Amouzou A, Maïga A, Akseer N, Huicho L, Matijasevich A. The impact of the COVID-19 pandemic on trends in stillbirths, under-5 and maternal mortality in Brazil: Excess deaths and regional inequalities. J Glob Health 2023; 13:06040. [PMID: 37772786 PMCID: PMC10540663 DOI: 10.7189/jogh.13.06040] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/30/2023] Open
Abstract
Background Despite the proliferation of studies on the impact of the coronavirus disease 2019 (COVID-19) pandemic, there is less evidence on the indirect death toll compared to the health system and service provision disruptions. We assessed the impact of the COVID-19 pandemic on national and regional trends and differences in stillbirths, under-5 and maternal deaths in Brazil. Methods We used the nationwide routine health information system data from January 2017 to December 2021, to which we applied descriptive and advanced mixed effects ordinary least squared regression models to measure the percent change in mortality levels during the COVID-19 pandemic (March 2020 to December 2021). We carried out counterfactual analyses comparing the observed and expected mortality levels for each type of mortality at national and regional levels. Results Stillbirths increased 4.8% (3.1% in 2020 and 6.2% in 2021) and most noticeably maternal deaths increased 71.6% (35.3% in 2020 and 103.3% in 2021) over the COVID-19 period. An opposite pattern was observed in under-5 mortality, which dropped -10.2% (-12.5% in 2020 and -8.1% in 2021). We identified regional disparities, with a higher percent increase in stillbirths observed in the Central-West region and in maternal deaths in the South region. Discussion Based on pre-pandemic trends and expected number of deaths in the absence of the COVID-19, we observed increases in stillbirths and maternal deaths and reductions in under-5 deaths during the pandemic. The months with the highest number of deaths (stillbirths and maternal deaths) coincided with the months with the highest mortality from COVID-19. The increase in deaths may also have resulted from indirect effects of the pandemic, such as unavailability of health services or even reluctance to go to the hospital when necessary due to fear of contagion. Conclusions In Brazil, the COVID-19 outbreak and subsequent restrictions had a detrimental impact on stillbirths and maternal deaths. Even before the pandemic, mortality trends highlighted pre-existing regional inequalities in the country's health care system. Although there were some variations, increases were observed in all regions, indicating potential weaknesses in the health system and inadequate management during the pandemic, particularly concerning pregnant and postpartum women.
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Affiliation(s)
- Mariana Otero Xavier
- Departamento de Medicina Preventiva, Faculdade de Medicina FMUSP, Universidade de São Paulo, São Paulo, Brasil
| | - Agbessi Amouzou
- Department of International Health, Johns Hopkins University Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - Abdoulaye Maïga
- Department of International Health, Johns Hopkins University Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - Nadia Akseer
- Department of International Health, Johns Hopkins University Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - Luis Huicho
- Centro de Investigación en Salud Materna e Infantil, Centro de Investigación para el Desarrollo Integral y Sostenible and Facultad de Medicina, Universidad Peruana Cayetano Heredia, Lima, Peru
| | - Alicia Matijasevich
- Departamento de Medicina Preventiva, Faculdade de Medicina FMUSP, Universidade de São Paulo, São Paulo, Brasil
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13
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Huang S, Wang H, Li L, Xiang W, Song Z, Li W. Molecular epidemiology and phylogenetic analyses of human adenovirus in pediatric patients with acute respiratory infections from Hangzhou during COVID-19 pandemic. Front Pediatr 2023; 11:1237074. [PMID: 37614906 PMCID: PMC10442704 DOI: 10.3389/fped.2023.1237074] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/08/2023] [Accepted: 07/28/2023] [Indexed: 08/25/2023] Open
Abstract
Background Acute Respiratory Infections (ARIs) are a major cause of morbidity and mortality worldwide. Human Adenovirus (HAdV), responsible for 5%-10% of children's ARIs, is one of the most prevalent pathogens. Our study aimed to analyze the epidemiology and phylogenesis of HAdV in pediatric patients with ARIs in Hangzhou during the COVID-19 pandemic. Method Between November 2020 and March 2021, we collected 1,442 nasopharyngeal swabs from children with ARIs at Children's Hospital, Zhejiang University School of Medicine. Epidemiological statistics, phylogenetic and amino acid (AA) mutation analysis were conducted. Results Our findings revealed that 386 (26.77%) samples tested positive for HAdV, with the highest rate in children aged 6-18 years and the lowest in children aged 0-1 year, indicating a different age preference of HAdV compared with pre-pandemic period. Outpatients had a significantly higher positive rate than inpatients. Moreover, patients with HAdV-coinfection exhibited more severe clinical symptoms than those with HAdV-single infection. Our phylogenetic analysis demonstrated that species HAdV-C (type 1, 2, 6) were the predominant circulating strains in Hangzhou during the COVID-19 pandemic. Further AA mutation analysis identified seventeen mutations of particular concern for biological characterization. Conclusion In conclusion, our study provides valuable epidemiological and molecular data that will aid in epidemiological surveillance, antiviral therapies and the development of specific vaccine types, leading to improve public health.
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Affiliation(s)
- Shuangshuang Huang
- Department of Clinical Laboratory, Children’s Hospital, Zhejiang University School of Medicine, National Clinical Research Center for Child Health, Hangzhou, China
| | - Hao Wang
- Department of Clinical Laboratory, Children’s Hospital, Zhejiang University School of Medicine, National Clinical Research Center for Child Health, Hangzhou, China
| | - Lin Li
- Department of Clinical Laboratory, Children’s Hospital, Zhejiang University School of Medicine, National Clinical Research Center for Child Health, Hangzhou, China
| | - Wenqing Xiang
- Department of Clinical Laboratory, Children’s Hospital, Zhejiang University School of Medicine, National Clinical Research Center for Child Health, Hangzhou, China
| | - Zhijian Song
- Department of Bioinformatics and Computational Oncology, OrigiMed, Shanghai, China
| | - Wei Li
- Department of Clinical Laboratory, Children’s Hospital, Zhejiang University School of Medicine, National Clinical Research Center for Child Health, Hangzhou, China
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14
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Kandeel A, Fahim M, Deghedy O, Roshdy WH, Khalifa MK, Shesheny RE, Kandeil A, Naguib A, Afifi S, Mohsen A, Abdelghaffar K. Resurgence of influenza and respiratory syncytial virus in Egypt following two years of decline during the COVID-19 pandemic: outpatient clinic survey of infants and children, October 2022. BMC Public Health 2023; 23:1067. [PMID: 37277781 DOI: 10.1186/s12889-023-15880-9] [Citation(s) in RCA: 16] [Impact Index Per Article: 16.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2023] [Accepted: 05/11/2023] [Indexed: 06/07/2023] Open
Abstract
INTRODUCTION Two years after unprecedented low rates of circulation of most common respiratory viruses (SARS-CoV-2), the Egyptian ARI surveillance system detected an increase in acute respiratory infections (ARIs) with a reduced circulation of the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), especially among school children. A national survey was conducted to estimate the burden and identify the viral causes of ARIs among children < 16 years of age. METHODS A one-day survey was carried out in 98 governmental outpatient clinics distributed all over Egypt 26 governorates. The four largest referral hospitals in each governorate where most influenza-like illness (ILI) patients seek care were selected. Using the WHO case definition, the first five patients < 16 years of age with ILI symptoms visiting the selected outpatient clinics on the survey day were enrolled. Basic demographic and clinical data of patients were collected using a linelist. Patients were swabbed and tested for SARS-CoV-2, influenza, and Respiratory Syncytial virus (RSV) by RT-PCR at the Central Laboratory in Cairo. RESULTS Overall, 530 patients enrolled, their mean age was 5.8 ± 4.2, 57.1% were males, and 70.2% reside in rural or semi-rural areas. Of all patients, 134 (25.3%) had influenza, 111 (20.9%) RSV, and 14 (2.8%) coinfections. Influenza-positive children were older compared to RSV, (7.2 ± 4.1, 4.3 ± 4.1, p < 0.001), with more than half of them (53.0%) being school students. Dyspnea was reported in RSV more than in influenza (62.2% vs. 49.3%, p < 0.05). Among RSV patients, children < 2 years had a higher rate of dyspnea than others (86.7% vs. 53.1%, < 0.001). CONCLUSIONS A resurgence of influenza and RSV was detected in Egypt in the 2022-2023 winter season. Influenza caused a higher rate of infection than RSV, while RSV caused more severe symptoms than influenza. Monitoring a broader range of respiratory pathogens is recommended to estimate the ARI burden and risky groups for severe disease in Egypt.
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Affiliation(s)
- Amr Kandeel
- Ministry of Health and Population, Cairo, Egypt
| | - Manal Fahim
- Ministry of Health and Population, Cairo, Egypt
| | - Ola Deghedy
- Ministry of Health and Population, Cairo, Egypt
| | - Wael H Roshdy
- Central Public Health Laboratory, Ministry of Health and Population, Cairo, Egypt
| | - Mohamed K Khalifa
- Centre of Scientific Excellence for Influenza Viruses, National Research Centre, 12622, Dokki, Giza, Egypt
| | - Rabeh El Shesheny
- Centre of Scientific Excellence for Influenza Viruses, National Research Centre, 12622, Dokki, Giza, Egypt
| | - Ahmed Kandeil
- Centre of Scientific Excellence for Influenza Viruses, National Research Centre, 12622, Dokki, Giza, Egypt
| | - Amel Naguib
- Central Public Health Laboratory, Ministry of Health and Population, Cairo, Egypt
| | - Salma Afifi
- Consultant Ministry of Health and Population, Cairo, Egypt
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Chand K, Butt MI, Tahir HM. Parental Attitude, Knowledge, and Practices Regarding the Usage of Antibiotics for Upper Respiratory Tract Infections in Children During the COVID-19 Pandemic. Cureus 2023; 15:e39932. [PMID: 37415993 PMCID: PMC10319945 DOI: 10.7759/cureus.39932] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2023] [Accepted: 06/03/2023] [Indexed: 07/08/2023] Open
Abstract
BACKGROUND The COVID-19 pandemic has raised knowledge of the proper antibiotic dosage for treating childhood upper respiratory tract infections (URTIs). In order to ensure proper antibiotic usage and prevent the establishment of illnesses that is antibiotic-resistant during the COVID-19 pandemic, parental attitudes, knowledge, and behaviour surrounding antibiotic use for URTIs in children are essential. The goal of this study was to find out the parental attitude, knowledge, and practices regarding the usage of antibiotics for URTIs in children during the COVID-19 epidemic. METHODOLOGY This cross-sectional was conducted in the Department of Paediatric Medicine, Central Hospital, Ganesh Nagar, New Delhi, India from September 2022 to February 2023. The study analysed a total of 500. All the children had URTIs. A structured questionnaire was randomly distributed among parents. Socio-demographic information like gender, age, occupation, monthly family income, and age of the children were noted at the time of enrollment. Outcomes were recorded in terms of responses to questions regarding attitude, knowledge, and practices regarding the use of antibiotics for URTIs in children during the COVID-19 epidemic. Results: Of a total of 500 parents, 380 (76.0%) were male. The mean age was 39.9±8.3 years while 280 (56.0%) participants were aged between 31 to 45 years. Relatively older age (p<0.0001) and occupational status as unemployed (p<0.0001) were found to have a significant association with response to "virus being the cause of COVID-19". Females (p=0.0004) and increasing age (p<0.0001) were found to have significant associations with incorrect responses to "antibiotics are essential for managing the symptoms in children with COVID-19". Incorrect responses to "without the use of antibiotics, children usually suffer from greater periods of sickness" were associated with females and increasing age (p<0.0001). Incorrect responses to "not using antibiotics will prove beneficial for the children suffering from COVID-19" were significantly associated with female gender (p=0.0016) and increasing age (p<0.0001). The incorrect responses to "how often are antibiotics being prescribed to the COVID-19 children" was significantly linked with females and relatively older age (p<0.0001). CONCLUSIONS Parental attitude, knowledge, and practices regarding the usage of antibiotics for URTIs in children during the COVID-19 epidemic showed variations. Parental attitude, knowledge, and practices were associated with gender, age, and socio-economic status.
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Affiliation(s)
- Kanwal Chand
- Department of Paediatric Medicine, Central Hospital, Delhi, IND
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16
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Lovinsky-Desir S, Volerman A. Applying Lessons from the COVID-19 Pandemic to Improve Pediatric Asthma Care. Pulm Ther 2023; 9:15-24. [PMID: 36443534 PMCID: PMC9707220 DOI: 10.1007/s41030-022-00207-7] [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: 10/13/2022] [Accepted: 11/07/2022] [Indexed: 12/02/2022] Open
Abstract
Asthma is the most common chronic childhood condition and is a risk factor for severe respiratory viral infections. Thus, early during the coronavirus disease 2019 (COVID-19) pandemic there was concern that children with asthma would be at risk for severe COVID-19 illness and that asthma control could worsen as a result of the pandemic. This article seeks to summarize what was learned in the early stages of the pandemic about the impact of COVID-19 on children with asthma. We review evidence from several studies that demonstrated a significant decline in asthma morbidity in the first year of the pandemic. Additionally, we describe several potential mechanisms that may explain the reduced frequency in childhood asthma exacerbations as well as review lessons learned for future management of childhood asthma. While the COVID-19 pandemic initially brought uncertainty, it soon became clear that the pandemic had several positive effects for children with asthma. Now we can apply the lessons that were learned during the pandemic to re-examine asthma care practices as well as advocate for best approaches for asthma management.
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Affiliation(s)
- Stephanie Lovinsky-Desir
- Department of Pediatrics and Environmental Health Sciences, Columbia University Irving Medical Center, New York, NY, USA.
| | - Anna Volerman
- Departments of Medicine and Pediatrics, University of Chicago, Chicago, IL, USA
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17
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Chuang YC, Lin KP, Wang LA, Yeh TK, Liu PY. The Impact of the COVID-19 Pandemic on Respiratory Syncytial Virus Infection: A Narrative Review. Infect Drug Resist 2023; 16:661-675. [PMID: 36743336 PMCID: PMC9897071 DOI: 10.2147/idr.s396434] [Citation(s) in RCA: 43] [Impact Index Per Article: 43.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2022] [Accepted: 01/12/2023] [Indexed: 02/01/2023] Open
Abstract
Respiratory syncytial virus (RSV) is one of the most common respiratory viruses. It not only affects young children but also the elderly and immunocompromised patients. After the emergence of SARS-CoV-2 and the corona virus disease 2019 (COVID-19) era, a dramatic reduction in RSV activity was found, which coincided with the implementation of public health and social measures (PHSMs). However, the correlation is more complicated than we initially thought. After PHSMs were gradually lifted, a seasonality shift and a delayed RSV outbreak with greater number of infected patients were found in numerous countries, such as Israel, Australia, South Africa, New Zealand, France, United States, and Japan. Several hypotheses and possible reasons explaining the interaction between SARS-CoV-2 and RSV were mentioned. Since RSV vaccinations are still under investigation, administration of palivizumab should be considered in high-risk patients. In the post-COVID-19 era, greater attention should be paid to a further resurgence of RSV. In this narrative review, we conducted a thorough review of the current knowledge on the epidemiology of RSV during the COVID-19 era, the out-of-season outbreak of RSV, and the data on co-infection with RSV and SARS-CoV-2.
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Affiliation(s)
- Yu-Chuan Chuang
- Department of Internal Medicine, Taichung Veterans General Hospital, Taichung, Taiwan
| | - Kuan-Pei Lin
- Department of Internal Medicine, Taichung Veterans General Hospital, Taichung, Taiwan
| | - Li-An Wang
- Department of Internal Medicine, Taichung Veterans General Hospital, Taichung, Taiwan
| | - Ting-Kuang Yeh
- Division of Infectious Disease, Department of Internal Medicine, Taichung Veterans General Hospital, Taichung, Taiwan,Genomic Center for Infectious Diseases, Taichung Veterans General Hospital, Taichung, Taiwan
| | - Po-Yu Liu
- Division of Infectious Disease, Department of Internal Medicine, Taichung Veterans General Hospital, Taichung, Taiwan,Genomic Center for Infectious Diseases, Taichung Veterans General Hospital, Taichung, Taiwan,Ph.D. in Translational Medicine, National Chung Hsing University, Taichung, Taiwan,Rong Hsing Research Center for Translational Medicine, National Chung Hsing University, Taichung, Taiwan,Department of Post-Baccalaureate Medicine, College of Medicine, National Chung Hsing University, Taichung, Taiwan,Correspondence: Po-Yu Liu, Division of Infectious Disease, Department of Internal Medicine, Taichung Veterans General Hospital, No. 1650, Sec. 4, Taiwan Blvd., Xitun Dist, Taichung City, 407219, Taiwan, Tel +886 4 2359 2525, Email
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Cui A, Xie Z, Xu J, Hu K, Zhu R, Li Z, Li Y, Sun L, Xiang X, Xu B, Zhang R, Gao Z, Zhang Y, Xu W. Comparative analysis of the clinical and epidemiological characteristics of human influenza virus versus human respiratory syncytial virus versus human metapneumovirus infection in nine provinces of China during 2009-2021. J Med Virol 2022; 94:5894-5903. [PMID: 35981880 DOI: 10.1002/jmv.28073] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2022] [Revised: 07/29/2022] [Accepted: 08/16/2022] [Indexed: 01/06/2023]
Abstract
A comparative analysis of confirmed cases of human influenza virus (HIFV), human respiratory syncytial virus (HRSV), and human metapneumovirus (HMPV) was conducted to describe their clinical and epidemiological characteristics. During 2009-2021, active surveillance of acute respiratory infections (ARIs) was performed in nine provinces of China. Clinical and epidemiological information and laboratory testing results of HIFV, HRSV, and HMPV were analyzed. Among 11591 ARI patients, the single-infection rates of HIFV, HRSV, and HMPV were 15.00%, 9.59%, and 2.24%, respectively; the coinfection rate of these three viruses was 0.64%. HIFV infection was mainly in adults aged 15-59 years, accounting for 39.10%. HRSV and HMPV infections were mainly in children under 5 years old, accounting for 87.13% and 83.46%, respectively. Patients with HRSV infection were younger than HMPV. HRSV and HMPV had high similarities in clinical manifestations, presenting with lower respiratory symptoms. HIFV mainly presented with an upper respiratory infection. The epidemic peak of HRSV was earlier than that of HIFV, and that of HMPV was later than those of HRSV and HFIV. A total of 85.14% of coinfection cases were children under 5 years old. Coinfection might increase the risk of pneumonia in HIFV cases. During 2020-2021, the positive rates and seasonal patterns of these three viruses changed due to the impact of the COVID-19 pandemic. Certain clinical and epidemiological features were observed in HIFV, HRSV, and HMPV infections, which could be beneficial for guiding clinical diagnosis, treatment, and prevention of these three viruses in China.
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Affiliation(s)
- Aili Cui
- NHC Key Laboratory of Medical Virology and Viral Diseases, Chinese Centers for Disease Control and Prevention, National Institute for Viral Disease Control and Prevention, Beijing, China
| | - Zhibo Xie
- NHC Key Laboratory of Medical Virology and Viral Diseases, Chinese Centers for Disease Control and Prevention, National Institute for Viral Disease Control and Prevention, Beijing, China
| | - Jing Xu
- Viral Disease Department, Shaanxi Center for Disease Control and Prevention, Xi'an, China
| | - Kongxin Hu
- Institute of Health Inspection and Quarantine, Chinese Academy of Inspection and Quarantine, Beijing, China
| | - Runan Zhu
- Department of Virology, Beijing Key Laboratory of Pediatric Virology, Capital Institute of Pediatrics, Beijing, China
| | - Zhong Li
- Department of Viral Diseases, Shandong Center for Disease Control and Prevention, Institute for Communicable Disease Control and Prevention, Jinan, China
| | - Yan Li
- Hebei Center for Disease Control and Prevention, Institute for Prevention and Control of Viral Diseases, Shijiazhuang, China
| | - Liwei Sun
- Precision Medicine Research Center, Children's Hospital of Changchun, Changchun, China
| | - Xingyu Xiang
- Microbiological Examination Department, Hunan Center for Disease Control and Prevention, Changsha, China
| | - Baoping Xu
- Respiratory Department, Research Unit of Critical Infection in Children, China National Clinical Research Center of Respiratory Diseases, National Center for Children's Health, Beijing Children's Hospital, Chinese Academy of Medical Sciences, Capital Medical University, Beijing, China
| | - Rongbo Zhang
- Department of Immunology, School of Medicine, Anhui University of Science and Technology, Huainan, China
| | - Zhenguo Gao
- Xinjiang Uyghur Autonomous Region Center for Disease Control and Prevention, Institute for Infectious Disease Prevention and Treatment, Wulumuqi, China
| | - Yan Zhang
- NHC Key Laboratory of Medical Virology and Viral Diseases, Chinese Centers for Disease Control and Prevention, National Institute for Viral Disease Control and Prevention, Beijing, China
| | - Wenbo Xu
- NHC Key Laboratory of Medical Virology and Viral Diseases, Chinese Centers for Disease Control and Prevention, National Institute for Viral Disease Control and Prevention, Beijing, China
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Díaz Pérez D, Reina J, Arcay RM, Osona B. Changes in the incidence and clinical manifestations of paediatric respiratory infections of viral aetiology during the SARS-CoV-2 pandemic. ENFERMEDADES INFECCIOSAS Y MICROBIOLOGIA CLINICA (ENGLISH ED.) 2022; 40:463-464. [PMID: 35624066 PMCID: PMC9127700 DOI: 10.1016/j.eimce.2022.05.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 09/17/2021] [Revised: 10/28/2021] [Accepted: 11/03/2021] [Indexed: 06/15/2023]
Affiliation(s)
- David Díaz Pérez
- Servicio de Pediatría, Hospital Universitario Son Espases, Palma, Spain.
| | - Jordi Reina
- Servicio de Microbiología, Hospital Universitario Son Espases, Palma, Spain
| | - Ricardo M Arcay
- Servicio de Microbiología, Hospital Universitario Son Espases, Palma, Spain
| | - Borja Osona
- Unidad de Neumología pediátrica, Servicio de Pediatría, Hospital Universitario Son Espases, Grupo de Investigación Multidisciplinar en Pediatría, Instituto de Investigación Sanitaria de las Islas Baleares (IdISBa), Palma, Spain
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20
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[Changes in the incidence and clinical manifestations of paediatric respiratory infections of viral aetiology during the SARS-CoV-2 pandemic]. Enferm Infecc Microbiol Clin 2022; 40:463-464. [PMID: 34975186 PMCID: PMC8713070 DOI: 10.1016/j.eimc.2021.11.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
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21
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Xiang WQ, Li L, Guo YJ, Lin J, Li W. The Impact of COVID-19 Public Health Measures on Detection of Other Respiratory Viruses in Children during the Winter of 2020–2021 in Hangzhou, China. J PEDIAT INF DIS-GER 2022. [DOI: 10.1055/s-0042-1756712] [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 Acute respiratory tract infection (ARTI) is one of the main diseases in childhood. This study aimed to monitor the distribution of respiratory tract viruses in children with ARTI in the impact of coronavirus disease 2019 (COVID-19).
Methods We conducted surveillance of 2019 novel coronavirus, human metapneumovirus, respiratory syncytial virus, human adenovirus, human parainfluenza virus 1–3, and influenza A and B virus by using quantitative real-time polymerase chain reaction.
Results During the winter of 2020 to 2021, among the 1,442 throat swabs we collected, 937 (64.98%, 937/1,442) were positive for respiratory viruses. Respiratory syncytial virus was the most frequently detected respiratory virus (34.12%, 492/1,442) and 2019 novel coronavirus and influenza A and B virus were not detected in the study period. Coinfection was observed in 156 positive samples including 149 samples of double infection and 7 of triple infection. The positive rate of viral respiratory tract infection in infants less than 6 months was the highest (72.95%) in the study period.
Conclusion There are some differences in the distribution of respiratory viruses in children after the outbreak of COVID-19 in Hangzhou, China.
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Affiliation(s)
- Wen-qing Xiang
- Department of Clinical Laboratory, The Children's Hospital, National Clinical Research Center For Child Health, Zhejiang University School of Medicine, Hangzhou, P.R. China
| | - Lin Li
- Department of Clinical Laboratory, The Children's Hospital, National Clinical Research Center For Child Health, Zhejiang University School of Medicine, Hangzhou, P.R. China
| | - Ya-jun Guo
- Department of Clinical Laboratory, The Children's Hospital, National Clinical Research Center For Child Health, Zhejiang University School of Medicine, Hangzhou, P.R. China
| | - Jian Lin
- Department of Clinical Laboratory, The Children's Hospital, National Clinical Research Center For Child Health, Zhejiang University School of Medicine, Hangzhou, P.R. China
| | - Wei Li
- Department of Clinical Laboratory, The Children's Hospital, National Clinical Research Center For Child Health, Zhejiang University School of Medicine, Hangzhou, P.R. China
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22
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Qashqari FSI. Human Mastadenovirus Infections in Children: A Review of the Current Status in the Arab World in the Middle East and North Africa. CHILDREN (BASEL, SWITZERLAND) 2022; 9:1356. [PMID: 36138665 PMCID: PMC9497993 DOI: 10.3390/children9091356] [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: 07/17/2022] [Revised: 08/08/2022] [Accepted: 09/03/2022] [Indexed: 11/17/2022]
Abstract
Human mastadenovirus (HAdV) is a non-enveloped icosahedral virus with double-stranded DNA genomes. The mortality rate of HAdV infections can reach 35.5%, while gastroenteritis HAdV infections, HAdV pneumonia, and disseminated disease tend to show a worse outcome, with rates ranging from 44.2% to 50%. In addition, HAdV can cause infections at any age but most commonly in the pediatric population, especially in young children and infants. Therefore, this review aims to assess the current status of HAdV infections among children in the Arab World, particularly in the Middle East and North Africa. Web of Science, Scopus, PubMed, EMBASE, and Google Scholar databases for publications in English were searched up to July 2022 for relevant articles. The literature search yielded a total of 21 studies, which were included in this review. Studies reporting HAdV infections in children were conducted in 17 out of the 22 countries. The average prevalence rate of HAdV infections in children was 12.7%, with average prevalence rates of 12.82% and 12.58% in the Middle East and North African countries, respectively. The highest prevalence rate (28.3%) was reported in Egypt, whereas the lowest prevalence (1.5%) was reported in Sudan. The included studies presented children with signs and symptoms of gastroenteritis, acute respiratory infection, acute diarrhea, and acute hemorrhagic conjunctivitis. In conclusion, the average prevalence rate of HAdV infections in children was 12.7%, with average prevalence rates of 12.82% and 12.58% in the Middle East and North African countries, respectively. Finding the precise prevalence rate of this virus is crucial because it will guide future planning for effective disease control and the selection of particular treatment options during epidemics and special seasons.
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Affiliation(s)
- Fadi S I Qashqari
- Department of Microbiology, College of Medicine, Umm Al-Qura University, Makkah 24381, Saudi Arabia
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23
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Ogunbayo AE, Mogotsi MT, Sondlane H, Nkwadipo KR, Sabiu S, Nyaga MM. Pathogen Profile of Children Hospitalised with Severe Acute Respiratory Infections during COVID-19 Pandemic in the Free State Province, South Africa. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph191610418. [PMID: 36012053 PMCID: PMC9408356 DOI: 10.3390/ijerph191610418] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/02/2022] [Revised: 08/10/2022] [Accepted: 08/17/2022] [Indexed: 05/30/2023]
Abstract
Severe acute respiratory infections (SARI) contribute to mortality in children ≤5 years. Their microbiological aetiologies are often unknown and may be exacerbated in light of coronavirus disease 19 (COVID-19). This study reports on respiratory pathogens in children ≤5 years (n = 84) admitted with SARI during and between the second and third waves of COVID-19 infection in South Africa. Nasopharyngeal/oropharyngeal swabs collected were subjected to viral detection using QIAstat-Dx® Respiratory SARS-CoV-2 Panel. The results revealed viral positivity and negativity detection rates of 88% (74/84) and 12% (10/84), respectively. Of the 21 targeted pathogens, human rhinovirus/enterovirus (30%), respiratory syncytial virus (RSV; 26%), and severe acute respiratory syndrome coronavirus 2 (24%) were mostly detected, with other viruses being 20% and a co-infection rate of 64.2% (54/84). Generally, RSV-positive samples had lower Ct values, and fewer viruses were detected during the third wave. Changes in the circulation patterns of respiratory viruses with total absence of influenza virus could be attributed to measures against COVID-19 transmission, which may result in waned immunity, thereby increasing susceptibility to severe infections in the following season. High viral co-infection rate, as detected, may complicate diagnosis. Nonetheless, accurate identification of the pathogens may guide treatment decisions and infection control.
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Affiliation(s)
- Ayodeji E. Ogunbayo
- Next Generation Sequencing Unit and Division of Virology, Faculty of Health Sciences, University of the Free State, P.O. Box 339, Bloemfontein 9300, South Africa
| | - Milton T. Mogotsi
- Next Generation Sequencing Unit and Division of Virology, Faculty of Health Sciences, University of the Free State, P.O. Box 339, Bloemfontein 9300, South Africa
| | - Hlengiwe Sondlane
- Next Generation Sequencing Unit and Division of Virology, Faculty of Health Sciences, University of the Free State, P.O. Box 339, Bloemfontein 9300, South Africa
| | - Kelebogile R. Nkwadipo
- Next Generation Sequencing Unit and Division of Virology, Faculty of Health Sciences, University of the Free State, P.O. Box 339, Bloemfontein 9300, South Africa
| | - Saheed Sabiu
- Department of Biotechnology and Food Science, Durban University of Technology, P.O. Box 1334, Durban 4000, South Africa
| | - Martin M. Nyaga
- Next Generation Sequencing Unit and Division of Virology, Faculty of Health Sciences, University of the Free State, P.O. Box 339, Bloemfontein 9300, South Africa
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Effect of the COVID-19 Pandemic on Lower Respiratory Tract Infection Determinants in Thai Hospitalized Children: National Data Analysis 2015-2020. Trop Med Infect Dis 2022; 7:tropicalmed7080151. [PMID: 36006243 PMCID: PMC9414978 DOI: 10.3390/tropicalmed7080151] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2022] [Revised: 07/23/2022] [Accepted: 07/26/2022] [Indexed: 12/28/2022] Open
Abstract
Background: The COVID-19 outbreak emerged in January 2020 and remains present in 2022. During this period, nonpharmaceutical interventions (NPIs) have been used to reduce the spread of COVID-19 infection. Nationwide data analysis should be pushed as the new standard to demonstrate the impact of COVID-19 infection on other respiratory illnesses and the reliability of NPIs during treatment. Objective: This study aims to identify and compare the incidence of lower respiratory tract infections (LRTIs) among children in Thailand before and after the emergence of COVID-19. Methods: A retrospective study was carried out in hospitalized children under the age of 18 in Thailand from October 2015 to September 2020. The International Statistical Classification of Diseases and Related Health Problems, 10th Revision, Thai Modification, was used to identify patient diagnoses (ICD-10-TM). The data were extracted from the Universal Coverage Health Security Scheme Database. Results: A total of 1,610,160 admissions were attributed to LRTIs. The most common diagnosis was pneumonia (61.9%). Compared to the 2019 fiscal year, the number of hospitalizations due to LRTIs decreased by 33.9% in the 2020 fiscal year (COVID-19 period) (282,590 vs. 186,651). The incidence of all three diagnostic groupings was substantially lower in the pre- and post-COVID-19 eras, with a decrease of 28% in the pneumonia group (incidence rate ratio (IRR) = 0.72; 95% confidence interval (CI): 0.71 to 0.72), 44% in the bronchiolitis group (IRR = 0.56; 95% CI: 0.55 to 0.57), and 34% in the bronchitis group (IRR = 0.66; 95% CI: 0.65 to 0.67). Between fiscal years 2019 and 2020, the overall monthly cost of all hospitalizations for LRTIs decreased considerably (p value < 0.001). Conclusions: NPIs may decrease the number of pediatric hospitalizations related to LRTIs. All policies designed to prevent the spread of COVID-19 must be continually utilized to maintain the prevention of LRTIs.
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25
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Protein and Peptide Substances in the Treatment of Respiratory Syncytial Infection: Current State. MOLECULES (BASEL, SWITZERLAND) 2022; 27:molecules27072263. [PMID: 35408661 PMCID: PMC9000545 DOI: 10.3390/molecules27072263] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 02/23/2022] [Revised: 03/25/2022] [Accepted: 03/29/2022] [Indexed: 12/05/2022]
Abstract
Respiratory syncytial virus infection (RSVI) is an acute medical and social problem in many countries globally. Infection is most dangerous for infants under one year old and the elderly. Despite its epidemiological relevance, only two drugs are registered for clinical use against RSVI: ribavirin (approved in a limited number of countries due to side effects) and palivizumab (Synagis), which is intended only for the prevention, but not the treatment, of infection. Currently, various research groups are searching for new drugs against RSV, with three main areas of research: small molecules, polymeric drugs (proteins and peptides), and plant extracts. This review is devoted to currently developed protein and peptide anti-RSV drugs.
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26
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Mameli C, Picca M, Buzzetti R, Pace ME, Badolato R, Cravidi C, Zuccotti GV, Marchisio P. Incidence of acute respiratory infections in preschool children in an outpatient setting before and during Covid-19 pandemic in Lombardy Region, Italy. Ital J Pediatr 2022; 48:18. [PMID: 35115026 PMCID: PMC8812240 DOI: 10.1186/s13052-022-01221-w] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/05/2021] [Accepted: 01/21/2022] [Indexed: 12/05/2022] Open
Abstract
Introduction The incidence of acute respiratory tract infections (ARTIs) in children is difficult to estimate because they are typically treated in outpatient settings and the majority of epidemiological data originate from hospital settings and refer to the most severe illnesses. Therefore, the incidence of ARTIs in a real-world setting remains largely unexplored. Therefore, this study aims to estimate the incidence of ARTIs, upper respiratory tract infections (URTIs), and lower respiratory tract infections (LRTIs) in children aged 0–5 years in an outpatient setting. Methods This prospective cohort study was conducted in Lombardy, Italy, from October 1st, 2019, to March 31st, 2021, before and during the COVID-19 pandemic that began in March 2020. Caucasian healthy children aged 0–5 years were recruited from 69 Family Pediatricians (FP) and followed-up in an outpatient setting. Data were collected whenever a child was referred to FP and ARTI was diagnosed (Covid-19 related ARTI were excluded). The primary outcome was an estimate of the incidence of ARTIs. The incidence of ARTIs in different age groups and the effect of the COVID-19 pandemic on the incidence of ARTIs were secondary outcomes. Results We enrolled 484 children, 249 male (51.8%), mean age of 2.39 ± 1.68 years. The mean estimated incidence of ARTIs was 12.1/100 children × 30 days (95% CIs: 9.5–12.9), with the highest value observed in infants aged 1–12 months (24.9/100 children × 30 days; 95% CIs: 17.6–28.9). The mean estimated incidence of URTIs was higher than that of LRTIs (8.3 – CIs: 7.6–8.9 vs 3.8/100 children × 30 days – CIs: 6.4–4.3, respectively). The comparison of ARTIs, which occurred in the pre-pandemic winter, to those measured during the COVID-19 pandemic, revealed an impressive 82.1% drop in the incidence rate (CIs: 77.8–85.7). Conclusions This study showed that infants aged 1–12 months are more likely to develop ARTIs than older children and that COVID-19 pandemic has dramatically altered the epidemiology of ARTIs in children aged 0–5 years. Supplementary Information The online version contains supplementary material available at 10.1186/s13052-022-01221-w.
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Affiliation(s)
- Chiara Mameli
- Department of Pediatrics, V Buzzi Children's Hospital, Milan, Italy. .,Department of Biomedical and Clinical Science L.Sacco, Università di Milano, Milan, Italy.
| | - Marina Picca
- Italian Primary Care Paediatrics Society (SICuPP), Lombardy, ATS Milano, Milan, Italy
| | | | - Maria Elisabetta Pace
- Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Pediatric Highly Intensive Care Unit, Milan, Italy
| | - Raffaele Badolato
- Department of Pediatrics, Università di Brescia, "Istituto di Medicina Molecolare Angelo Nocivelli", ASST Spedali civili, Brescia, Italy
| | | | | | - Paola Marchisio
- Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Pediatric Highly Intensive Care Unit, Milan, Italy.,Università di Milano, Milan, Italy
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27
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Rios Guzman E, Hultquist JF. Clinical and biological consequences of respiratory syncytial virus genetic diversity. Ther Adv Infect Dis 2022; 9:20499361221128091. [PMID: 36225856 PMCID: PMC9549189 DOI: 10.1177/20499361221128091] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2022] [Accepted: 08/30/2022] [Indexed: 11/17/2022] Open
Abstract
Respiratory syncytial virus (RSV) is one of the most common etiological agents of global acute respiratory tract infections with a disproportionate burden among infants, individuals over the age of 65, and immunocompromised populations. The two major subtypes of RSV (A and B) co-circulate with a predominance of either group during different epidemic seasons, with frequently emerging genotypes due to RSV's high genetic variability. Global surveillance systems have improved our understanding of seasonality, disease burden, and genomic evolution of RSV through genotyping by sequencing of attachment (G) glycoprotein. However, the integration of these systems into international infrastructures is in its infancy, resulting in a relatively low number (~2200) of publicly available RSV genomes. These limitations in surveillance hinder our ability to contextualize RSV evolution past current canonical attachment glycoprotein (G)-oriented understanding, thus resulting in gaps in understanding of how genetic diversity can play a role in clinical outcome, therapeutic efficacy, and the host immune response. Furthermore, utilizing emerging RSV genotype information from surveillance and testing the impact of viral evolution using molecular techniques allows us to establish causation between the clinical and biological consequences of arising genotypes, which subsequently aids in informed vaccine design and future vaccination strategy. In this review, we aim to discuss the findings from current molecular surveillance efforts and the gaps in knowledge surrounding the consequence of RSV genetic diversity on disease severity, therapeutic efficacy, and RSV-host interactions.
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Affiliation(s)
- Estefany Rios Guzman
- Department of Medicine, Division of Infectious
Diseases, Northwestern University Feinberg School of Medicine, Chicago, IL,
USA
- Center for Pathogen Genomics and Microbial
Evolution, Institute for Global Health, Northwestern University Feinberg
School of Medicine, Chicago, IL, USA
| | - Judd F. Hultquist
- Robert H. Lurie Medical Research Center,
Northwestern University, 9-141, 303 E. Superior St., Chicago, IL 60611,
USA
- Department of Medicine, Division of Infectious
Diseases, Northwestern University Feinberg School of Medicine, Chicago, IL,
USA
- Center for Pathogen Genomics and Microbial
Evolution, Institute for Global Health, Northwestern University Feinberg
School of Medicine, Chicago, IL, USA
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Dos Santos G, Wang H, Jindal P, Rybo M, Roul H, Pallem S, Eckermann T, Godderis L, Martínez Gómez X, Godard E, Soler M, Yousefi M, Salamanca de la Cueva I, Nwoji U. Brand-Specific Enhanced Safety Surveillance Study of GSK's Quadrivalent Seasonal Influenza Vaccine, Conducted During the COVID-19 Pandemic, in Belgium, Germany and Spain, for the 2020/21 Season. Infect Dis Ther 2021; 11:463-483. [PMID: 34961900 PMCID: PMC8711683 DOI: 10.1007/s40121-021-00571-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2021] [Accepted: 11/17/2021] [Indexed: 12/22/2022] Open
Abstract
INTRODUCTION Seasonal influenza poses a major public health burden worldwide. Influenza vaccines, updated yearly to match circulating strains based on World Health Organization (WHO) recommendations, are the cornerstone of prevention and require regular monitoring. The COVID-19 pandemic is expected to cause logistical, site access and medical staff constraints and could affect the safety profile of influenza vaccines. METHODS Following European Medicines Agency guidance, an enhanced safety surveillance (ESS) study assessed the frequency and severity of predefined and other adverse events (AEs) occurring within 7 days of receiving GSK's inactivated quadrivalent seasonal influenza vaccine (IIV4), in Belgium, Germany and Spain in 2020/21, using adverse drug reaction (ADR) cards. RESULTS During the 2020/21 influenza season, 1054 participants vaccinated with GSK's IIV4 were enrolled (all adults in Belgium and Germany, 30% adults/70% children in Spain); 96 eligible children received a second dose. Overall, 1042 participants completed the study. After doses 1 and 2, 98.9% and 100% of participants, respectively, returned their completed ADR card. After doses 1 and 2, 37.8% (398/1054) and 13.5% (13/96) of participants, respectively, reported at least one AE. The most frequently reported categories of AEs were "general disorders and administration site conditions" (e.g. injection site pain) and "nervous system disorders" (e.g. headache). There were no deaths or serious AEs deemed related to GSK's IIV4. CONCLUSION This ESS study assessed AEs in near real time. The COVID-19 pandemic did not alter the safety profile of GSK's IIV4. No safety signals were detected during the study, which confirms the excellent safety profile of GSK's IIV4.
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Affiliation(s)
| | | | - Pooja Jindal
- Parexel International, Chandigarh, India, C/O GSK, Rockville, MD, USA
| | | | - Hélène Roul
- Keyrus Life Science, Levallois-Perret, France, C/O GSK, Wavre, Belgium
| | - Sridevi Pallem
- Keyrus Life Science, New York, NY, USA, C/O GSK, New York, NY, USA
| | | | - Lode Godderis
- Environment and Health, Department of Public Health and Primary Care, KU Leuven, Leuven, Belgium.,External Service for Prevention and Protection at Work, IDEWE, Heverlee, Belgium
| | | | | | - Muriel Soler
- 4Clinics, Waterloo, Belgium, C/O GSK, Wavre, Belgium
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Bergeron HC, Tripp RA. Immunopathology of RSV: An Updated Review. Viruses 2021; 13:2478. [PMID: 34960746 PMCID: PMC8703574 DOI: 10.3390/v13122478] [Citation(s) in RCA: 29] [Impact Index Per Article: 9.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2021] [Revised: 12/06/2021] [Accepted: 12/08/2021] [Indexed: 12/14/2022] Open
Abstract
RSV is a leading cause of respiratory tract disease in infants and the elderly. RSV has limited therapeutic interventions and no FDA-approved vaccine. Gaps in our understanding of virus-host interactions and immunity contribute to the lack of biological countermeasures. This review updates the current understanding of RSV immunity and immunopathology with a focus on interferon responses, animal modeling, and correlates of protection.
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Affiliation(s)
| | - Ralph A. Tripp
- Department of Infectious Diseases, College of Veterinary Medicine, University of Georgia, Athens, GA 30602, USA;
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30
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Li W, Zhu Y, Lou J, Chen J, Xie X, Mao J. Rotavirus and adenovirus infections in children during COVID-19 outbreak in Hangzhou, China. Transl Pediatr 2021; 10:2281-2286. [PMID: 34733668 PMCID: PMC8506064 DOI: 10.21037/tp-21-150] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/02/2021] [Accepted: 06/29/2021] [Indexed: 12/17/2022] Open
Abstract
BACKGROUND This study aims to investigate the impact of protective measures and isolation on intestinal infection in children before and after COVID-19 outbreak in Hangzhou, China. METHODS Data on outpatient visits, intestinal infection visits, and tests of adenovirus or rotavirus from electronic healthcare records were extracted in Children's Hospital of Zhejiang University School of Medicine during the COVID-19 outbreak (January-December, 2020), and be compared with those in 2019 during the same period. RESULTS We found that pediatric outpatient visits, patients with intestinal infection and its proportion from January to December of 2020 were significantly less than that in the same period of 2019. Furthermore, the numbers of outpatient visits and patients with intestinal infection were the lowest in February and elevated slowly from March to December in 2020. We also found significantly decreased number of completed tests for intestinal viruses, positive cases of adenovirus and rotavirus, positive rate of rotavirus during January-December, 2020. The positive rates of adenovirus from March to September and December of 2020 were significantly lower than the levels of the same period in 2019. The positive rate of rotavirus and adenovirus in all age groups in 2020 is lower than the level of all age groups in 2019. CONCLUSIONS The outpatient visits and intestinal, rotavirus and adenovirus infections in children significantly decreased during COVID-19 outbreak. Adequate protective measures and isolation in children may help to prevent intestinal virus infections in children.
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Affiliation(s)
- Wei Li
- Department of Clinical Laboratory, The Children's Hospital, Zhejiang University School of Medicine, National Clinical Research Center for Child Health, National Children's Regional Medical Center, Hangzhou, China
| | - Yueling Zhu
- Department of Traditional Chinese Medicine, The Children's Hospital, Zhejiang University School of Medicine, National Clinical Research Center for Child Health, National Children's Regional Medical Center, Hangzhou, China
| | - Jingan Lou
- Department of Gastroenterology, The Children's Hospital, Zhejiang University School of Medicine, National Clinical Research Center for Child Health, National Children's Regional Medical Center, Hangzhou, China
| | - Jie Chen
- Department of Gastroenterology, The Children's Hospital, Zhejiang University School of Medicine, National Clinical Research Center for Child Health, National Children's Regional Medical Center, Hangzhou, China
| | - Xiaojun Xie
- Department of Clinical Laboratory, The Children's Hospital, Zhejiang University School of Medicine, National Clinical Research Center for Child Health, National Children's Regional Medical Center, Hangzhou, China
| | - Jianhua Mao
- Department of Nephrology, The Children's Hospital, Zhejiang University School of Medicine, National Clinical Research Center for Child Health, National Children's Regional Medical Center, Hangzhou, China
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Tang X, Dai G, Jiang X, Wang T, Sun H, Chen Z, Huang L, Wang M, Zhu C, Yan Y, Jiang W. Clinical Characteristics of Pediatric Respiratory Tract Infection and Respiratory Pathogen Isolation During the Coronavirus Disease 2019 Pandemic. Front Pediatr 2021; 9:759213. [PMID: 35071128 PMCID: PMC8767000 DOI: 10.3389/fped.2021.759213] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/27/2021] [Accepted: 12/13/2021] [Indexed: 11/25/2022] Open
Abstract
Objective: We sought to compare the clinical characteristics of pediatric respiratory tract infection and respiratory pathogen isolations during the coronavirus disease (COVID-19) pandemic to those of cases in 2018 and 2019. Methods: Our study included all children from 28 days to 15 years old with respiratory tract infections who were admitted to the Department of Respiration, in the Children's Hospital of Soochow University, between January 2018 and December 2020. Human rhinovirus (HRV) and human metapneumovirus (hMPV) were detected by reverse transcription polymerase chain reaction (RT-PCR). Mycoplasma pneumoniae (MP) and human bocavirus (HBoV) were detected by real-time fluorescence quantitative polymerase chain reaction (qPCR); In parallel, Mycoplasma pneumoniae was detected by enzyme-linked immunosorbent assays, and bacteria were detected by culture in blood, bronchoalveolar lavage specimen, and pleural fluid. Results: Compared to 2018 and 2019, the pathogen detection rate was significantly lower in 2020. With regard to infections caused by single pathogens, in 2020, the detection rates of MP were the lowest and those of HRV were the highest when compared to those in 2018 and 2019. Meanwhile, the positive rates of respiratory syncytial virus (RSV) and hMPV reported in 2020 were less than those recorded in 2018 but similar to those recorded in 2019. Also, the 2020 rate of adenovirus (ADV) was lower than that recorded in 2019, but similar to that recorded in 2018. There were no statistical differences in the positive rates of HBoV and PIV III over the 3 years surveyed. Infections in infants were significantly less common in 2020, but no significant difference was found among children aged 1 to 3 years. The detection rate of pathogens in children old than 5 years in 2020 was significantly lower than those recorded in the previous 2 years. Notably, the pathogen detection rates in the first and second quarters of 2020 were similar to those recorded in the previous 2 years; however, the rates were reduced in the third and fourth quarters of 2020. As for co-infections, the positive rate was at its lowest in 2020. In the previous 2 years, viral-MP was the most common type of mixed infection. By contrast, in 2020, viral-viral infections were the most common combination. Conclusion: The pathogen detection rate was significantly reduced in Suzhou City during the COVID-19 pandemic. Public interventions may help to prevent respiratory pathogen infections in children.
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Affiliation(s)
- Xifeng Tang
- Department of Respiratory Medicine, Children's Hospital of Soochow University, Suzhou, China
| | - Ge Dai
- Department of Respiratory Medicine, Children's Hospital of Soochow University, Suzhou, China
| | - Xiaohui Jiang
- Department of Respiratory Medicine, Children's Hospital of Soochow University, Suzhou, China
| | - Ting Wang
- Department of Respiratory Medicine, Children's Hospital of Soochow University, Suzhou, China
| | - Huiming Sun
- Department of Respiratory Medicine, Children's Hospital of Soochow University, Suzhou, China
| | - Zhengrong Chen
- Department of Respiratory Medicine, Children's Hospital of Soochow University, Suzhou, China
| | - Li Huang
- 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
| | - Canhong Zhu
- 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
| | - Wujun Jiang
- Department of Respiratory Medicine, Children's Hospital of Wujiang District, Children's Hospital of Soochow University, Suzhou, China
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