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Sang L, Gong X, Huang Y, Zhang L, Sun J. Immunotherapeutic implications on targeting the cytokines produced in rhinovirus-induced immunoreactions. FRONTIERS IN ALLERGY 2024; 5:1427762. [PMID: 38859875 PMCID: PMC11163110 DOI: 10.3389/falgy.2024.1427762] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2024] [Accepted: 05/13/2024] [Indexed: 06/12/2024] Open
Abstract
Rhinovirus is a widespread virus associated with several respiratory diseases, especially asthma exacerbation. Currently, there are no accurate therapies for rhinovirus. Encouragingly, it is found that during rhinovirus-induced immunoreactions the levels of certain cytokines in patients' serum will alter. These cytokines may have pivotal pro-inflammatory or anti-inflammatory effects via their specific mechanisms. Thus far, studies have shown that inhibitions of cytokines such as IL-1, IL-4, IL-5, IL-6, IL-13, IL-18, IL-25, and IL-33 may attenuate rhinovirus-induced immunoreactions, thereby relieving rhinovirus infection. Furthermore, such therapeutics for rhinovirus infection can be applied to viruses of other species, with certain practicability.
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Affiliation(s)
- Le Sang
- Department of Medicine, Shaoxing University, Shaoxing City, Zhejiang Province, China
| | - Xia Gong
- Department of Medicine, Shaoxing University, Shaoxing City, Zhejiang Province, China
| | - Yunlei Huang
- Department of Medicine, Shaoxing University, Shaoxing City, Zhejiang Province, China
| | - Linling Zhang
- Department of Respiratory Medicine, Shaoxing People’s Hospital, Shaoxing City, Zhejiang Province, China
| | - Jian Sun
- Department of Respiratory Medicine, Shaoxing People’s Hospital, Shaoxing City, Zhejiang Province, China
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2
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Gao Y, Zhou J, Wang M, Liang Y, Zhang T, Mao Y, Ma J, Li L, Zhang T, Guo L. Characteristics of upper respiratory tract rhinovirus in children with allergic rhinitis and its role in disease severity. Microbiol Spectr 2024:e0385323. [PMID: 38780281 DOI: 10.1128/spectrum.03853-23] [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: 11/06/2023] [Accepted: 04/16/2024] [Indexed: 05/25/2024] Open
Abstract
Allergic rhinitis (AR) is a global health challenge that particularly affects the quality of life of children. Human rhinovirus (HRV) infection usually causes common cold in the upper respiratory tract (URT) and can also affect airway allergy development, such as asthma exacerbation, but its relationship with AR is poorly understood. The study aimed to gain insight into the characteristics of HRV that is prevalent in AR children and its role in AR severity. A total of 362 children with symptomatic AR were enrolled from southwestern China during 2022-2023, and nasal lavage samples were collected for HRV molecular characterization and cytokine measurement. HRV was detected in 40% of the AR children, with peak detection in autumn. The positive rate was not correlated with whether the subjects were under allergen-specific immunotherapy (AIT). Among the detected HRVs, 42% were species A, 36% were species B, and 22% were species C, involving 21 A genotypes, 6 B genotypes, and 7 C genotypes. HRV positivity was significantly associated with symptom severity (visual analog scale [VAS] score) and elevated levels of local nasal IgE, interleukin-25 (IL-25), IL-4, and CXCL13 in AR children who did not receive antiallergic treatment. All three species of HRV strains (A1B, A21, B27, B70, and C17) had been isolated and were able to infect respiratory epithelial tissue in vitro. Complete genome sequencing showed that the antigenic epitopes of the isolated HRVs had certain variations. Our work reveals the etiological characteristics of URT-HRV in AR children and suggests a role of HRV infection in the pathogenesis of childhood AR. IMPORTANCE Our study revealed high human rhinovirus (HRV) detection rate in children with allergic rhinitis (AR), and HRV infection (A, B, or C species) is positively associated with the symptom severity in AR children. Elevated nasal IgE, interleukin-25 (IL-25), IL-4, and CXCL13 levels suggest a potential pathogenic mechanism by which HRV infection induces nasal type 2 immune/inflammation responses and local IgE production in AR patients. In addition, etiological analysis found that the main prevalent HRV species in AR children are A and B (~80%), which is different from acute respiratory infection and asthma exacerbation, where species A and C are dominant. The data reveal the distinct species prevalence characteristics of HRV infection in AR. Finally, we isolated all three species of HRV strains from nasal cavity of AR children with varying degrees of antigenic epitope mutations and in vitro infectivity, highlighting the importance of strengthening monitoring and intervention for respiratory HRV infection in AR children.
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Affiliation(s)
- Yingqin Gao
- Affiliated Children's Hospital of Kunming Medical University, Kunming, China
| | - Jienan Zhou
- Yunnan Center for Disease Control and Prevention, Kunming, China
| | - Meilan Wang
- Affiliated Children's Hospital of Kunming Medical University, Kunming, China
| | - Yanqi Liang
- Affiliated Children's Hospital of Kunming Medical University, Kunming, China
| | | | - Yunxiang Mao
- Affiliated Children's Hospital of Kunming Medical University, Kunming, China
| | - Jing Ma
- Affiliated Children's Hospital of Kunming Medical University, Kunming, China
| | - Li Li
- Affiliated Children's Hospital of Kunming Medical University, Kunming, China
| | - Tiesong Zhang
- Affiliated Children's Hospital of Kunming Medical University, Kunming, China
| | - Lei Guo
- Affiliated Children's Hospital of Kunming Medical University, Kunming, China
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3
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Waeijen-Smit K, Crutsen M, Keene S, Miravitlles M, Crisafulli E, Torres A, Mueller C, Schuetz P, Ringbæk TJ, Fabbian F, Mekov E, Harries TH, Lun CT, Ergan B, Esteban C, Quintana Lopez JM, López-Campos JL, Chang CL, Hancox RJ, Shafuddin E, Ellis H, Janson C, Suppli Ulrik C, Gudmundsson G, Epstein D, Dominguez J, Lacoma A, Osadnik C, Alia I, Spannella F, Karakurt Z, Mehravaran H, Utens C, de Kruif MD, Ko FWS, Trethewey SP, Turner AM, Bumbacea D, Murphy PB, Vermeersch K, Zilberman-Itskovich S, Steer J, Echevarria C, Bourke SC, Lane N, de Batlle J, Sprooten RTM, Russell R, Faverio P, Cross JL, Prins HJ, Spruit MA, Simons SO, Houben-Wilke S, Franssen FME. Global mortality and readmission rates following COPD exacerbation-related hospitalisation: a meta-analysis of 65 945 individual patients. ERJ Open Res 2024; 10:00838-2023. [PMID: 38410700 PMCID: PMC10895439 DOI: 10.1183/23120541.00838-2023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2023] [Accepted: 12/16/2023] [Indexed: 02/28/2024] Open
Abstract
Background Exacerbations of COPD (ECOPD) have a major impact on patients and healthcare systems across the world. Precise estimates of the global burden of ECOPD on mortality and hospital readmission are needed to inform policy makers and aid preventive strategies to mitigate this burden. The aims of the present study were to explore global in-hospital mortality, post-discharge mortality and hospital readmission rates after ECOPD-related hospitalisation using an individual patient data meta-analysis (IPDMA) design. Methods A systematic review was performed identifying studies that reported in-hospital mortality, post-discharge mortality and hospital readmission rates following ECOPD-related hospitalisation. Data analyses were conducted using a one-stage random-effects meta-analysis model. This study was conducted and reported in accordance with the PRISMA-IPD statement. Results Data of 65 945 individual patients with COPD were analysed. The pooled in-hospital mortality rate was 6.2%, pooled 30-, 90- and 365-day post-discharge mortality rates were 1.8%, 5.5% and 10.9%, respectively, and pooled 30-, 90- and 365-day hospital readmission rates were 7.1%, 12.6% and 32.1%, respectively, with noticeable variability between studies and countries. Strongest predictors of mortality and hospital readmission included noninvasive mechanical ventilation and a history of two or more ECOPD-related hospitalisations <12 months prior to the index event. Conclusions This IPDMA stresses the poor outcomes and high heterogeneity of ECOPD-related hospitalisation across the world. Whilst global standardisation of the management and follow-up of ECOPD-related hospitalisation should be at the heart of future implementation research, policy makers should focus on reimbursing evidence-based therapies that decrease (recurrent) ECOPD.
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Affiliation(s)
- Kiki Waeijen-Smit
- Department of Research and Development, Ciro, Horn, the Netherlands
- Department of Respiratory Medicine, NUTRIM School of Nutrition and Translational Research in Metabolism, Faculty of Health Medicine and Life Sciences, Maastricht University Medical Centre (MUMC+), Maastricht, the Netherlands
| | - Mieke Crutsen
- Pulmonary Function and Exercise Testing Laboratory, MUMC+, Maastricht, the Netherlands
| | - Spencer Keene
- Department of Research and Development, Ciro, Horn, the Netherlands
- Institute of Applied Health Research, College of Medical and Dental Sciences, University of Birmingham, Birmingham, UK
- Department of Clinical Pharmacy and Toxicology, MUMC+, Maastricht, the Netherlands
| | - Marc Miravitlles
- Pneumology Department, Hospital Universitari Vall d'Hebron, Vall d'Hebron Institut de Recerca, Vall d'Hebron Barcelona Hospital Campus, Ciber de Enfermedades Respiratorias (CIBERES), Barcelona, Spain
| | - Ernesto Crisafulli
- Respiratory Medicine Unit, Department of Medicine, University of Verona, Verona, Italy
| | - Antoni Torres
- Department of Pulmonology, Hospital Clinic of Barcelona and University of Barcelona. Institut d'Investigacions Biomèdiques August Pi i Sunyer, Institución Catalana de Investigación y Estudios Avanzados, CIBERES, Barcelona, Spain
| | - Christian Mueller
- Cardiovascular Research Institute Base, Department of Cardiology, University Hospital Basel, University of Basel, Basel, Switzerland
| | - Philipp Schuetz
- Medical University Department, Kantonsspital Aarau, Aarau, Switzerland
| | - Thomas J Ringbæk
- Department of Respiratory Medicine, Copenhagen University Hospital-Hvidovre, Hvidovre, Denmark
| | - Fabio Fabbian
- Department of Medical Sciences, Faculty of Medicine, Pharmacy and Prevention, University of Ferrara, University Hospital of Ferrara, Ferrara, Italy
| | - Evgeni Mekov
- Department of Occupational Diseases, Medical University Sofia, Sofia, Bulgaria
| | - Timothy H Harries
- Department of Population Health Sciences, School of Life Course and Population Sciences, King's College London, London, UK
| | - Chung-Tat Lun
- Department of Medicine and ICU, Alice Ho Miu Ling Nethersole Hospital, Hong Kong, Hong Kong
| | - Begum Ergan
- Dokuz Eylul University, Faculty of Medicine, Department of Pulmonary and Critical Care, Division of Critical Care, Izmir, Turkey
| | - Cristóbal Esteban
- Respiratory Department, Hospital Galdakao, Galdakao, Spain
- Instituto BioCruces-Bizkaia, Barakaldo, Spain
- Red de Investigación en Servicios Sanitarios y Enfermedades Crónicas, Red de Investigación en Cronicidad, Atención Primaria y Promoción de la Salud, Bizkaia, Spain
| | - Jose M Quintana Lopez
- Red de Investigación en Servicios Sanitarios y Enfermedades Crónicas, Red de Investigación en Cronicidad, Atención Primaria y Promoción de la Salud, Bizkaia, Spain
- Unidad de Investigación, Hospital Galdakao-Usansolo, Galdakao, Spain
| | - José Luis López-Campos
- Unidad Médico-Quirúrgica de Enfermedades Respiratorias, Instituto de Biomedicina de Sevilla, Hospital Universitario Virgen del Rocío/Universidad de Sevilla, Seville, Spain
- CIBERES, Instituto de Salud Carlos III, Madrid, Spain
| | - Catherina L Chang
- Department of Respiratory Medicine, Waikato Hospital, Hamilton, New Zealand
| | - Robert J Hancox
- Department of Respiratory Medicine, Waikato Hospital, Hamilton, New Zealand
- Department of Preventive and Social Medicine, University of Otago, Dunedin, New Zealand
| | | | - Hollie Ellis
- Department of Respiratory Medicine, Waikato Hospital, Hamilton, New Zealand
| | - Christer Janson
- Department of Medical Sciences: Respiratory, Allergy and Sleep Research, Uppsala University, Uppsala, Sweden
| | - Charlotte Suppli Ulrik
- Department of Respiratory Medicine, Copenhagen University Hospital-Hvidovre, Hvidovre, Denmark
| | - Gunnar Gudmundsson
- Landspitali - The National University Hospital of Iceland, Reykjavik, Iceland
- Faculty of Medicine, University of Iceland School of Health Sciences, Reykjavik, Iceland
| | - Danny Epstein
- Critical Care Division, Rambam Health Care Campus, Haifa, Israel
| | - José Dominguez
- Servei de Microbiologia, Hospital Universitari Germans Trias i Pujol, Institut d'Investigació Germans Trias i Pujol, Universitat Autònoma de Barcelona, CIBERES, Barcelona, Spain
| | - Alicia Lacoma
- Servei de Microbiologia, Hospital Universitari Germans Trias i Pujol, Institut d'Investigació Germans Trias i Pujol, Universitat Autònoma de Barcelona, CIBERES, Barcelona, Spain
| | | | - Inmaculada Alia
- Intensive Care Units, Hospital Universitario de Getafe, CIBERES, Getafe, Spain
| | - Francesco Spannella
- Internal Medicine and Geriatrics, Hypertension Excellence Centre of the European Society of Hypertension, IRCCS INRCA, Ancona, Italy
- Department of Clinical and Molecular Sciences, University Politecnica delle Marche, Ancona, Italy
| | - Zuhal Karakurt
- Respiratory Critical Care Unit, University of Health Sciences Istanbul Sureyyapasa Chest Diseases and Thoracic Surgery Training and Research Hospital, Istanbul, Turkey
| | - Hossein Mehravaran
- Pulmonary and Critical Care Division, Department of Internal Medicine, Mazandaran University of Medical Sciences, Sari, Iran
| | - Cecile Utens
- Libra, Rehabilitation and Audiology, Eindhoven, the Netherlands
| | - Martijn D de Kruif
- Department of Pulmonary Medicine, Zuyderland Medical Center, Heerlen, The Netherlands
| | - Fanny Wai San Ko
- Department of Medicine and Therapeutics, Prince of Wales Hospital, Hong Kong, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, Hong Kong
| | - Samuel P Trethewey
- Gloucestershire Hospitals NHS Foundation Trust, Cheltenham, UK
- University of Exeter, Exeter, UK
| | - Alice M Turner
- Institute for Applied Health Research, University of Birmingham, Birmingham, UK
- University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK
| | - Dragos Bumbacea
- Department of Pneumology and Acute Respiratory Care, Elias Emergency University Hospital, Carol Davila University of Medicine and Pharmacy, Bucharest, Romania
| | - Patrick B Murphy
- Lane Fox Unit, Guy's and St Thomas' NHS Foundation Trust, London, UK
- Centre for Human and Applied Physiological Sciences, King's College, London, UK
| | - Kristina Vermeersch
- Department of Chronic Diseases, Metabolism and Ageing, Research Group BREATHE, KU Leuven, Leuven, Belgium
| | - Shani Zilberman-Itskovich
- Nephrology Division, Assaf-Harofeh (Shamir) Medical Center, Be'er Ya'akov, Israel
- Sackler School of Medicine, Tel-Aviv University, Tel-Aviv, Israel
| | - John Steer
- Translational and Clinical Research Institute, Newcastle University, Newcastle upon Tyne, UK
- Respiratory Department, North Tyneside General Hospital, North Shields, UK
| | - Carlos Echevarria
- Translational and Clinical Research Institute, Newcastle University, Newcastle upon Tyne, UK
- Respiratory Department, Royal Victoria Infirmary, Newcastle upon Tyne, UK
| | - Stephen C Bourke
- Translational and Clinical Research Institute, Newcastle University, Newcastle upon Tyne, UK
- Respiratory Department, North Tyneside General Hospital, North Shields, UK
| | - Nicholas Lane
- Translational and Clinical Research Institute, Newcastle University, Newcastle upon Tyne, UK
- Respiratory Department, Royal Victoria Infirmary, Newcastle upon Tyne, UK
| | - Jordi de Batlle
- Group of Translational Research in Respiratory Medicine, Institut de Recerca Biomèdica de Lleida (Fundació Dr Pifarré), Lleida, Spain
- CIBERES, Madrid, Spain
| | - Roy T M Sprooten
- Department of Respiratory Medicine, MUMC+, Maastricht, The Netherlands
| | - Richard Russell
- School of Immunology and Microbial Sciences, Guy's Campus, Kings College, London, UK
| | - Paola Faverio
- School of Medicine and Surgery, University of Milan Bicocca, Respiratory Unit, San Gerardo Hospital, ASST Monza, Monza, Italy
| | - Jane L Cross
- Faculty of Medicine and Health, University of East Anglia, Norwich, UK
| | - Hendrik J Prins
- Department of PMR, Libra, Rehabilitation and Audiology, Eindhoven, The Netherlands
- Department of PMR, Anna Hospital, Geldrop, The Netherlands
- Department of PMR, Catharina Hospital, Eindhoven, The Netherlands
| | - Martijn A Spruit
- Department of Research and Development, Ciro, Horn, the Netherlands
- Department of Respiratory Medicine, NUTRIM School of Nutrition and Translational Research in Metabolism, Faculty of Health Medicine and Life Sciences, Maastricht University Medical Centre (MUMC+), Maastricht, the Netherlands
| | - Sami O Simons
- Department of Respiratory Medicine, NUTRIM School of Nutrition and Translational Research in Metabolism, Faculty of Health Medicine and Life Sciences, Maastricht University Medical Centre (MUMC+), Maastricht, the Netherlands
| | | | - Frits M E Franssen
- Department of Research and Development, Ciro, Horn, the Netherlands
- Department of Respiratory Medicine, NUTRIM School of Nutrition and Translational Research in Metabolism, Faculty of Health Medicine and Life Sciences, Maastricht University Medical Centre (MUMC+), Maastricht, the Netherlands
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4
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Chen X, Zhang P, Ma Y. Prevalence of acute infection in adults with asthma exacerbation: A systematic review and meta-analysis. Ann Thorac Med 2023; 18:132-151. [PMID: 37663878 PMCID: PMC10473064 DOI: 10.4103/atm.atm_422_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/01/2022] [Accepted: 03/29/2023] [Indexed: 09/05/2023] Open
Abstract
BACKGROUND Acute respiratory infections are a major trigger of asthma exacerbations. This study sought to estimate the overall proportion of viruses, atypical pathogens, and bacteria detected in adults with asthma exacerbations. METHODS PubMed, EMBASE, and Cochrane Library databases and all related studies from the reviews and references were searched from inception to February 13, 2020. Two authors independently performed study selection, data extraction, as well as quality evaluation. Subsequently, meta-analysis, between-study heterogeneity, and publication bias assessment were conducted on RStudio. RESULTS Forty-three eligible studies comprising 3511 adults were included, of which 21 publications mentioned multiple infections during acute asthma attacks. Meta-analysis showed an acute infection prevalence of 40.19% (95% confidence interval [CI] 34.53%-45.99%). Viruses, atypical pathogens, and bacteria were detected in 38.76% (95% CI 32.02%-45.71%), 8.29% (95% CI 2.64%-16.27%), and 7.05% (95% CI 3.34%-11.81%) of asthmatics during exacerbations, respectively. Rhinovirus infections are always the dominant trigger for exacerbations with a proportion of 20.02% (95% CI 14.84%-25.73%). Substantial heterogeneity across studies (Cochran Q test: 479.43, P < 0.0001, I2 = 91.2%) was explained by subgroup analysis, indicating that year, region, population, respiratory secretion, detection method, pathogen, and study quality were all influencing factors. CONCLUSION This meta-analysis provided the first quantitative epidemiological data for adults, and in the future, more research and health-care supports are necessary in this area.
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Affiliation(s)
- Xi Chen
- Department of Respiratory and Critical Care Medicine, Peking University People’s Hospital, Beijing, China
| | - Pingan Zhang
- Department of Respiratory and Critical Care Medicine, Peking University People’s Hospital, Beijing, China
| | - Yanliang Ma
- Department of Respiratory and Critical Care Medicine, Peking University People’s Hospital, Beijing, China
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5
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Moreno-Martos D, Verhamme K, Ostropolets A, Kostka K, Duarte-Sales T, Prieto-Alhambra D, Alshammari TM, Alghoul H, Ahmed WUR, Blacketer C, DuVall S, Lai L, Matheny M, Nyberg F, Posada J, Rijnbeek P, Spotnitz M, Sena A, Shah N, Suchard M, Chan You S, Hripcsak G, Ryan P, Morales D. Characteristics and outcomes of COVID-19 patients with COPD from the United States, South Korea, and Europe. Wellcome Open Res 2023; 7:22. [PMID: 36845321 PMCID: PMC9951545 DOI: 10.12688/wellcomeopenres.17403.3] [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: 12/20/2022] [Indexed: 01/11/2023] Open
Abstract
Background: Characterization studies of COVID-19 patients with chronic obstructive pulmonary disease (COPD) are limited in size and scope. The aim of the study is to provide a large-scale characterization of COVID-19 patients with COPD. Methods: We included thirteen databases contributing data from January-June 2020 from North America (US), Europe and Asia. We defined two cohorts of patients with COVID-19 namely a 'diagnosed' and 'hospitalized' cohort. We followed patients from COVID-19 index date to 30 days or death. We performed descriptive analysis and reported the frequency of characteristics and outcomes among COPD patients with COVID-19. Results: The study included 934,778 patients in the diagnosed COVID-19 cohort and 177,201 in the hospitalized COVID-19 cohort. Observed COPD prevalence in the diagnosed cohort ranged from 3.8% (95%CI 3.5-4.1%) in French data to 22.7% (95%CI 22.4-23.0) in US data, and from 1.9% (95%CI 1.6-2.2) in South Korean to 44.0% (95%CI 43.1-45.0) in US data, in the hospitalized cohorts. COPD patients in the hospitalized cohort had greater comorbidity than those in the diagnosed cohort, including hypertension, heart disease, diabetes and obesity. Mortality was higher in COPD patients in the hospitalized cohort and ranged from 7.6% (95%CI 6.9-8.4) to 32.2% (95%CI 28.0-36.7) across databases. ARDS, acute renal failure, cardiac arrhythmia and sepsis were the most common outcomes among hospitalized COPD patients. Conclusion: COPD patients with COVID-19 have high levels of COVID-19-associated comorbidities and poor COVID-19 outcomes. Further research is required to identify patients with COPD at high risk of worse outcomes.
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Affiliation(s)
| | - Katia Verhamme
- Medical Informatics, Erasmus MC, Rotterdam, The Netherlands
| | - Anna Ostropolets
- Biomedical Informatics, Columbia University Medical Center, New York, USA
| | - Kristin Kostka
- Real World Solutions, IQVIA, Cambridge, MA, USA
- OHDSI Center at The Roux Institute, Northeastern University, Portland, ME, USA
| | - Talita Duarte-Sales
- Fundació Institut Universitari per a la recerca a l’Atenció Primaria de Salut Jordi Gol i Gurina (IDIAPJGol), IDIAPJGol, Barcelona, Spain
| | - Daniel Prieto-Alhambra
- Nuffield Department of Orthopaedics, Rheumatology, and Musculoskeletal Sciences, University of Oxford, Oxford, UK
| | | | - Heba Alghoul
- Faculty of Medicine, Islamic University of Gaza, Gaza, Palestinian Territory
| | - Waheed-Ul-Rahman Ahmed
- Nuffield Department of Orthopaedics, Rheumatology, and Musculoskeletal Sciences, University of Oxford, Oxford, UK
- College of Medicine and Health, University of Exeter, Exeter, UK
| | - Clair Blacketer
- Medical Informatics, Erasmus MC, Rotterdam, The Netherlands
- Janssen Research and Development, Janssen Research and Development, Titusville, NJ, USA
| | - Scott DuVall
- VA Informatics and Computing Infrastructure, University of Utah, Salt Lake City, UT, USA
| | - Lana Lai
- Department of Medical Sciences, University of Manchester, Manchester, UK
| | - Michael Matheny
- Geriatrics Research Education and Clinical Care Service & VINCI, Tennessee Valley Healthcare System VA, nashville, TN, USA
- Department of Biomedical Informatics, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Fredrik Nyberg
- School of Public Health and Community Medicine, University of Gothenburg, Gothenburg, Sweden
| | - Jose Posada
- Department of Medicine, Stanford University, Redwood City, CA, USA
| | - Peter Rijnbeek
- Medical Informatics, Erasmus MC, Rotterdam, The Netherlands
| | - Matthew Spotnitz
- Biomedical Informatics, Columbia University Medical Center, New York, USA
| | - Anthony Sena
- Medical Informatics, Erasmus MC, Rotterdam, The Netherlands
- Janssen Research and Development, Janssen Research and Development, Titusville, NJ, USA
| | - Nigam Shah
- Department of Medicine, Stanford University, Redwood City, CA, USA
| | - Marc Suchard
- Department of Biostatistics UCLA Fielding School of Public Health, University of California, Los Angeles, Los Angeles, CA, USA
- Department of Computational Medicine David Geffen School of Medicine at UCLA,, University of California, Los Angeles, Los Angeles, CA, USA
| | - Seng Chan You
- Department of Preventive Medicine, Yonsei University, Seoul, South Korea
| | - George Hripcsak
- Biomedical Informatics, Columbia University Medical Center, New York, USA
| | - Patrick Ryan
- Biomedical Informatics, Columbia University Medical Center, New York, USA
- Janssen Research and Development, Janssen Research and Development, Titusville, NJ, USA
| | - Daniel Morales
- Population Health and Genomics, University of Dundee, Dundee, UK
- Department of Public Health, University of Southern Denmark, Odense, Denmark
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6
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Morales DR, Ostropolets A, Lai L, Sena A, Duvall S, Suchard M, Verhamme K, Rjinbeek P, Posada J, Ahmed W, Alshammary T, Alghoul H, Alser O, Areia C, Blacketer C, Burn E, Casajust P, You SC, Dawoud D, Golozar A, Gong M, Jonnagaddala J, Lynch K, Matheny M, Minty E, Nyberg F, Uribe A, Recalde M, Reich C, Scheumie M, Shah K, Shah N, Schilling L, Vizcaya D, Zhang L, Hripcsak G, Ryan P, Prieto-Alhambra D, Durate-Salles T, Kostka K. Characteristics and outcomes of COVID-19 patients with and without asthma from the United States, South Korea, and Europe. J Asthma 2023; 60:76-86. [PMID: 35012410 DOI: 10.1080/02770903.2021.2025392] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
Objective: Large international comparisons describing the clinical characteristics of patients with COVID-19 are limited. The aim of the study was to perform a large-scale descriptive characterization of COVID-19 patients with asthma.Methods: We included nine databases contributing data from January to June 2020 from the US, South Korea (KR), Spain, UK and the Netherlands. We defined two cohorts of COVID-19 patients ('diagnosed' and 'hospitalized') based on COVID-19 disease codes. We followed patients from COVID-19 index date to 30 days or death. We performed descriptive analysis and reported the frequency of characteristics and outcomes in people with asthma defined by codes and prescriptions.Results: The diagnosed and hospitalized cohorts contained 666,933 and 159,552 COVID-19 patients respectively. Exacerbation in people with asthma was recorded in 1.6-8.6% of patients at presentation. Asthma prevalence ranged from 6.2% (95% CI 5.7-6.8) to 18.5% (95% CI 18.2-18.8) in the diagnosed cohort and 5.2% (95% CI 4.0-6.8) to 20.5% (95% CI 18.6-22.6) in the hospitalized cohort. Asthma patients with COVID-19 had high prevalence of comorbidity including hypertension, heart disease, diabetes and obesity. Mortality ranged from 2.1% (95% CI 1.8-2.4) to 16.9% (95% CI 13.8-20.5) and similar or lower compared to COVID-19 patients without asthma. Acute respiratory distress syndrome occurred in 15-30% of hospitalized COVID-19 asthma patients.Conclusion: The prevalence of asthma among COVID-19 patients varies internationally. Asthma patients with COVID-19 have high comorbidity. The prevalence of asthma exacerbation at presentation was low. Whilst mortality was similar among COVID-19 patients with and without asthma, this could be confounded by differences in clinical characteristics. Further research could help identify high-risk asthma patients.[Box: see text]Supplemental data for this article is available online at https://doi.org/10.1080/02770903.2021.2025392 .
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Affiliation(s)
- Daniel R Morales
- Division of Population Health and Genomics, University of Dundee, Dundee, United Kingdom of Great Britain and Northern Ireland.,Department of Public Health, University of Southern Denmark, Odense, Denmark
| | - Anna Ostropolets
- Department of Biomedical Informatics, Columbia University, New York, NY, USA
| | - Lana Lai
- The University of Manchester, University of Manchester, Manchester, United Kingdom of Great Britain and Northern Ireland
| | - Anthony Sena
- Janssen Research and Development LLC, Raritan, NJ, USA
| | - Scott Duvall
- University of Utah Health, Epidemiology, Salt Lake City, UT, USA
| | | | - Katia Verhamme
- Erasmus MC, Medical Informatics, Erasmus MC, Dr Molewaterplein, Rotterdam, CA, The Netherlands
| | - Peter Rjinbeek
- Erasmus MC, Medical Informatics, Erasmus MC, Dr Molewaterplein, Rotterdam, CA, The Netherlands
| | - Joe Posada
- Stanford University, Medicine, Stanford, CA, USA
| | - Waheed Ahmed
- Department of Orthopedics, University of Oxford, Oxford, United Kingdom of Great Britain and Northern Ireland
| | | | - Heba Alghoul
- Islamic University of Gaza, Medicine, Gaza, State of Palestine
| | - Osaid Alser
- Department of Orthopedics, University of Oxford, Oxford, United Kingdom of Great Britain and Northern Ireland
| | - Carlos Areia
- Department of Orthopedics, University of Oxford, Oxford, United Kingdom of Great Britain and Northern Ireland
| | - Clair Blacketer
- Erasmus MC, Medical Informatics, Erasmus MC, Dr Molewaterplein, Rotterdam, CA, The Netherlands
| | - Edward Burn
- Department of Orthopedics, University of Oxford, Oxford, United Kingdom of Great Britain and Northern Ireland
| | - Paula Casajust
- Trial Form Support, Real World Evidence, Barcelona, Spain
| | - Seng Chan You
- Ajou University, Medicine, Suwon, The Republic of Korea
| | - Dalia Dawoud
- Stanford University, Medicine, Stanford, CA, USA
| | - Asieh Golozar
- Johns Hopkins University, Epidemiology, Baltimore, MD, USA
| | | | | | - Kristine Lynch
- University of Utah Health, Epidemiology, Salt Lake City, UT, USA
| | - Michael Matheny
- University of Utah Health, Epidemiology, Salt Lake City, UT, USA
| | - Evan Minty
- University of Calgary, Public Health, Calgary, Alberta, Canada
| | - Fredrik Nyberg
- University of Gothenburg, Public health, Goteborg, Sweden
| | - Albert Uribe
- Department of Orthopedics, University of Oxford, Oxford, United Kingdom of Great Britain and Northern Ireland
| | | | | | | | - Karishma Shah
- Department of Orthopedics, University of Oxford, Oxford, United Kingdom of Great Britain and Northern Ireland
| | - Nigam Shah
- Stanford University, Medicine, Stanford, CA, USA
| | - Lisa Schilling
- University of Colorado, School of Medicine, Denver, CO, USA
| | | | - Lin Zhang
- Chinese Academy of Medical Sciences and Peking Union Medical College, Public health, Beijing, China
| | - George Hripcsak
- Department of Biomedical Informatics, Columbia University, New York, NY, USA
| | - Patrick Ryan
- Janssen Research and Development LLC, Raritan, NJ, USA
| | - Daniel Prieto-Alhambra
- Department of Orthopedics, University of Oxford, Oxford, United Kingdom of Great Britain and Northern Ireland
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7
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Chong YM, Chan YF, Jamaluddin MFH, Hasan MS, Pang YK, Ponnampalavanar S, Syed Omar SF, Sam IC. Rhinovirus/enterovirus was the most common respiratory virus detected in adults with severe acute respiratory infections pre-COVID-19 in Kuala Lumpur, Malaysia. PLoS One 2022; 17:e0273697. [PMID: 36054088 PMCID: PMC9439195 DOI: 10.1371/journal.pone.0273697] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2022] [Accepted: 08/14/2022] [Indexed: 02/01/2023] Open
Abstract
Background Severe acute respiratory infections (SARI) pose a great global burden. The contribution of respiratory viruses to adult SARI is relatively understudied in Asia. We aimed to determine viral aetiology of adult SARI patients in Kuala Lumpur, Malaysia. Methods The prevalence of 20 common (mainly viral) respiratory pathogens, and MERS-CoV, SARS-CoV and 5 bacterial select agents was investigated from May 2017 to October 2019 in 489 SARI adult patients in Kuala Lumpur, Malaysia, using molecular assays (Luminex NxTAG-RPP kit and qPCR assays). Viral metagenomics analysis was performed on 105 negative samples. Results Viral respiratory pathogens were detected by PCR in 279 cases (57.1%), including 10 (2.0%) additional detections by metagenomics analysis. The most detected viruses were rhinovirus/enterovirus (RV/EV) (49.1%) and influenza virus (7.4%). Three melioidosis cases were detected but no SARS-CoV, MERS-CoV or other bacterial select agents. Bacterial/viral co-detections and viral co-detections were found in 44 (9.0%) and 27 (5.5%) cases respectively, mostly involving RV/EV. Independent predictors of critical disease were male gender, chronic lung disease, lack of runny nose and positive blood culture with a significant bacterial pathogen. Asthma and sore throat were associated with increased risk of RV/EV detection, while among RV/EV cases, males and those with neurological disease were at increased risk of critical disease. Conclusions Prior to the COVID-19 pandemic, the high prevalence of respiratory viruses in adults with SARI was mainly attributed to RV/EV. Continued surveillance of respiratory virus trends contributes to effective diagnostic, prevention, and treatment strategies.
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Affiliation(s)
- Yoong Min Chong
- Department of Medical Microbiology, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | - Yoke Fun Chan
- Department of Medical Microbiology, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
- * E-mail: (YFC); (ICS)
| | | | - M. Shahnaz Hasan
- Department of Anesthesiology, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | - Yong Kek Pang
- Department of Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | | | | | - I-Ching Sam
- Department of Medical Microbiology, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
- * E-mail: (YFC); (ICS)
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8
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Moreno-Martos D, Verhamme K, Ostropolets A, Kostka K, Duarte-Sales T, Prieto-Alhambra D, Alshammari TM, Alghoul H, Ahmed WUR, Blacketer C, DuVall S, Lai L, Matheny M, Nyberg F, Posada J, Rijnbeek P, Spotnitz M, Sena A, Shah N, Suchard M, Chan You S, Hripcsak G, Ryan P, Morales D. Characteristics and outcomes of COVID-19 patients with COPD from the United States, South Korea, and Europe. Wellcome Open Res 2022; 7:22. [PMID: 36845321 PMCID: PMC9951545 DOI: 10.12688/wellcomeopenres.17403.2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/18/2022] [Indexed: 01/08/2023] Open
Abstract
Background: Characterization studies of COVID-19 patients with chronic obstructive pulmonary disease (COPD) are limited in size and scope. The aim of the study is to provide a large-scale characterization of COVID-19 patients with COPD. Methods: We included thirteen databases contributing data from January-June 2020 from North America (US), Europe and Asia. We defined two cohorts of patients with COVID-19 namely a 'diagnosed' and 'hospitalized' cohort. We followed patients from COVID-19 index date to 30 days or death. We performed descriptive analysis and reported the frequency of characteristics and outcomes among COPD patients with COVID-19. Results: The study included 934,778 patients in the diagnosed COVID-19 cohort and 177,201 in the hospitalized COVID-19 cohort. Observed COPD prevalence in the diagnosed cohort ranged from 3.8% (95%CI 3.5-4.1%) in French data to 22.7% (95%CI 22.4-23.0) in US data, and from 1.9% (95%CI 1.6-2.2) in South Korean to 44.0% (95%CI 43.1-45.0) in US data, in the hospitalized cohorts. COPD patients in the hospitalized cohort had greater comorbidity than those in the diagnosed cohort, including hypertension, heart disease, diabetes and obesity. Mortality was higher in COPD patients in the hospitalized cohort and ranged from 7.6% (95%CI 6.9-8.4) to 32.2% (95%CI 28.0-36.7) across databases. ARDS, acute renal failure, cardiac arrhythmia and sepsis were the most common outcomes among hospitalized COPD patients. Conclusion: COPD patients with COVID-19 have high levels of COVID-19-associated comorbidities and poor COVID-19 outcomes. Further research is required to identify patients with COPD at high risk of worse outcomes.
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Affiliation(s)
| | - Katia Verhamme
- Medical Informatics, Erasmus MC, Rotterdam, The Netherlands
| | - Anna Ostropolets
- Biomedical Informatics, Columbia University Medical Center, New York, USA
| | - Kristin Kostka
- Real World Solutions, IQVIA, Cambridge, MA, USA
- OHDSI Center at The Roux Institute, Northeastern University, Portland, ME, USA
| | - Talita Duarte-Sales
- Fundació Institut Universitari per a la recerca a l’Atenció Primaria de Salut Jordi Gol i Gurina (IDIAPJGol), IDIAPJGol, Barcelona, Spain
| | - Daniel Prieto-Alhambra
- Nuffield Department of Orthopaedics, Rheumatology, and Musculoskeletal Sciences, University of Oxford, Oxford, UK
| | | | - Heba Alghoul
- Faculty of Medicine, Islamic University of Gaza, Gaza, Palestinian Territory
| | - Waheed-Ul-Rahman Ahmed
- Nuffield Department of Orthopaedics, Rheumatology, and Musculoskeletal Sciences, University of Oxford, Oxford, UK
- College of Medicine and Health, University of Exeter, Exeter, UK
| | - Clair Blacketer
- Medical Informatics, Erasmus MC, Rotterdam, The Netherlands
- Janssen Research and Development, Janssen Research and Development, Titusville, NJ, USA
| | - Scott DuVall
- VA Informatics and Computing Infrastructure, University of Utah, Salt Lake City, UT, USA
| | - Lana Lai
- Department of Medical Sciences, University of Manchester, Manchester, UK
| | - Michael Matheny
- Geriatrics Research Education and Clinical Care Service & VINCI, Tennessee Valley Healthcare System VA, nashville, TN, USA
- Department of Biomedical Informatics, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Fredrik Nyberg
- School of Public Health and Community Medicine, University of Gothenburg, Gothenburg, Sweden
| | - Jose Posada
- Department of Medicine, Stanford University, Redwood City, CA, USA
| | - Peter Rijnbeek
- Medical Informatics, Erasmus MC, Rotterdam, The Netherlands
| | - Matthew Spotnitz
- Biomedical Informatics, Columbia University Medical Center, New York, USA
| | - Anthony Sena
- Medical Informatics, Erasmus MC, Rotterdam, The Netherlands
- Janssen Research and Development, Janssen Research and Development, Titusville, NJ, USA
| | - Nigam Shah
- Department of Medicine, Stanford University, Redwood City, CA, USA
| | - Marc Suchard
- Department of Biostatistics UCLA Fielding School of Public Health, University of California, Los Angeles, Los Angeles, CA, USA
- Department of Computational Medicine David Geffen School of Medicine at UCLA,, University of California, Los Angeles, Los Angeles, CA, USA
| | - Seng Chan You
- Department of Preventive Medicine, Yonsei University, Seoul, South Korea
| | - George Hripcsak
- Biomedical Informatics, Columbia University Medical Center, New York, USA
| | - Patrick Ryan
- Biomedical Informatics, Columbia University Medical Center, New York, USA
- Janssen Research and Development, Janssen Research and Development, Titusville, NJ, USA
| | - Daniel Morales
- Population Health and Genomics, University of Dundee, Dundee, UK
- Department of Public Health, University of Southern Denmark, Odense, Denmark
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9
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Targeting intercellular adhesion molecule-1 (ICAM-1) to reduce rhinovirus-induced acute exacerbations in chronic respiratory diseases. Inflammopharmacology 2022; 30:725-735. [PMID: 35316427 PMCID: PMC8938636 DOI: 10.1007/s10787-022-00968-2] [Citation(s) in RCA: 15] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2021] [Accepted: 02/24/2022] [Indexed: 01/21/2023]
Abstract
The chronic respiratory non-communicable diseases, asthma and chronic obstructive pulmonary disease (COPD) are among the leading causes of global mortality and morbidity. Individuals suffering from these diseases are particularly susceptible to respiratory infections caused by bacterial and/or viral pathogens, which frequently result in exacerbation of symptoms, lung function decline, frequent hospital emergency visits and increased socioeconomic burden. Human rhinoviruses (HRV) remain the major viral pathogen group implicated in exacerbations of both asthma and COPD. The rhinoviral entry into the host lung epithelium is facilitated primarily by the adhesion site (“receptor”) intercellular adhesion molecule-1 (ICAM-1), coincidentally expressed on the respiratory epithelium in these conditions. Multiple observations of increased airway ICAM-1 protein in asthmatics, smokers and smoking-related COPD have been recorded in the literature. However, the lack of robust therapies for COPD in particular has triggered a renewed interest in assessing receptor antagonism-based anti-viral strategies for treatment of intercurrent viral infections in those with pre-existing chronic lung diseases. Given the crucial role ICAM-1 plays in facilitating HRV adhesion and, thus, transmissibility to the host respiratory system, as well as the up-regulation of ICAM-1 by smoking, we summarize the role of HRV in smoking-induced COPD and especially highlight the role of ICAM-1 in epithelial viral adhesion and chronic lung disease progression. Further, the review also sheds light specifically on evolving precision therapeutic strategies in blocking ICAM-1 for preventing viral adhesion and exacerbations of COPD.
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10
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Esmaeilzadeh H, Sanaei Dashti A, Mortazavi N, Fatemian H, Vali M. Persistent cough and asthma-like symptoms post COVID-19 hospitalization in children. BMC Infect Dis 2022; 22:244. [PMID: 35279094 PMCID: PMC8917254 DOI: 10.1186/s12879-022-07252-2] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2021] [Accepted: 03/08/2022] [Indexed: 12/16/2022] Open
Abstract
Backgrounds Respiratory viruses are the main triggers of asthma. Coronavirus is shown to contribute to respiratory tract infections that can lead to prolonged cough and asthma. Objectives Present study aimed to determine the risk of developing Persistent cough and asthma-like symptoms in hospitalized children due to COVID-19. Methods This prospective study was carried out in a tertiary referral center. During the COVID-19 pandemic, 69 hospitalized pediatric patients admitted with COVID-19 were observed from February 2020 to January 2021. Clinical and laboratory data were recorded, and after discharge, patients were followed and visited for cough and asthma evaluation one, 2 and 6 months later. Patients with asthma-like diagnoses in follow up defined as asthma-like groups, and patients without any sign of asthma were categorized as the non-asthma group. Asthma-like co-morbids and risk factors were evaluated and compared between the two groups. Results In follow-up, most of the COVID-19 hospitalized patients (N = 42) (58.5%) were not affected by asthma-like symptoms. 60.9% of the COVID-19 patients were male. The asthma-like group cases had a significantly familial history of asthma (63.0%), past medical history of asthma (33.3%), and Allergic rhinitis (85.2%). Rates of signs and symptoms during hospitalization were significantly higher in patients with COVID-19 and past medical history of asthma. Conclusions We found an asthma-like prevalence of 41.5% in the cohort of COVID-19 hospitalized children. Family history of asthma and previous history of asthma and allergic rhinitis are risk factors for asthma-like after COVID-19 hospitalization. COVID-19 presentations are more severe in the asthma-like group.
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11
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Sallard E, Schult F, Baehren C, Buedding E, Mboma O, Ahmad-Nejad P, Ghebremedhin B, Ehrhardt A, Wirth S, Aydin M. Viral Infection and Respiratory Exacerbation in Children: Results from a Local German Pediatric Exacerbation Cohort. Viruses 2022; 14:v14030491. [PMID: 35336898 PMCID: PMC8955305 DOI: 10.3390/v14030491] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2022] [Revised: 02/20/2022] [Accepted: 02/23/2022] [Indexed: 02/05/2023] Open
Abstract
Respiratory viruses play an important role in asthma exacerbation, and early exposure can be involved in recurrent bronchitis and the development of asthma. The exact mechanism is not fully clarified, and pathogen-to-host interaction studies are warranted to identify biomarkers of exacerbation in the early phase. Only a limited number of international exacerbation cohorts were studied. Here, we have established a local pediatric exacerbation study in Germany consisting of children with asthma or chronic, recurrent bronchitis and analyzed the viriome within the nasopharyngeal swab specimens derived from the entire cohort (n = 141). Interestingly, 41% of exacerbated children had a positive test result for human rhinovirus (HRV)/human enterovirus (HEV), and 14% were positive for respiratory syncytial virus (RSV). HRV was particularly prevalent in asthmatics (56%), wheezers (50%), and atopic (66%) patients. Lymphocytes were decreased in asthmatics and in HRV-infected subjects, and patients allergic to house dust mites were more susceptible to HRV infection. Our study thus confirms HRV infection as a strong ‘biomarker’ of exacerbated asthma. Further longitudinal studies will show the clinical progress of those children with a history of an RSV or HRV infection. Vaccination strategies and novel treatment guidelines against HRV are urgently needed to protect those high-risk children from a serious course of disease.
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Affiliation(s)
- Erwan Sallard
- Center for Biomedical Education and Research (ZBAF), Department of Human Medicine, Faculty of Health, Institute of Virology and Microbiology, Witten/Herdecke University, 58453 Witten, Germany; (E.S.); (A.E.)
| | - Frank Schult
- Center for Child and Adolescent Medicine, Center for Clinical and Translational Research (CCTR), Helios University Hospital Wuppertal, Witten/Herdecke University, 42283 Wuppertal, Germany; (F.S.); (O.M.); (S.W.)
| | - Carolin Baehren
- Laboratory of Experimental Pediatric Pneumology and Allergology, Center for Biomedical Education and Research, Faculty of Health, School of Life Sciences (ZBAF), Witten/Herdecke University, 58455 Witten, Germany; (C.B.); (E.B.)
| | - Eleni Buedding
- Laboratory of Experimental Pediatric Pneumology and Allergology, Center for Biomedical Education and Research, Faculty of Health, School of Life Sciences (ZBAF), Witten/Herdecke University, 58455 Witten, Germany; (C.B.); (E.B.)
| | - Olivier Mboma
- Center for Child and Adolescent Medicine, Center for Clinical and Translational Research (CCTR), Helios University Hospital Wuppertal, Witten/Herdecke University, 42283 Wuppertal, Germany; (F.S.); (O.M.); (S.W.)
| | - Parviz Ahmad-Nejad
- Institute for Medical Laboratory Diagnostics, Center for Clinical and Translational Research (CCTR), Helios University Hospital Wuppertal, Witten/Herdecke University, 42283 Wuppertal, Germany;
| | - Beniam Ghebremedhin
- Institute for Medical Laboratory Diagnostics, Center for Clinical and Translational Research (CCTR), Helios University Hospital Wuppertal, Witten/Herdecke University, 42283 Wuppertal, Germany;
| | - Anja Ehrhardt
- Center for Biomedical Education and Research (ZBAF), Department of Human Medicine, Faculty of Health, Institute of Virology and Microbiology, Witten/Herdecke University, 58453 Witten, Germany; (E.S.); (A.E.)
| | - Stefan Wirth
- Center for Child and Adolescent Medicine, Center for Clinical and Translational Research (CCTR), Helios University Hospital Wuppertal, Witten/Herdecke University, 42283 Wuppertal, Germany; (F.S.); (O.M.); (S.W.)
| | - Malik Aydin
- Center for Child and Adolescent Medicine, Center for Clinical and Translational Research (CCTR), Helios University Hospital Wuppertal, Witten/Herdecke University, 42283 Wuppertal, Germany; (F.S.); (O.M.); (S.W.)
- Laboratory of Experimental Pediatric Pneumology and Allergology, Center for Biomedical Education and Research, Faculty of Health, School of Life Sciences (ZBAF), Witten/Herdecke University, 58455 Witten, Germany; (C.B.); (E.B.)
- Correspondence: ; Tel.: +49-(0)-202-896-2384; Fax: +49-(0)-202-896-3834
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12
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Moreno-Martos D, Verhamme K, Ostropolets A, Kostka K, Duarte-Sales T, Prieto-Alhambra D, Alshammari TM, Alghoul H, Ahmed WUR, Blacketer C, DuVall S, Lai L, Matheny M, Nyberg F, Posada J, Rijnbeek P, Spotnitz M, Sena A, Shah N, Suchard M, Chan You S, Hripcsak G, Ryan P, Morales D. Characteristics and outcomes of COVID-19 patients with COPD from the United States, South Korea, and Europe. Wellcome Open Res 2022; 7:22. [PMID: 36845321 PMCID: PMC9951545 DOI: 10.12688/wellcomeopenres.17403.1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/20/2021] [Indexed: 01/08/2023] Open
Abstract
Background: Characterization studies of COVID-19 patients with chronic obstructive pulmonary disease (COPD) are limited in size and scope. The aim of the study is to provide a large-scale characterization of COVID-19 patients with COPD. Methods: We included thirteen databases contributing data from January-June 2020 from North America (US), Europe and Asia. We defined two cohorts of patients with COVID-19 namely a 'diagnosed' and 'hospitalized' cohort. We followed patients from COVID-19 index date to 30 days or death. We performed descriptive analysis and reported the frequency of characteristics and outcomes among COPD patients with COVID-19. Results: The study included 934,778 patients in the diagnosed COVID-19 cohort and 177,201 in the hospitalized COVID-19 cohort. Observed COPD prevalence in the diagnosed cohort ranged from 3.8% (95%CI 3.5-4.1%) in French data to 22.7% (95%CI 22.4-23.0) in US data, and from 1.9% (95%CI 1.6-2.2) in South Korean to 44.0% (95%CI 43.1-45.0) in US data, in the hospitalized cohorts. COPD patients in the hospitalized cohort had greater comorbidity than those in the diagnosed cohort, including hypertension, heart disease, diabetes and obesity. Mortality was higher in COPD patients in the hospitalized cohort and ranged from 7.6% (95%CI 6.9-8.4) to 32.2% (95%CI 28.0-36.7) across databases. ARDS, acute renal failure, cardiac arrhythmia and sepsis were the most common outcomes among hospitalized COPD patients. Conclusion: COPD patients with COVID-19 have high levels of COVID-19-associated comorbidities and poor COVID-19 outcomes. Further research is required to identify patients with COPD at high risk of worse outcomes.
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Affiliation(s)
| | - Katia Verhamme
- Medical Informatics, Erasmus MC, Rotterdam, The Netherlands
| | - Anna Ostropolets
- Biomedical Informatics, Columbia University Medical Center, New York, USA
| | - Kristin Kostka
- Real World Solutions, IQVIA, Cambridge, MA, USA
- OHDSI Center at The Roux Institute, Northeastern University, Portland, ME, USA
| | - Talita Duarte-Sales
- Fundació Institut Universitari per a la recerca a l’Atenció Primaria de Salut Jordi Gol i Gurina (IDIAPJGol), IDIAPJGol, Barcelona, Spain
| | - Daniel Prieto-Alhambra
- Nuffield Department of Orthopaedics, Rheumatology, and Musculoskeletal Sciences, University of Oxford, Oxford, UK
| | | | - Heba Alghoul
- Faculty of Medicine, Islamic University of Gaza, Gaza, Palestinian Territory
| | - Waheed-Ul-Rahman Ahmed
- Nuffield Department of Orthopaedics, Rheumatology, and Musculoskeletal Sciences, University of Oxford, Oxford, UK
- College of Medicine and Health, University of Exeter, Exeter, UK
| | - Clair Blacketer
- Medical Informatics, Erasmus MC, Rotterdam, The Netherlands
- Janssen Research and Development, Janssen Research and Development, Titusville, NJ, USA
| | - Scott DuVall
- VA Informatics and Computing Infrastructure, University of Utah, Salt Lake City, UT, USA
| | - Lana Lai
- Department of Medical Sciences, University of Manchester, Manchester, UK
| | - Michael Matheny
- Geriatrics Research Education and Clinical Care Service & VINCI, Tennessee Valley Healthcare System VA, nashville, TN, USA
- Department of Biomedical Informatics, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Fredrik Nyberg
- School of Public Health and Community Medicine, University of Gothenburg, Gothenburg, Sweden
| | - Jose Posada
- Department of Medicine, Stanford University, Redwood City, CA, USA
| | - Peter Rijnbeek
- Medical Informatics, Erasmus MC, Rotterdam, The Netherlands
| | - Matthew Spotnitz
- Biomedical Informatics, Columbia University Medical Center, New York, USA
| | - Anthony Sena
- Medical Informatics, Erasmus MC, Rotterdam, The Netherlands
- Janssen Research and Development, Janssen Research and Development, Titusville, NJ, USA
| | - Nigam Shah
- Department of Medicine, Stanford University, Redwood City, CA, USA
| | - Marc Suchard
- Department of Biostatistics UCLA Fielding School of Public Health, University of California, Los Angeles, Los Angeles, CA, USA
- Department of Computational Medicine David Geffen School of Medicine at UCLA,, University of California, Los Angeles, Los Angeles, CA, USA
| | - Seng Chan You
- Department of Preventive Medicine, Yonsei University, Seoul, South Korea
| | - George Hripcsak
- Biomedical Informatics, Columbia University Medical Center, New York, USA
| | - Patrick Ryan
- Biomedical Informatics, Columbia University Medical Center, New York, USA
- Janssen Research and Development, Janssen Research and Development, Titusville, NJ, USA
| | - Daniel Morales
- Population Health and Genomics, University of Dundee, Dundee, UK
- Department of Public Health, University of Southern Denmark, Odense, Denmark
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13
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Understanding Rhinovirus Circulation and Impact on Illness. Viruses 2022; 14:v14010141. [PMID: 35062345 PMCID: PMC8778310 DOI: 10.3390/v14010141] [Citation(s) in RCA: 19] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2021] [Revised: 01/08/2022] [Accepted: 01/10/2022] [Indexed: 01/27/2023] Open
Abstract
Rhinoviruses (RVs) have been reported as one of the main viral causes for severe respiratory illnesses that may require hospitalization, competing with the burden of other respiratory viruses such as influenza and RSV in terms of severity, economic cost, and resource utilization. With three species and 169 subtypes, RV presents the greatest diversity within the Enterovirus genus, and despite the efforts of the research community to identify clinically relevant subtypes to target therapeutic strategies, the role of species and subtype in the clinical outcomes of RV infection remains unclear. This review aims to collect and organize data relevant to RV illness in order to find patterns and links with species and/or subtype, with a specific focus on species and subtype diversity in clinical studies typing of respiratory samples.
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14
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Kan-O K, Washio Y, Fujimoto T, Shiroyama N, Nakano T, Wakamatsu K, Takata S, Yoshida M, Fujita M, Matsumoto K. Differences in the spectrum of respiratory viruses and detection of human rhinovirus C in exacerbations of adult asthma and chronic obstructive pulmonary disease. Respir Investig 2021; 60:129-136. [PMID: 34580039 DOI: 10.1016/j.resinv.2021.08.009] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2021] [Revised: 08/08/2021] [Accepted: 08/27/2021] [Indexed: 11/26/2022]
Abstract
BACKGROUND Viral respiratory infections are a common cause of acute exacerbations of chronic obstructive pulmonary disease (AECOPD) and asthma. We conducted a multicenter prospective study to determine the differences in the spectrum of viruses between adults with asthma exacerbations and AECOPD and assessed the prevalence and impact of human rhinovirus (HRV)-C in adults, which is more pathogenic in children with asthma than other HRV species. METHODS Nasopharyngeal and serum samples and clinical information were collected from 64 outpatients with adult asthma exacerbations and 44 outpatients with AECOPD between April 2018 and March 2020. Viral pathogens and HRV strains were identified from nasal samples by multiplex PCR and VP4/VP2 nested PCR. RESULTS Viral pathogens were identified in 31 patients with asthma exacerbations (48.4%) and 17 patients with AECOPD (38.6%). The most commonly detected viruses were HRV/enterovirus followed by human metapneumovirus (hMPV) in patients with asthma exacerbations, and hMPV followed by parainfluenza virus in patients with AECOPD. HRV-C was the HRV species most commonly associated with both asthma exacerbations and AECOPD. Clinical characteristics, baseline lung function, serum inflammatory chemokines, hospitalization, and systemic steroid use did not differ between HRV-C-positive patients and those positive for other HRV species. CONCLUSIONS Exacerbation-associated spectrum of viruses differed between adults with asthma exacerbations and AECOPD. HRV-C was the HRV species most often observed in adult asthma exacerbations and AECOPD, although it did not worsen patients' clinical outcomes relative to those of patients with other HRVs. Underlying disease-specific factors may be responsible for susceptibility to respiratory viruses. TRIAL REGISTRATION UMIN-CTR UMIN000031934.
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Affiliation(s)
- Keiko Kan-O
- Research Institute for Diseases of the Chest, Graduate School of Medical Sciences, Kyushu University, Fukuoka, 812-8582, Japan; Department of Endoscopic Diagnostics and Therapeutics, Kyushu University Hospital, Fukuoka, 812-8582, Japan.
| | - Yasuyoshi Washio
- Research Institute for Diseases of the Chest, Graduate School of Medical Sciences, Kyushu University, Fukuoka, 812-8582, Japan
| | - Tsuguto Fujimoto
- Center for Emergency Preparedness and Response, National Institute of Infectious Diseases, Tokyo, 162-8640, Japan
| | - Natsuko Shiroyama
- Department of Respiratory Medicine, Fukuoka University School of Medicine, Fukuoka, 814-0180, Japan
| | - Takako Nakano
- Department of Respiratory Medicine, National Hospital Organization Fukuokahigashi Medical Center, Koga, 811-3195, Japan
| | - Kentaro Wakamatsu
- Department of Respiratory Medicine, National Hospital Organization Omuta National Hospital, Omuta, 837-0911, Japan
| | - Shohei Takata
- Department of Respiratory Medicine, National Hospital Organization Fukuokahigashi Medical Center, Koga, 811-3195, Japan
| | - Makoto Yoshida
- Division of Respiratory Medicine, National Hospital Organization Fukuoka National Hospital, Fukuoka, 811-1394, Japan
| | - Masaki Fujita
- Department of Respiratory Medicine, Fukuoka University School of Medicine, Fukuoka, 814-0180, Japan
| | - Koichiro Matsumoto
- Research Institute for Diseases of the Chest, Graduate School of Medical Sciences, Kyushu University, Fukuoka, 812-8582, Japan
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15
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Feng Y, Liu E. Detection of respiratory viruses and expression of inflammatory cytokines in patients with acute exacerbation chronic obstructive pulmonary disease in Mongolia China. BRAZ J BIOL 2021; 82:e231134. [PMID: 34076157 DOI: 10.1590/1519-6984.231134] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2019] [Accepted: 07/10/2020] [Indexed: 11/22/2022] Open
Abstract
Chronic obstructive pulmonary disease (COPD) was estimated to be the third cause of global mortality by 2020. Acute exacerbation COPD (AECOPD) is a sudden worsening of COPD symptoms and could be due to virus/bacterial infections and air pollution. Increased expression of inflammatory markers in patients with AECOPD is associated with viral infection. This study aimed to detect different viruses and analyze the expression of various inflammatory markers associated with AECOPD patients. Three hundred and forty-seven patients diagnosed with COPD according to GOLD criteria were included in this study. Swab samples and blood were collected for the detection of viruses by RT-PCR and expression of inflammatory markers, respectively. Of the swab samples, 113 (32.6%) of samples were positive for virus detection. Of these, HRV (39.8%) was the predominant virus detected followed by FluB (27.4%) and FluA (22.1%). The presence of HRV was significantly higher (p=0.044) among the other detected viruses. When compared to healthy controls the expression levels of TNF-α, IL-6 and IL-8 were significantly higher (p<0.05) in virus-positive patients. The IL-6 and IL-8 were the next predominantly expressed in markers among the samples. The higher expression rate of IL-8 was significantly (p<0.05) associated with patients having COPD GOLD III severity level and smoking history. Although HRV was the predominant virus detected the combined prevalence of Influenza A and B surpassing the rate of HRV. The high-level expression of well known inflammatory markers of AECOPD, TNF-α, IL-6 and IL-8 indicates a chronic severe illness. These markers play an important role and could be used as a marker for determining the severity of AECOPD.
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Affiliation(s)
- Y Feng
- People's Hospital of Xing'an League, Department of Clinical Laboratory, Ulanhot, Inner Mongolia, China
| | - E Liu
- Hulunbeier People's Hospital, Hulunbuir Clinical Medical College, Department of Clinical Laboratory, Inner Mongolia University for Nationalities, Hulunbeier, Inner Mongolia 021008, China
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16
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COPD Is Associated with Elevated IFN-β Production by Bronchial Epithelial Cells Infected with RSV or hMPV. Viruses 2021; 13:v13050911. [PMID: 34069223 PMCID: PMC8156254 DOI: 10.3390/v13050911] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2021] [Revised: 05/05/2021] [Accepted: 05/08/2021] [Indexed: 12/22/2022] Open
Abstract
IFN treatment may be a viable option for treating COPD exacerbations based on evidence of IFN deficiency in COPD. However, in vitro studies have used primarily influenza and rhinoviruses to investigate IFN responses. This study aims to investigate the susceptibility to infection and IFN response of primary bronchial epithelial cells (BECs) from COPD donors to infection with RSV and hMPV. BECs from five COPD and five healthy donors were used to establish both submerged monolayer and well-differentiated (WD) cultures. Two isolates of both RSV and hMPV were used to infect cells. COPD was not associated with elevated susceptibility to infection and there was no evidence of an intrinsic defect in IFN production in either cell model to either virus. Conversely, COPD was associated with significantly elevated IFN-β production in response to both viruses in both cell models. Only in WD-BECs infected with RSV was elevated IFN-β associated with reduced viral shedding. The role of elevated epithelial cell IFN-β production in the pathogenesis of COPD is not clear and warrants further investigation. Viruses vary in the responses that they induce in BECs, and so conclusions regarding antiviral responses associated with disease cannot be made based on single viral infections.
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17
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Lee N, Smith S, Zelyas N, Klarenbach S, Zapernick L, Bekking C, So H, Yip L, Tipples G, Taylor G, Mubareka S. Burden of noninfluenza respiratory viral infections in adults admitted to hospital: analysis of a multiyear Canadian surveillance cohort from 2 centres. CMAJ 2021; 193:E439-E446. [PMID: 33782171 PMCID: PMC8099164 DOI: 10.1503/cmaj.201748] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/20/2021] [Indexed: 12/15/2022] Open
Abstract
BACKGROUND: Data on the outcomes of noninfluenza respiratory virus (NIRV) infections among hospitalized adults are lacking. We aimed to study the burden, severity and outcomes of NIRV infections in this population. METHODS: We analyzed pooled patient data from 2 hospital-based respiratory virus surveillance cohorts in 2 regions of Canada during 3 consecutive seasons (2015/16, 2016/17, 2017/18; n = 2119). We included patients aged ≥ 18 years who developed influenza-like illness or pneumonia and were hospitalized for management. We included patients confirmed positive for ≥ 1 virus by multiplex polymerase chain reaction assays (respiratory syncytial virus [RSV], human rhinovirus/enterovirus (hRV), human coronavirus (hCoV), metapneumovirus, parainfluenza virus, adenovirus, influenza viruses). We compared patient characteristics, clinical severity conventional outcomes (e.g., hospital length-of stay, 30-day mortality) and ordinal outcomes (5 levels: discharged, receiving convalescent care, acute ward or intensive care unit [ICU] care and death) for patients with NIRV infections and those with influenza. RESULTS: Among 2119 adults who were admitted to hospital, 1156 patients (54.6%) had NIRV infections (hRV 14.9%, RSV 12.9%, hCoV 8.2%) and 963 patients (45.4%) had influenza (n = 963). Patients with NIRVs were younger (mean 66.4 [standard deviation 20.4] yr), and more commonly had immunocompromising conditions (30.3%) and delay in diagnosis (median 4.0 [interquartile range (IQR) 2.0–7.0] days). Overall, 14.6% (12.4%–19.5%) of NIRV infections were acquired in hospital. Admission to ICU (18.2%, median 6.0 [IQR 3.0–13.0] d), hospital length-of-stay (median 5.0 [IQR 2.0–10.0] d) and 30-day mortality (8.4%; RSV 9.5%, hRV 6.6%, hCoV 9.2%) and the ordinal outcomes were similar for patients with NIRV infection and those with influenza. Age > 60 years, immunocompromised state and hospital-acquired viral infection were associated with worse outcomes. The estimated median cost per acute care admission was $6000 (IQR $2000–$16 000). INTERPRETATION: The burden of NIRV infection is substantial in adults admitted to hospital and associated outcomes may be as severe as for influenza, suggesting a need to prioritize therapeutics and vaccines for at-risk people.
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Affiliation(s)
- Nelson Lee
- Division of Infectious Disease (Lee, Smith, Zapernick, Taylor), Department of Medicine, and Department of Laboratory Medicine and Pathology (Zelyas, Tipples), and Division of Nephrology (Klarenbach, So), Department of Medicine, University of Alberta, Edmonton, Alta.; Sunnybrook Research Institute (Bekking, Yip, Mubareka); Department of Laboratory Medicine and Pathobiology (Mubareka), University of Toronto, Toronto, Ont.
| | - Stephanie Smith
- Division of Infectious Disease (Lee, Smith, Zapernick, Taylor), Department of Medicine, and Department of Laboratory Medicine and Pathology (Zelyas, Tipples), and Division of Nephrology (Klarenbach, So), Department of Medicine, University of Alberta, Edmonton, Alta.; Sunnybrook Research Institute (Bekking, Yip, Mubareka); Department of Laboratory Medicine and Pathobiology (Mubareka), University of Toronto, Toronto, Ont
| | - Nathan Zelyas
- Division of Infectious Disease (Lee, Smith, Zapernick, Taylor), Department of Medicine, and Department of Laboratory Medicine and Pathology (Zelyas, Tipples), and Division of Nephrology (Klarenbach, So), Department of Medicine, University of Alberta, Edmonton, Alta.; Sunnybrook Research Institute (Bekking, Yip, Mubareka); Department of Laboratory Medicine and Pathobiology (Mubareka), University of Toronto, Toronto, Ont
| | - Scott Klarenbach
- Division of Infectious Disease (Lee, Smith, Zapernick, Taylor), Department of Medicine, and Department of Laboratory Medicine and Pathology (Zelyas, Tipples), and Division of Nephrology (Klarenbach, So), Department of Medicine, University of Alberta, Edmonton, Alta.; Sunnybrook Research Institute (Bekking, Yip, Mubareka); Department of Laboratory Medicine and Pathobiology (Mubareka), University of Toronto, Toronto, Ont
| | - Lori Zapernick
- Division of Infectious Disease (Lee, Smith, Zapernick, Taylor), Department of Medicine, and Department of Laboratory Medicine and Pathology (Zelyas, Tipples), and Division of Nephrology (Klarenbach, So), Department of Medicine, University of Alberta, Edmonton, Alta.; Sunnybrook Research Institute (Bekking, Yip, Mubareka); Department of Laboratory Medicine and Pathobiology (Mubareka), University of Toronto, Toronto, Ont
| | - Christian Bekking
- Division of Infectious Disease (Lee, Smith, Zapernick, Taylor), Department of Medicine, and Department of Laboratory Medicine and Pathology (Zelyas, Tipples), and Division of Nephrology (Klarenbach, So), Department of Medicine, University of Alberta, Edmonton, Alta.; Sunnybrook Research Institute (Bekking, Yip, Mubareka); Department of Laboratory Medicine and Pathobiology (Mubareka), University of Toronto, Toronto, Ont
| | - Helen So
- Division of Infectious Disease (Lee, Smith, Zapernick, Taylor), Department of Medicine, and Department of Laboratory Medicine and Pathology (Zelyas, Tipples), and Division of Nephrology (Klarenbach, So), Department of Medicine, University of Alberta, Edmonton, Alta.; Sunnybrook Research Institute (Bekking, Yip, Mubareka); Department of Laboratory Medicine and Pathobiology (Mubareka), University of Toronto, Toronto, Ont
| | - Lily Yip
- Division of Infectious Disease (Lee, Smith, Zapernick, Taylor), Department of Medicine, and Department of Laboratory Medicine and Pathology (Zelyas, Tipples), and Division of Nephrology (Klarenbach, So), Department of Medicine, University of Alberta, Edmonton, Alta.; Sunnybrook Research Institute (Bekking, Yip, Mubareka); Department of Laboratory Medicine and Pathobiology (Mubareka), University of Toronto, Toronto, Ont
| | - Graham Tipples
- Division of Infectious Disease (Lee, Smith, Zapernick, Taylor), Department of Medicine, and Department of Laboratory Medicine and Pathology (Zelyas, Tipples), and Division of Nephrology (Klarenbach, So), Department of Medicine, University of Alberta, Edmonton, Alta.; Sunnybrook Research Institute (Bekking, Yip, Mubareka); Department of Laboratory Medicine and Pathobiology (Mubareka), University of Toronto, Toronto, Ont
| | - Geoff Taylor
- Division of Infectious Disease (Lee, Smith, Zapernick, Taylor), Department of Medicine, and Department of Laboratory Medicine and Pathology (Zelyas, Tipples), and Division of Nephrology (Klarenbach, So), Department of Medicine, University of Alberta, Edmonton, Alta.; Sunnybrook Research Institute (Bekking, Yip, Mubareka); Department of Laboratory Medicine and Pathobiology (Mubareka), University of Toronto, Toronto, Ont
| | - Samira Mubareka
- Division of Infectious Disease (Lee, Smith, Zapernick, Taylor), Department of Medicine, and Department of Laboratory Medicine and Pathology (Zelyas, Tipples), and Division of Nephrology (Klarenbach, So), Department of Medicine, University of Alberta, Edmonton, Alta.; Sunnybrook Research Institute (Bekking, Yip, Mubareka); Department of Laboratory Medicine and Pathobiology (Mubareka), University of Toronto, Toronto, Ont.
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18
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Messous S, Elargoubi A, Pillet S, Rajoharison A, Hoffmann J, Trabelsi I, Grissa MH, Boukef R, Beltaief K, Mastouri M, Paranhos-Baccalà G, Nouira S, Pozzetto B. Bacterial and Viral Infection in Patients Hospitalized for Acute Exacerbation of Chronic Obstructive Pulmonary Disease: Implication for Antimicrobial Management and Clinical Outcome. COPD 2020; 18:53-61. [PMID: 33353408 DOI: 10.1080/15412555.2020.1854210] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
Patients with chronic obstructive pulmonary disease (COPD) exhibit frequent acute exacerbations (AE). The objectives of this study were first to evaluate the prevalence of pathogens associated to these episodes by combining conventional bacteriology and multiplex viral and bacterial PCR assays in sputum specimens, and second to determine whether C-reactive protein (CRP) value and clinical outcome could be influenced by the type of microbial agent(s) recovered from these samples. A cohort of 84 Tunisian patients hospitalized at the emergency room for AECOPD was investigated prospectively for the semi-quantitative detection of bacteria by conventional culture (the threshold of positivity was of 107 CFU/ml) and for the detection of viral genome and DNA of atypical bacteria by quantitative PCR using two commercial multiplex respiratory kits (Seegene and Fast-track). The two kits exhibited very similar performances although the Seegene assay was a bit more sensitive. A large number and variety of pathogens were recovered from the sputum samples of these 84 patients, including 15 conventional bacteria, one Chlamydia pneumoniae and 63 respiratory viruses, the most prevalent being rhinoviruses (n = 33) and influenza viruses (n = 13). From complete results available for 74 patients, the presence of bacteria was significantly associated with risk of recurrence at 6 and 12 months post-infection. The combination of these different markers appears useful for delineating correctly the antimicrobial treatment and for initiating a long-term surveillance in those patients with high risk of recurrent exacerbation episodes. A prospective study is required for confirming the benefits of this strategy aimed at improving the stewardship of antibiotics.
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Affiliation(s)
- Salma Messous
- Research Laboratory (LR12SP18), University of Monastir, Monastir, Tunisia.,Microbiology Laboratory, Fattouma Bourguiba University Hospital of Monastir, Monastir, Tunisia
| | - Aida Elargoubi
- Microbiology Laboratory, Fattouma Bourguiba University Hospital of Monastir, Monastir, Tunisia
| | - Sylvie Pillet
- Laboratory of Infectious Agents and Hygiene, University Hospital of Saint-Etienne, and GIMAP group (EA 3064), Faculty of Medicine de Saint-Etienne, University of Lyon, Lyon, France
| | - Alain Rajoharison
- Laboratory of Emerging Pathogens, Mérieux Foundation, CIRI, Inserm U1111, Lyon, France
| | - Jonathan Hoffmann
- Laboratory of Emerging Pathogens, Mérieux Foundation, CIRI, Inserm U1111, Lyon, France
| | - Imen Trabelsi
- Research Laboratory (LR12SP18), University of Monastir, Monastir, Tunisia
| | - Mohamed Habib Grissa
- Research Laboratory (LR12SP18), University of Monastir, Monastir, Tunisia.,Department of Emergency, Fattouma Bourguiba University Hospital of Monastir, Monastir, Tunisia
| | - Riadh Boukef
- Research Laboratory (LR12SP18), University of Monastir, Monastir, Tunisia.,Department of Emergency, Sahloul University Hospital, Sousse, Tunisia
| | - Kaouther Beltaief
- Research Laboratory (LR12SP18), University of Monastir, Monastir, Tunisia.,Department of Emergency, Fattouma Bourguiba University Hospital of Monastir, Monastir, Tunisia
| | - Maha Mastouri
- Microbiology Laboratory, Fattouma Bourguiba University Hospital of Monastir, Monastir, Tunisia
| | | | - Semir Nouira
- Research Laboratory (LR12SP18), University of Monastir, Monastir, Tunisia.,Department of Emergency, Fattouma Bourguiba University Hospital of Monastir, Monastir, Tunisia
| | - Bruno Pozzetto
- Laboratory of Infectious Agents and Hygiene, University Hospital of Saint-Etienne, and GIMAP group (EA 3064), Faculty of Medicine de Saint-Etienne, University of Lyon, Lyon, France
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19
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On R, Matsumoto T, Kushima H, Hirano R, Fujita M. Prevalence of viral infection in acute exacerbation of interstitial lung diseases in Japan. Respir Investig 2020; 58:473-478. [PMID: 32753313 PMCID: PMC7395810 DOI: 10.1016/j.resinv.2020.06.006] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2020] [Revised: 06/24/2020] [Accepted: 06/28/2020] [Indexed: 01/08/2023]
Abstract
Background Fatal acute exacerbation of interstitial lung diseases is often accompanied by indicators of infection such as fever, cough, and sputum. Although viral infection can contribute to acute exacerbation of interstitial lung diseases, few studies have identified a relationship between acute exacerbations and viral infections. The present study aimed to prospectively clarify the role of viral infection in patients showing acute exacerbation of interstitial lung disease in Japan. Methods Nasopharyngeal swab specimens were collected from patients with acute exacerbation of interstitial lung disease between May 2017 and February 2019. Respiratory viruses were detected by the Luminex xTAG Respiratory Viral Panel FAST v2 RUO kit and the BioFire FilmArray Respiratory Panel assay. Results Three of 29 patients demonstrated respiratory viral infection during acute exacerbation of interstitial lung diseases. The infectious agents were identified as respiratory syncytial virus, respiratory syncytial virus and influenza A virus, and influenza A virus and rhino/enterovirus in the three patients, respectively. Conclusions These results suggest that viral infection did not frequently induce acute exacerbation of interstitial lung diseases in Japan.
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Affiliation(s)
- Rintaro On
- Department of Respiratory Medicine, Fukuoka University Hospital, Japan.
| | | | - Hisako Kushima
- Department of Respiratory Medicine, Fukuoka University Hospital, Japan.
| | - Ryosuke Hirano
- Department of Respiratory Medicine, Fukuoka University Hospital, Japan.
| | - Masaki Fujita
- Department of Respiratory Medicine, Fukuoka University Hospital, Japan.
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20
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Liu B, Shao N, Wang J, Zhou S, Su H, Dong J, Sun L, Li L, Zhang T, Yang F. An Optimized Metagenomic Approach for Virome Detection of Clinical Pharyngeal Samples With Respiratory Infection. Front Microbiol 2020; 11:1552. [PMID: 32754134 PMCID: PMC7366072 DOI: 10.3389/fmicb.2020.01552] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2020] [Accepted: 06/16/2020] [Indexed: 12/23/2022] Open
Abstract
Respiratory virus infections are one of the major causes of acute respiratory disease or exacerbation of chronic obstructive pulmonary disease (COPD). However, next-generation sequencing has not been used for routine viral detection in clinical respiratory samples owing to its sophisticated technology. Here, several pharyngeal samples with COPD were collected to enrich viral particles using an optimized method (M3), which involved M1 with centrifugation, filtration, and concentration, M2 (magnetic beads) combined with mixed nuclease digestion, and M4 with no pretreatment as a control. Metagenomic sequencing and bioinformatics analyses showed that the M3 method for viral enrichment was superior in both viral sequencing composition and viral taxa when compared to M1, M2, and M4. M3 acquired the most viral reads and more complete sequences within 15-h performance, indicating that it might be feasible for viral detection in multiple respiratory samples in clinical practice. Based on sequence similarity analysis, 12 human viruses, including nine Anelloviruses and three coronaviruses, were characterized. Coronavirus OC43 with the largest number of viral reads accounted for nearly complete (99.8%) genome sequences, indicating that it may be a major viral pathogen involved in exacerbation of COPD.
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Affiliation(s)
- Bo Liu
- National Health Commission of the People's Republic of China Key Laboratory of Systems Biology of Pathogens, Institute of Pathogen Biology, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Nan Shao
- National Health Commission of the People's Republic of China Key Laboratory of Systems Biology of Pathogens, Institute of Pathogen Biology, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Jing Wang
- Division of Pulmonary and Critical Care Medicine, Beijing Chaoyang Hospital, Capital Medical University, Beijing, China
| | - SiYu Zhou
- National Health Commission of the People's Republic of China Key Laboratory of Systems Biology of Pathogens, Institute of Pathogen Biology, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - HaoXiang Su
- National Health Commission of the People's Republic of China Key Laboratory of Systems Biology of Pathogens, Institute of Pathogen Biology, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Jie Dong
- National Health Commission of the People's Republic of China Key Laboratory of Systems Biology of Pathogens, Institute of Pathogen Biology, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - LiLian Sun
- National Health Commission of the People's Republic of China Key Laboratory of Systems Biology of Pathogens, Institute of Pathogen Biology, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Li Li
- National Health Commission of the People's Republic of China Key Laboratory of Systems Biology of Pathogens, Institute of Pathogen Biology, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Ting Zhang
- National Health Commission of the People's Republic of China Key Laboratory of Systems Biology of Pathogens, Institute of Pathogen Biology, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Fan Yang
- National Health Commission of the People's Republic of China Key Laboratory of Systems Biology of Pathogens, Institute of Pathogen Biology, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
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21
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Chhiba KD, Patel GB, Vu THT, Chen MM, Guo A, Kudlaty E, Mai Q, Yeh C, Muhammad LN, Harris KE, Bochner BS, Grammer LC, Greenberger PA, Kalhan R, Kuang FL, Saltoun CA, Schleimer RP, Stevens WW, Peters AT. Prevalence and characterization of asthma in hospitalized and nonhospitalized patients with COVID-19. J Allergy Clin Immunol 2020; 146:307-314.e4. [PMID: 32554082 PMCID: PMC7295471 DOI: 10.1016/j.jaci.2020.06.010] [Citation(s) in RCA: 208] [Impact Index Per Article: 52.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2020] [Revised: 06/05/2020] [Accepted: 06/09/2020] [Indexed: 12/23/2022]
Abstract
Background The Centers for Disease Control and Prevention advises that patients with moderate to severe asthma belong to a high-risk group that is susceptible to severe coronavirus disease 2019 (COVID-19). However, the association between asthma and COVID-19 has not been well-established. Objective The primary objective was to determine the prevalence of asthma among patients with COVID-19 in a major US health system. We assessed the clinical characteristics and comorbidities in asthmatic and nonasthmatic patients with COVID-19. We also determined the risk of hospitalization associated with asthma and/or inhaled corticosteroid use. Methods Medical records of patients with COVID-19 were searched by a computer algorithm (March 1 to April 15, 2020), and chart review was used to validate the diagnosis of asthma and medications prescribed for asthma. All patients had PCR-confirmed COVID-19. Demographic and clinical features were characterized. Regression models were used to assess the associations between asthma and corticosteroid use and the risk of COVID-19–related hospitalization. Results Of 1526 patients identified with COVID-19, 220 (14%) were classified as having asthma. Asthma was not associated with an increased risk of hospitalization (relative risk, 0.96; 95% CI, 0.77-1.19) after adjusting for age, sex, and comorbidities. The ongoing use of inhaled corticosteroids did not increase the risk of hospitalization in a similar adjusted model (relative risk, 1.39; 95% CI, 0.90-2.15). Conclusions Despite a substantial prevalence of asthma in our COVID-19 cohort, asthma was not associated with an increased risk of hospitalization. Similarly, the use of inhaled corticosteroids with or without systemic corticosteroids was not associated with COVID-19–related hospitalization.
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Affiliation(s)
- Krishan D Chhiba
- Division of Allergy and Immunology, Department of Medicine, Northwestern University Feinberg School of Medicine, Chicago, Ill
| | - Gayatri B Patel
- Division of Allergy and Immunology, Department of Medicine, Northwestern University Feinberg School of Medicine, Chicago, Ill
| | - Thanh Huyen T Vu
- Division of Epidemiology, Department of Preventive Medicine, Northwestern University Feinberg School of Medicine, Chicago, Ill
| | - Michael M Chen
- Division of Allergy and Immunology, Department of Medicine, Northwestern University Feinberg School of Medicine, Chicago, Ill
| | - Amina Guo
- Division of Allergy and Immunology, Department of Medicine, Northwestern University Feinberg School of Medicine, Chicago, Ill
| | - Elizabeth Kudlaty
- Division of Allergy and Immunology, Department of Medicine, Northwestern University Feinberg School of Medicine, Chicago, Ill
| | - Quan Mai
- Department of Feinberg Information and Technology, Northwestern University Feinberg School of Medicine, Chicago, Ill
| | - Chen Yeh
- Division of Biostatistics, Department of Preventive Medicine, Northwestern University Feinberg School of Medicine, Chicago, Ill
| | - Lutfiyya N Muhammad
- Division of Biostatistics, Department of Preventive Medicine, Northwestern University Feinberg School of Medicine, Chicago, Ill
| | - Kathleen E Harris
- Division of Allergy and Immunology, Department of Medicine, Northwestern University Feinberg School of Medicine, Chicago, Ill
| | - Bruce S Bochner
- Division of Allergy and Immunology, Department of Medicine, Northwestern University Feinberg School of Medicine, Chicago, Ill
| | - Leslie C Grammer
- Division of Allergy and Immunology, Department of Medicine, Northwestern University Feinberg School of Medicine, Chicago, Ill
| | - Paul A Greenberger
- Division of Allergy and Immunology, Department of Medicine, Northwestern University Feinberg School of Medicine, Chicago, Ill
| | - Ravi Kalhan
- Division of Pulmonary and Critical Care, Department of Medicine, Northwestern University Feinberg School of Medicine, Chicago, Ill
| | - Fei Li Kuang
- Division of Allergy and Immunology, Department of Medicine, Northwestern University Feinberg School of Medicine, Chicago, Ill
| | - Carol A Saltoun
- Division of Allergy and Immunology, Department of Medicine, Northwestern University Feinberg School of Medicine, Chicago, Ill
| | - Robert P Schleimer
- Division of Allergy and Immunology, Department of Medicine, Northwestern University Feinberg School of Medicine, Chicago, Ill
| | - Whitney W Stevens
- Division of Allergy and Immunology, Department of Medicine, Northwestern University Feinberg School of Medicine, Chicago, Ill
| | - Anju T Peters
- Division of Allergy and Immunology, Department of Medicine, Northwestern University Feinberg School of Medicine, Chicago, Ill.
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22
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Jenkins VA, Savic M, Kandeil W. Pertussis in high-risk groups: an overview of the past quarter-century. Hum Vaccin Immunother 2020; 16:2609-2617. [PMID: 32298213 PMCID: PMC7746252 DOI: 10.1080/21645515.2020.1738168] [Citation(s) in RCA: 22] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022] Open
Abstract
Infectious diseases can impact chronic medical conditions. However, it is currently not clear how pertussis correlates with preexisting or underlying disorders. We reviewed literature from the last 25 years to describe the burden and impact of pertussis infection in specific risk groups in individuals aged ≥11 years. Our literature search returned 543 hits, of which 18 were eligible for this review. Adolescents and adults with underlying conditions, such as asthma, chronic obstructive pulmonary disease (COPD), or obesity are potentially at increased risk of pertussis infection. Immunodeficiency and smoking have also been associated with worsened pertussis symptoms and an increased pertussis-related hospitalization rate. In patients with pertussis and preexisting asthma or COPD, symptoms were worsened, and health-care costs were consequently increased. Further efforts are needed to close the knowledge gap and to understand the burden of pertussis in at-risk adolescent and adult populations to help inform vaccination strategies and recommendations.
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23
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Tan KS, Lim RL, Liu J, Ong HH, Tan VJ, Lim HF, Chung KF, Adcock IM, Chow VT, Wang DY. Respiratory Viral Infections in Exacerbation of Chronic Airway Inflammatory Diseases: Novel Mechanisms and Insights From the Upper Airway Epithelium. Front Cell Dev Biol 2020; 8:99. [PMID: 32161756 PMCID: PMC7052386 DOI: 10.3389/fcell.2020.00099] [Citation(s) in RCA: 33] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2019] [Accepted: 02/07/2020] [Indexed: 12/16/2022] Open
Abstract
Respiratory virus infection is one of the major sources of exacerbation of chronic airway inflammatory diseases. These exacerbations are associated with high morbidity and even mortality worldwide. The current understanding on viral-induced exacerbations is that viral infection increases airway inflammation which aggravates disease symptoms. Recent advances in in vitro air-liquid interface 3D cultures, organoid cultures and the use of novel human and animal challenge models have evoked new understandings as to the mechanisms of viral exacerbations. In this review, we will focus on recent novel findings that elucidate how respiratory viral infections alter the epithelial barrier in the airways, the upper airway microbial environment, epigenetic modifications including miRNA modulation, and other changes in immune responses throughout the upper and lower airways. First, we reviewed the prevalence of different respiratory viral infections in causing exacerbations in chronic airway inflammatory diseases. Subsequently we also summarized how recent models have expanded our appreciation of the mechanisms of viral-induced exacerbations. Further we highlighted the importance of the virome within the airway microbiome environment and its impact on subsequent bacterial infection. This review consolidates the understanding of viral induced exacerbation in chronic airway inflammatory diseases and indicates pathways that may be targeted for more effective management of chronic inflammatory diseases.
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Affiliation(s)
- Kai Sen Tan
- Department of Otolaryngology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Rachel Liyu Lim
- Infectious Disease Research and Training Office, National Centre for Infectious Diseases, Singapore, Singapore
| | - Jing Liu
- Department of Otolaryngology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Hsiao Hui Ong
- Department of Otolaryngology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Vivian Jiayi Tan
- Department of Otolaryngology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Hui Fang Lim
- Division of Respiratory and Critical Care Medicine, National University Hospital, Singapore, Singapore.,Department of Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Kian Fan Chung
- Airway Disease, National Heart and Lung Institute, Faculty of Medicine, Imperial College London, London, United Kingdom
| | - Ian M Adcock
- Airway Disease, National Heart and Lung Institute, Faculty of Medicine, Imperial College London, London, United Kingdom
| | - Vincent T Chow
- Department of Microbiology and Immunology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - De Yun Wang
- Department of Otolaryngology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
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