Epidemiology and clinical features of respiratory syncytial virus (RSV) infection in hospitalized children during the COVID-19 pandemic in Gorgan, Iran.

Background and Aims: Respiratory syncytial virus (RSV) is a leading cause of acute respiratory infection in infants and young children. Given the altered circulation patterns of respiratory viruses during the coronavirus disease pandemic-2019 (COVID-19), the study aimed to evaluate epidemiology and clinical features of RSV infections in hospitalized children during the COVID-19 pandemic in Gorgan, northeastern Iran. Molecular epidemiology studies on respiratory viral infections are necessary to monitor circulating viruses, disease severity, and clinical symptoms, in addition to early warning of new outbreaks. Methods: Overall, 411 respiratory swab samples from hospitalized children from October 2021 to March 2022 were collected at Taleghani Children's Hospital, Gorgan, Iran. The incidence of RSV, as well as the circulating subgroups and genotypes, were investigated and confirmed using PCR methods. Additionally, all samples tested for severe acute respiratory syndrome-associated coronavirus 2 (SARS-CoV-2) and influenza, and demographic and clinical data were analyzed using SPSS software. Results: The share of RSV, SARS-CoV-2, and influenza among hospitalized children with acute lower respiratory infections (ALRI) were 27%, 16.5%, and 4.1%, respectively. The RSV subgroup A (genotype ON1) was dominant over subgroup B (genotype BA9), with more severe clinical symptoms. Compared with the prepandemic era there were high numbers of hospitalized SARS-CoV-2 positive children and low numbers of other respiratory viruses. Despite this, the prevalence of ALRI-related RSV-disease among hospitalized children in our specialized pediatric center was higher than COVID-19 disease in the same cohort. Conclusions: Studying the epidemiology of respiratory viruses and determining the circulating strains can contribute to effective infection control and treatment strategies.

A multicenter retrospective study of clinical features, laboratory characteristics, and outcomes of 166 hospitalized children with coronavirus disease 2019 (COVID-19): A preliminary report from Iranian Network for Research in Viral Diseases (INRVD).

BACKGROUND: The objectives of this study were to analyze the clinical features and laboratory profiles and risk factors associated with critical illness of children with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). METHODS: One hundred and sixty-six coronavirus disease 2019 (COVID-19) Iranian pediatric patients were recruited through a collaborative research network between March and May 2020. Demographics, clinical, laboratory, and radiological results were obtained from patient files. RESULTS: Of 166 patients, 102 (61%) and 64 (39%) were males and females, respectively. Ninety-six (57.8%) and 70 (42.2%), had moderate and severe conditions, respectively. Thirty (18%) of patients died. The common symptoms were fever (73%), cough (54%), and shortness of breath, headache decrease in neutrophil and platelet counts; increase values in lactate dehydrogenase, decrease in the blood pH and HCO3 were significantly associated with the disease severity. 54% and 56% of patients showed abnormal radiographic appearance in Chest X-ray and in chest computed tomography scan, respectively. Sixty-one (36.7%) of patients were referred to intensive care unit (ICU). The coexistence of comorbidity was the main factor associated with ICU admission, shock, arrhythmia, acute kidney injury, acute respiratory distress syndrome, acute cardiac injury, and death. CONCLUSIONS: We describe a higher than previously recognized rate of COVID-19 mortality in Iranian pediatric patients. Epidemiological factors, such as the relatively high case fatality rate in the country and the presence of underlying diseases were the main factors for the high death rate.

A case series of pediatric COVID-19 with complicated symptoms in Iran.

People in different age groups are susceptible to SARS-CoV-2 infection as a newly emerging virus. However, the clinical course, symptoms and disease outcome vary from case to case. Although COVID-19 is usually milder in children than adults, some studies reported nonspecific symptoms. Here, we report eight pediatric cases of COVID-19 admitted in the Taleghani Children Hospital in Gorgan city, north of Iran, with complicated symptoms. The current case series poses several challenges to the pediatricians regarding the pediatric cases of COVID-19. As most literature relating to adults are not always transferable to children, clinicians should be warned about such presentations among children with COVID-19.

Case Report: Detection of SARS-CoV-2 From Cerebrospinal Fluid in a 34-Month-Old Child With Encephalitis.

Novel coronavirus (severe acute respiratory syndrome-coronavirus-2: SARS-CoV-2), which arose from Wuhan, China, has rapidly spread to other countries and developed into a pandemic. Although the respiratory manifestations of SARS-CoV-2 are well-documented, there is a considerable challenge regarding the direct and/or indirect infection in other organs. Several preliminary reports confirmed neurological manifestations in the SARS-CoV-2-infected patients. Here, we report the detection of SARS-CoV-2 from the nasopharyngeal swab and cerebrospinal fluid (CSF) in a 34-month-old child with encephalitis. This finding expands the spectrum of the neurological manifestations associated with SARS-CoV-2 infection.

Seroprevalence, risk factors, and clinical symptoms of Toxocara spp. infection among children 3-15 years old in northern Iran.

The World Health Organization has categorized toxocarosis as a neglected tropical disease despite its significant impact on high-risk groups such as children. This study aimed to investigate the seroprevalence, risk factors, and clinical symptoms of Toxocara spp. infection among children 3-15 years old in northern Iran. A total of 386 children were enrolled in the study. All serum samples were tested for the presence of IgG antibodies against Toxocara spp. infection using an enzyme-linked immunosorbent assay. Moreover, relevant risk factors and clinical symptom data were obtained using questionnaires. Data analysis was performed using the SPSS software version 24. The overall seroprevalence of Toxocara spp. infection was found 2.85 % (11/386). However, Toxocara spp. infection was high for some risk factors, including eating soil (14.3 %), contacting cats (6.7 %), and consuming raw vegetables (3.7 %). However, there were no statistically significant differences regarding the risk factors and socio-demographic characteristics. Considering the clinical symptoms, Toxocara spp. infection was different in children with eosinophilia (20 %), ocular disorders (8.3 %), skin disorders (7.7 %), liver disorders (4.5 %), and stomach ache (4.2 %), although not statistically significant. The results revealed that the seroprevalence of Toxocara spp. infection was relatively low in children in northern Iran. It is suggested to conduct more studies in different parts of Iran to gain a deeper understanding of the toxocarosis seroprevalence and its status in high-risk groups such as children with asthma, hypereosinophilic syndrome, allergic skin disorders, and epilepsy.

COVID-19 in Pediatrics: Demographic, Clinical, Laboratory, and Radiological Characteristics of Infected Patients With SARS-CoV-2.

The COVID-19 disease usually leads to mild infectious disease in children, but some develop serious complications. Here, we describe the characteristics of children with COVID-19 in northern Iran, the Golestan province. Ninety-one confirmed cases were enrolled in the study, aged 0-18 years. Demographic, clinical, comorbidity, laboratory, and radiological data were compared based on the disease severity (admitted to intensive care unit (ICU) or not) and disease outcome (recovered or deceased). Sixteen (17.5%) cases were hospitalized in ICU, and 8/91 (8.8%) deceased. Fever and cough were the most common clinical symptoms. Among all symptoms notified there were no significant differences between severe and milder cases, or between those who deceased and recovered. Failure to thrive (FTT), malignant disease and neurological disease were significantly more prevalent in severe cases as was frequently reported comorbidities. Laterality, ground-glass opacity, and lung consolidation were the most common findings in chest computed tomography. The data confirms that the COVID-19 disease has various presentations in children, and clinical, laboratory, and radiological findings may help predict the development of severe forms of COVID-19 among children.

Characterization of Microcapsule Containing Walnut (Juglans regia L.) Green Husk Extract as Preventive Antioxidant and Antimicrobial Agent.

BACKGROUND: Walnut green husk (WGH) extract has been known as potential preventive and therapeutic antioxidants and antimicrobials due to its high polyphenol content. In this study, preparation of spray dried WGH extract-loaded microcapsules by maltodextrin and its blending with two other natural biodegradable polymers, pectin, or alginate were investigated. METHODS: In this study, encapsulation efficiency (EE), total phenol content (Folin-Ciocalteu reagent method), antioxidant (DPPH scavenging assay) and antimicrobial activities (agar well diffusion method) structural (SEM and FTIR studies), and release properties of WGH extract-loaded microcapsules were investigated. RESULTS: High retention of phenolic content in microcapsules indicated the successful encapsulation of WGH extract. Addition of biopolymers to maltodextrin matrix has a positive effect on EE and other properties of microcapsules. The microcapsules prepared with mixture of maltodextrin and pectin had higher EE (79.35 ± 0.87%) and total phenolic (TP) content (56.83 ± 1.04 mg gallic acid equivalents [GAE]/100 g) in comparison to maltodextrin and alginate mixture (EE: 75.21 ± 0.24%, TP content: 54.33 ± 1.53 mg GAE/100 g) and maltodextrin only matrix (EE: 72.50 ± 1.00%, TP content: 50.67 ± 1.35 mg GAE/100 g). Extract-loaded microcapsules also showed nearly spherical structure, good antioxidant (with the percentage DPPH inhibition ranged from 75.17 ± 1.42% to 80.87 ± 2.29%), and antimicrobial properties (with mean inhibition diameter zone ranged from 7.76 ± 0.86 mm to 11.53 ± 0.45 mm). Fourier transform infrared analyses suggested the presence of extract on microcapsules. The in vitro extract release from microcapsules followed an anomalous non-Fickian diffusion mechanism with almost complete release. CONCLUSIONS: WGH extract microcapsules can be used as novel and economic bioactive phytochemical and therapeutic agents to prevent oxidation and microbial activity.

Discrimination of Entamoeba Spp. in children with dysentery.

AIM: The present study was performed in order to differentiate E. histolytica and E. dispar in children from Gorgan city, using a PCR method. BACKGROUND: Differential detection of two morphologically indistinguishable protozoan parasites Entamoeba histolytica and E. dispar has a great clinical and epidemiological importance because of potential invasive pathogenic E. histolytica and non-invasive parasite E. dispar. PATIENTS AND METHODS: One hundred and five dysentery samples were collected from children hospitalized in Taleghani hospital in Gorgan city. The fecal specimens were examined by light microscopy (10X then 40X) to distinguish Entamoeba complex. A single round PCR amplifying partial small-subunit rRNA gene was performed on positive microscopy samples to differentiate E. histolytica/ E. dispar and E. moshkovskii from each other. RESULTS: Twenty-five specimens (23.8%) were positive for Enramoeba complex in direct microscopic examination. PCR using positive controls indicated E. histolytica and E. dispar in two (2/25, 8%) and three (3/25, 12%) samples, respectively. CONCLUSION: There is a warrant to performing molecular diagnosis for stool examination at least in hospitalized children in order to prevent incorrect reports from laboratories and consequently mistreating by physicians.

Herpes simplex virus meningitis in children in South East of caspian sea, iran.

BACKGROUND: Herpes simplex virus (HSV) is a member of Herpesviridae and a leading cause of human viral diseases. Meningitis occurs as a complication of HSV-1 or HSV-2 primary infection. OBJECTIVES: We aimed to evaluate HSV meningitis in children in Gorgan province, Iran. PATIENTS AND METHODS: Forty-five cerebrospinal fluid samples were taken from children referred with meningitis symptoms. Samples with negative bacterial culture results were tested for viral, biochemical and cytological assays. DNA extraction and PCR were performed. RESULTS: HSV-1 detected in 4 (8.8%) samples without any HSV-2 infections. Cases with positive results had fever and CSF pleocytosis. Vomiting, headache and higher count of WBC were observed in 3, 2 and 3 cases respectively. The cerebrospinal fluid (CSF) glucose and protein levels were normal and 3 cases showed positive C-reactive protein (CRP) results. Also erythrocyte sedimentation rate (ESR) was higher than normal in all positive cases. CONCLUSIONS: Distribution of HSV types in children with meningitis in our area predominantly was type 1 compared with type 2, which has been reported more in other area.

Incidence of childhood cancers in golestan province of iran.

OBJECTIVE: This paper presents the incidence rates of childhood cancers using the data obtained from Golestan population based cancer registry (GPCR) between 2004 and 2006. METHODS: GPCR registers only primary cancers based on standard protocols of the international association of cancer registries (IACR). We collect data on newly diagnosed (incident) cancer cases from all public and private diagnostic and therapeutic centers of the whole province. CanReg-4 software was used for data entry and analysis. FINDINGS: Totally 5076 cancer cases (all ages) were diagnosed in GPCR between 2004 and 2006. Of these, 139 (2.74 %) were children (aged 0-14 years) with mean (±SD) age of 8.06 (±4.48) years. The age standardized incidence rates for childhood cancer were 119.8 and 78.3 per 1000000 person-years in male and female children, respectively. Leukemia was the most common childhood cancer in Golestan province of Iran. Lymphomas and central nervous system tumors were the second and third ones, respectively. CONCLUSION: The incidence rates of childhood cancers were relatively high in Golestan province of Iran. So, controlling of childhood cancers should be mentioned as an important issue in health policy making in this area.