Síndrome Respiratória Aguda Grave por Influenza A/B: Análise da Situação Vacinal / Severe Acute Respiratory Syndrome due to Influenza A/B: Analysis of Vaccination Status

Introdução: A Influenza é uma doença respiratória altamente contagiosa, prevenível por vacinação, afetando todos os grupos etários,com morbidade e mortalidade variáveis. O objetivo deste estudo foi analisar a relação da situação vacinal dos pacientes com Influenza A/B atendidos com Síndrome Respiratória Aguda Grave. Métodos: Estudo retrospectivo, a partir das notificações do Sistema de Informação de Agravos de Notificação Compulsório do Brasil, de pacientes com esquema vacinal conhecido para Influenza A/B em um hospital-escola do interior do Rio Grande do Sul (2012 a 2018). Resultados: Foram incluídos 596 casos de SRAG, sendo 179 (30,0%) por vírus respiratórios [92 (51,4%) Influenza A/B e 87 (48,6%) outros vírus respiratórios]. Na faixa etária de maiores de 50 anos, a frequência foi 28,2%, 6 meses a 1 ano foi de 19,6%, seguido de 13% no grupo etário de 2 a 4 anos. O esquema vacinal estava completo em 59,8% dos casos, sendo que em 37,5% dos pacientes apresentavam esquema vacinal incompleto. O tratamento antiviral foi administrado em 90,2% do pacientes com SRAG por Influenza A/B, e a alta hospitalar ocorreu em 91,3% dos casos. Conclusão: A vacinação é uma estratégia para prevenção de complicações relacionadas à Influenza. No entanto, a SRAG é uma apresentação com diagnóstico diferencial amplo, e as causas virais necessitam de confirmação para uma otimização da terapêutica antiviral. A equipe de saúde deve estar atenta a pacientes com riscos de SRAG, a fim de minimizar os desfechos negativos, mesmo nos vacinados.

Introduction: Influenza is a highly contagious respiratory disease, preventable by vaccination, affecting all age groups, with variable morbidity and mortality. The objective of this study was to analyze the relationship between the vaccination status of Influenza A/B patients seen with Severe Acute Respiratory Syndrome. Methods: Retrospective study, from notifications of the Brazilian Compulsory Notification Agencies Information System (Sistema de Informação de Agravos de Notificação Compulsório do Brasil), of patients with known vaccination schemes for Influenza A/B in a teaching hospital in the interior of Rio Grande do Sul (2012 to 2018). Results: Of the 596 cases of SARS included, 179 (30.0%) were due to respiratory viruses [92 (51.4%) Influenza A/B and 87 (48.6%) other respiratory viruses]. In the age group over 50 years, the frequency was 28.2%, from 6 months to 1 year old was 19.6%, followed by 13% in the age group of 2 to 4 years. The vaccination schedule was complete in 59.8% of cases, with 37.5% having an incomplete vaccination scheme. Antiviral treatment was administered in 90.2% of the patients with SARS by Influenza A/B, and hospital discharge occurred in 91.3% of the cases. Conclusion: Vaccination is a strategy to prevent complications related to Influenza. However, SARS is a presentation with wide differential diagnosis, and the viral causes need confirmation for an optimization of the antiviral therapy. The healthcare team must be aware of patients at risk of SARS to minimize negative outcomes, even in vaccinated patients.

Respiratory virus infection and risk factors in children with bronchial asthma / 公共卫生与预防医学

Objective To understand the etiological characteristics and risk factors of respiratory virus infection in children with bronchial asthma, and to provide theoretical basis for the prevention and treatment of respiratory virus infection in children with bronchial asthma. Methods A total of 374 children with bronchial asthma who were treated in Jianyang People's Hospital from December 2018 to December 2020 were enrolled. Pharyngeal swabs were collected from the outpatient children on the day of treatment, and 2 mL of nasopharyngeal secretions were collected from the hospitalized children within 24 hours by negative pressure aspirator. Seven viral antigens including RSV, ADV, IVA, IVB, PIVI, PIV II, and PIV III were detected. According to whether the virus test results were positive or not, they were divided into the experimental group (n=191) and the control group (n=183). Logistic regression analysis was used to screen the risk factors of respiratory virus infection in children with bronchial asthma. Results Among the 374 samples, the virus positive rate was 51.07% (191/374), and the top 3 virus species in the positive samples were RSV, ADV, and PIV III, accounting for 41.36% (79/191), 30.36% (58/191), and 9.42% (18/191), respectively. In addition, IVA accounted for 5.24% (10/191), PIV II accounted for 5.24% (10/191), PIVI accounted for 3.66% (7/191), and IVB accounted for 1.57% (3 /191). The positive rates of virus were 47.96% (94/196) and 54.49% (97/178) in male and female children, respectively, with no significant difference (χ2=1.597，P>0.05). The positive rate of 1~3 years old children was significantly higher than that of >3 years old group (χ2=6.412，P3 times, intravenous glucocorticoid application and onset season were independent risk factors for respiratory virus infection in children with bronchial asthma (P<0.05). Conclusion The infection season of acute respiratory tract infection in children with asthma is mainly concentrated in autumn and winter, with RSV as the main viral pathogen. Targeted preventive measures should be given to children with bronchial asthma who have more than 3 asthma attacks and intravenous glucocorticoid application, which can reduce respiratory virus infection in children with asthma.

Detection of respiratory viruses and expression of inflammatory cytokines in patients with acute exacerbation chronic obstructive pulmonary disease in Mongolia China / Detecção de vírus respiratórios e expressão de citocinas inflamatórias em pacientes com doença pulmonar obstrutiva crônica de exacerbação aguda na Mongólia, China

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.

Estima-se que a doença pulmonar obstrutiva crônica (DPOC) seja a terceira causa de mortalidade global em 2020. A exacerbação aguda DPOC (AECOPD) é um agravamento súbito dos sintomas da DPOC e pode ser devido a infecções por vírus/bactérias e poluição do ar. O aumento da expressão de marcadores inflamatórios em pacientes com AECOPD está associado à infecção viral. Este estudo teve como objetivo detectar diferentes vírus e analisar a expressão de vários marcadores inflamatórios associados a pacientes com AECOPD. Trezentos e quarenta e sete pacientes com diagnóstico de DPOC de acordo com os critérios GOLD foram incluídos neste estudo. Amostras de swab e sangue foram coletadas para detecção de vírus por RT-PCR e expressão de marcadores inflamatórios, respectivamente. Das amostras de esfregaço, 113 (32,6%) amostras foram positivas para detecção de vírus. Nestas, o HRV (39,8%) foi o vírus predominante detectado, seguido do FluB (27,4%) e do FluA (22,1%). A presença de VFC foi significativamente maior (p = 0,044) entre os demais vírus detectados. Quando comparados a controles saudáveis, os níveis de expressão de TNF-α, IL-6 e IL-8 foram significativamente maiores (p <0,05) em pacientes com vírus positivo. A IL-6 e a IL-8 foram as próximas predominantemente expressas em marcadores entre as amostras. A maior taxa de expressão de IL-8 foi significativamente (p <0,05) associada a pacientes com grau de gravidade GOLD III da DPOC e história de tabagismo. Embora o HRV tenha sido o vírus predominante, a prevalência combinada de Influenza A e B ultrapassou a taxa de HRV. O alto nível de expressão de marcadores inflamatórios bem conhecidos de AECOPD, TNF-α, IL-6 e IL-8 indica uma doença crônica grave. Esses marcadores desempenham um papel importante e podem ser usados como um marcador para determinar a gravidade da AECOPD.

Detection of respiratory viruses and expression of inflammatory cytokines in patients with acute exacerbation chronic obstructive pulmonary disease in Mongolia China / Detecção de vírus respiratórios e expressão de citocinas inflamatórias em pacientes com doença pulmonar obstrutiva crônica de exacerbação aguda na Mongólia, China

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.

Estima-se que a doença pulmonar obstrutiva crônica (DPOC) seja a terceira causa de mortalidade global em 2020. A exacerbação aguda DPOC (AECOPD) é um agravamento súbito dos sintomas da DPOC e pode ser devido a infecções por vírus/bactérias e poluição do ar. O aumento da expressão de marcadores inflamatórios em pacientes com AECOPD está associado à infecção viral. Este estudo teve como objetivo detectar diferentes vírus e analisar a expressão de vários marcadores inflamatórios associados a pacientes com AECOPD. Trezentos e quarenta e sete pacientes com diagnóstico de DPOC de acordo com os critérios GOLD foram incluídos neste estudo. Amostras de swab e sangue foram coletadas para detecção de vírus por RT-PCR e expressão de marcadores inflamatórios, respectivamente. Das amostras de esfregaço, 113 (32,6%) amostras foram positivas para detecção de vírus. Nestas, o HRV (39,8%) foi o vírus predominante detectado, seguido do FluB (27,4%) e do FluA (22,1%). A presença de VFC foi significativamente maior (p = 0,044) entre os demais vírus detectados. Quando comparados a controles saudáveis, os níveis de expressão de TNF-α, IL-6 e IL-8 foram significativamente maiores (p <0,05) em pacientes com vírus positivo. A IL-6 e a IL-8 foram as próximas predominantemente expressas em marcadores entre as amostras. A maior taxa de expressão de IL-8 foi significativamente (p <0,05) associada a pacientes com grau de gravidade GOLD III da DPOC e história de tabagismo. Embora o HRV tenha sido o vírus predominante, a prevalência combinada de Influenza A e B ultrapassou a taxa de HRV. O alto nível de expressão de marcadores inflamatórios bem conhecidos de AECOPD, TNF-α, IL-6 e IL-8 indica uma doença crônica grave. Esses marcadores desempenham um papel importante e podem ser usados como um marcador para determinar a gravidade da AECOPD.

Detection of respiratory viruses and expression of inflammatory cytokines in patients with acute exacerbation chronic obstructive pulmonary disease in Mongolia China

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-, 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-, 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.

Resumo Estima-se que a doença pulmonar obstrutiva crônica (DPOC) seja a terceira causa de mortalidade global em 2020. A exacerbação aguda DPOC (AECOPD) é um agravamento súbito dos sintomas da DPOC e pode ser devido a infecções por vírus/bactérias e poluição do ar. O aumento da expressão de marcadores inflamatórios em pacientes com AECOPD está associado à infecção viral. Este estudo teve como objetivo detectar diferentes vírus e analisar a expressão de vários marcadores inflamatórios associados a pacientes com AECOPD. Trezentos e quarenta e sete pacientes com diagnóstico de DPOC de acordo com os critérios GOLD foram incluídos neste estudo. Amostras de swab e sangue foram coletadas para detecção de vírus por RT-PCR e expressão de marcadores inflamatórios, respectivamente. Das amostras de esfregaço, 113 (32,6%) amostras foram positivas para detecção de vírus. Nestas, o HRV (39,8%) foi o vírus predominante detectado, seguido do FluB (27,4%) e do FluA (22,1%). A presença de VFC foi significativamente maior (p = 0,044) entre os demais vírus detectados. Quando comparados a controles saudáveis, os níveis de expressão de TNF-, IL-6 e IL-8 foram significativamente maiores (p 0,05) em pacientes com vírus positivo. A IL-6 e a IL-8 foram as próximas predominantemente expressas em marcadores entre as amostras. A maior taxa de expressão de IL-8 foi significativamente (p 0,05) associada a pacientes com grau de gravidade GOLD III da DPOC e história de tabagismo. Embora o HRV tenha sido o vírus predominante, a prevalência combinada de Influenza A e B ultrapassou a taxa de HRV. O alto nível de expressão de marcadores inflamatórios bem conhecidos de AECOPD, TNF-, IL-6 e IL-8 indica uma doença crônica grave. Esses marcadores desempenham um papel importante e podem ser usados como um marcador para determinar a gravidade da AECOPD.

Non-pharmaceutical interventions for respiratory virus infection in children and its effect / 中华实用儿科临床杂志

With the emergence of new respiratory virus, it is more apparent for the vulnerability of population to respiratory viral infection.Non-pharmaceutical interventions (NPIs) for respiratory virus infection have become the main way to prevent corona virus disease 2019.Some studies had proven its effectiveness.In addition, the NPIs also significantly reduced the incidence and hospitalization rate of other respiratory disease in children.NPIs for respiratory virus infection in children have its particularity and challenge.In daily life, it is important to guide children how to do the NPIs, so as to protect susceptible children and reduce the disease burden in children′s health system.Therefore, the aerosol transmission, the specificity of the NPIs in children, and the impact on childhood respiratory diseases are described in this article, to improve the prevention of common respiratory diseases in children.

Progress of neonatal respiratory viral infection / 国际儿科学杂志

The common pathogens of neonatal respiratory viruses include respiratory syncytial virus, influenza virus, parainfluenza virus, adenovirus and rhinovirus, among which respiratory syncytial virus is the most common.Neonates infected with respiratory viruses can not only show respiratory symptoms such as cough, nasal obstruction and rhinorrhea, but also lead to multiple organ injury in severe cases.It is one of the causes of neonatal death.In the past, more attention has been paid to the harm caused by bacterial infection in the neonatal period.However, with the constant mutation of previous virus and the emergence of new virus, there are also some reports about the outbreaks of respiratory tract virus infection in neonatal wards.Neonatal immune system is immature.Newborns are susceptible to respiratory virus infection.Therefore, clinicians should pay more attention to the harm caused by respiratory infection in neonatal period.

Etiological analysis of acute respiratory tract infection in Taizhou of Zhejiang Province from 2020 to 2021 / 上海预防医学

ObjectiveWe examined the principal respiratory pathogens in patients with acute respiratory tract infection in Taizhou， Zhejiang Province during 2020‒2021 to provide evidence for prevention， diagnosis and treatment of acute respiratory tract infection. MethodsFrom September 2020 to August 2021， a total of 2 831 cases with acute respiratory tract infection were collected from two influenza sentinel surveillance hospitals in Taizhou， which had then received the examination of 22 respiratory pathogens by multiple fluorescence quantitative PCR. ResultsThe total positive rate of respiratory pathogens in 2 831 samples was 14.13%， among which enterovirus （7.77%） and respiratory syncytial virus （1.59%） were the principal pathogens. Except enterovirus， there was no significant difference in the positive rate of pathogens detected by gender（P>0.05）. Moreover， there was significant difference in pathogens by age （P<0.05）， with the highest positive rate in 0‒4 years（35.21%）. There was also significant difference in pathogens by seasons （P<0.05）， with the highest positive rate in summer（20.54%）. ConclusionThe positive rate of acute respiratory tract infection decreases significantly， compared with that before the COVID-19 epidemic. The differences in the positive rate differ significantly by age and seasons. Comprehensive consideration of diverse factors before diagnosis and the utilization of multiple fluorescent quantitative PCR can quickly and effectively determine the pathogens in the early stage of infection. Our findings may provide certain support for the diagnosis and treatment of acute respiratory infections in the context of COVID-19 in Taizhou.

Respiratory viral infections in pediatric patients with hematopoietic stem cell transplantation / Infecciones respiratorias virales en pacientes pediátricos con trasplante de células progenitoras hematopoyéticas

Abstract Background: Viral respiratory infections in pediatric patients with hematopoietic stem cell transplantation (HSCT) significantly impact morbidity and mortality. It is necessary to determine the viral agents and their frequency of presentation to understand their impact on transplantation patients’ evolution. Methods: From January 2017 to December 2019, we conducted a cross-sectional, descriptive, and observational study of patients who underwent HSCT with a viral respiratory infection. Viral identification was performed using multiplex polymerase chain reaction for nine respiratory viruses. Descriptive statistics were performed with a report of central tendency measures and percentages. Results: Of the 54 pediatric patients who underwent HSCT, 59.2% presented an airway infection; in turn, at least one viral agent was identified in 59.3% of these patients. The most frequent viral agents were influenza (25.9%), human rhinovirus (18.5%), and respiratory syncytial virus (18.5%). Viral co-infections occurred in 36.8% of the cases. The reported complications were supplemental oxygen requirement (73.6%), support with mechanical ventilation (21%), admission to the pediatric intensive care unit (15.7%), and mortality associated with a viral respiratory infection (10.5%). Conclusions: Viral respiratory infections are frequent in pediatric patients with HSCT; influenza A/B virus was the most frequent agent. As morbidity and mortality increase due to these infections in patients with HSCT, strategies are necessary for its prevention and timely treatment after transplantation.

Resumen Introducción: Las infecciones respiratorias virales en los pacientes pediátricos con trasplante de células progenitoras hematopoyéticas (TCPH) impactan significativamente la morbilidad y la mortalidad. Para comprender su impacto en la evolución de los pacientes receptores de trasplantes es necesario conocer la frecuencia de presentación y los agentes virales. Métodos: De enero de 2017 a diciembre de 2019 se llevó a cabo un estudio transversal, descriptivo y observacional de los pacientes sometidos a TCPH que tuvieron una infección viral de vías respiratorias. La identificación de los virus se realizó por medio de la prueba de reacción en cadena de la polimerasa multiplex para nueve virus respiratorios. Se realizó estadística descriptiva con reporte de medidas de tendencia central y porcentajes. Resultados: De los 54 pacientes incluidos, el 59.2% presentaron una infección de vías respiratorias y se identificó al menos un agente viral en el 59.3% de estos casos. Los virus más frecuentes fueron influenza (25.9%), rinovirus humano (18.5%) y virus sincitial respiratorio (18.5%). En el 36.8% de los casos se detectaron coinfecciones virales. Se presentaron las siguientes complicaciones: requerimiento de oxígeno suplementario (73.6%), soporte con ventilación mecánica (21%), ingreso a la unidad de cuidados intensivos pediátricos (15.7%) y muerte asociada a infección por virus respiratorios (10.5%). Conclusiones: Las infecciones respiratorias virales en los pacientes pediátricos con TCPH son frecuentes; el virus influenza A/B es el agente más habitual. Debido a que estas infecciones se asocian con mayor morbimortalidad en los pacientes con TCPH, son estrategias necesarias para su prevención y tratamiento oportuno posterior al trasplante.

Infecciones respiratorias agudas virales en pacientes menores de 5 años hospitalizados / Viral acute respiratory infections in hospitalized patients under 5 years

Introducción: Los virus constituyen las causas más frecuentes de infección respiratoria aguda, aunque el diagnóstico causal suele ser empírico dada la complejidad de su aislamiento. Objetivo: Caracterizar a pacientes menores de 5 años de edad con infecciones respiratorias agudas, según variables epidemiológicas, clínicas e imagenológicas. Métodos: Se efectuó una investigación descriptiva y transversal de 171 pacientes con infecciones respiratorias agudas y aislamiento viral mediante exudado nasofaríngeo profundo, egresados del Servicio de Neonatología del Hospital Docente Infantil Sur Antonio María Béguez César de Santiago de Cuba, desde el 2014 hasta el 2016, para lo cual se realizaron cálculos de frecuencias y porcentajes. Resultados: Predominaron los lactantes (57,9 %), el sexo masculino y los afectados con diagnósticos de neumonía (40,9 %) y bronquiolitis (28,0 %) por virus sincitial respiratorio y rinovirus. La supresión precoz de lactancia materna y tabaquismo fueron los factores de riesgo prevalentes. Tanto la fiebre como la tos y las secreciones nasales resultaron preponderantes, e infrecuentes las complicaciones. La consolidación alveolar prevaleció en pacientes con neumonía. Conclusiones: Se caracterizó epidemiológica y clínicamente a los pacientes con virus respiratorios y se evidenció discordancia con el predominio del patrón de infiltrado alveolar descrito en la bibliografía médica consultada.

Introduction: Viruses constitute the most frequent causes in acute respiratory infection, although the causal diagnosis is usually empiric given the complexity of its isolation. Objective: To characterize patients under 5 years with acute respiratory infections, according to epidemiological, clinical and imaging variables. Methods: A descriptive and cross-sectional investigation of 171 patients with acute respiratory infections and viral isolation was carried out by means of deep nasopharyngeal swab. They were discharged from the Neonatology Service of Antonio María Béguez César Southern Children Teaching Hospital in Santiago de Cuba, from 2014 to 2016, for which calculations of frequencies and percentages were carried out. Results: There was a prevalence of infants (57.9 %), the male sex and those affected patients with diagnosis of pneumonia (40.9 %) and bronchiolitis (28.0 %) due to respiratory syncytial virus and rhinovirus. The early suppression of breast feeding and nicotine addiction were the prevalent risk factors. Both fever and cough and the nasal secretions were preponderant, and the complications were infrequent. The alveolar consolidation prevailed in patients with pneumonia. Conclusions: Patients with respiratory virus were clinically and epidemiologically characterized and conflict with the pattern prevalence of alveolar infiltrates described in the consulted medical literature was evidenced.

Analysis of the clinical features of 400 suspected cases of pediatric pertussis / 中华实用儿科临床杂志

Objective:To summarize the suspected cases of pertussis, to explore the pathogen, and to analyze the clinical features of pertussis.Methods:A retrospective study was conducted to analyze the clinical data of suspected pertussis cases who visited the Department of Infectious Diseases in the Children′s Hospital Affiliated to Capital Institute of Pediatrics from June 2015 to May 2019.Results:(1) The PCR test for respiratory secretions of Bacillus pertussis was completed in 400 cases, with 198 cases positive (49.5%). (2) Among the 198 cases, 158 cases with pertussis were less than 1 year old (79.8%), 113 cases had a clear history of close contact with cough patients (57.1%), and 162 cases were not vaccinated or did not complete full diphtheria and tetanus toxoids and pertussis(DTP) vaccination (81.8%). The incidence of spasmodic cough was 73.7%(146/198 cases); the duration from onset to diagnosis was (17.2±12.3) d; the incidence of cyanosis after cough was 31.3%(62/198 cases), cough with vomiting 17.7% (35/198 cases), inspiratory croup 12.1%(24/198 cases); other concomitant symptoms included wheezing, runny nose, fever, diarrhea, etc.(3) All the patients were divided into the pertussis group (198 cases), other pathogen group (104 cases), and unknown pathogen group (98 cases). Comparison of the clinical symptoms of the three groups showed the highest incidence of cyanosis after cough in pertussis group ( χ2=15.334, P<0.001), and the highest incidence of wheezing, dyspnea, fever, pulmonary rales and stridor in other pathogen group ( χ2=79.208, 38.214, 16.709, 44.794, 42.480, all P<0.001). The percentages of white blood cells, lymphocytes and platelets in the pertussis group were higher than those in the other two groups ( F=15.812, 18.198, 10.819, all P<0.001). Conclusions:Suspected cases of pertussis are infected with various pathogens.Improving the pertussis nucleic acid detection and respiratory virus detection can help to make a clear diagnosis.Pertussis is more common in infants under 1 year of age and in those who have not completed vaccination.The most prominent clinical symptom is spasmodic cough, and the incidence of cyanosis after cough is higher than that of patients infected with other pathogens.

Epidemiological study and intervention measures of acute respiratory virus infection in hospitalized patients / 公共卫生与预防医学

Objective To understand the epidemiological characteristics of acute respiratory virus infection in hospitalized patients, and to provide reference for clinical diagnosis and treatment, and to develop relevant intervention measures. Methods A total of 414 hospitalized patients with respiratory virus infection admitted to our hospital from March 2019 to March 2021 were selected. Immunofluorescence method was used to qualitative detect parainfluenza virus type 1-3, influenza A virus, respiratory syncytial virus (RSV), influenza B virus and adenovirus. Results Among the 414 ARTI patients, 84 cases were positive for respiratory virus, with a positive detection rate of 20.29% (84/414 ) . 76 cases were positive for single virus infection, with a positive detection rate of 18.36% (76/414) . The positive detection rate was 1.93% (8/414). The most common pathogens of virus infection were influenza A virus (25.00%), influenza B virus (20.23%) and RSV(17.86%). There was statistical significance in the positive rate of ARTI among different age groups (χ2, P2, P0.05). The positive rate of PIV3 was the highest in spring (4.04%), and the positive rate of RSV in spring and winter was 24.24% and 25.20%, respectively. The positive rates of influenza A virus and influenza B virus were the highest in winter (9.45%) and (7.09%). There was statistical significance in the positive rate of ARTI among different clinical diagnoses (χ2, P<0.05). The positive rates of PIV2, PIV3, influenza A virus and influenza B virus were significantly different (P<0.05). The positive rate of bronchopneumonia virus was the highest (27.48%). Conclusion: RSV infection is the most common in patients with acute respiratory virus infection in Chengdu area, which mostly occurs in autumn and winter, and the main clinical manifestation is bronchopneumonia. The main infected population is children under 8 years old, and the surveillance of respiratory syncytial virus should be strengthened in the future.

Repeated respiratory viral infections in children / 中华实用儿科临床杂志

Respiratory virus is a common cause of acute respiratory tract infection, especially in infant that accounts for 80%.However, reinfections usually occur after primary infection, which is not only infected by the different virus strains, but also the identical virus strains.Reinfections are common in children.As the pandemic of the 2019 novel coronavirus (2019-nCoV), its reinfections are similar to other respiratory viruses.Repeated respiratory viral infections in infants may lead to recurrent wheezing and asthma, which are also responsible for declined lung function and chronic obstructive pulmonary disease in adults.This study aims to review the epidemiology, pathogenesis and long-term effects of repeated respiratory viral infections in children, thus improving the ability to identify and support further research and vaccine strategy.

Challenge of respiratory virus infection in children / 中华实用儿科临床杂志

Respiratory tract infection is a common infectious disease in children, which seriously threatens children′s health.The level of diagnosis and treatment of children′s respiratory virus infection has been significantly improved in China, but the diagnosis and treatment of children′s respiratory virus infection still face many challenges.This paper analyzes the challenges faced by children′s respiratory virus infection from the aspects of the harm of respiratory virus infection to children′s health, novel and recurrent respiratory virus infection, the infectivity of respiratory virus infection, vaccines and specific antiviral drugs, molecular diagnosis of respiratory virus infection and cytokine storm.

Tracking excess deaths associated with the COVID-19 epidemic as an epidemiological surveillance strategy-preliminary results of the evaluation of six Brazilian capitals

Abstract INTRODUCTION: In March 2020, the World Health Organization declared the coronavirus disease (COVID-19) outbreak a pandemic. In Brazil, 110 thousand cases and 5,901 deaths were confirmed by the end of April 2020. The scarcity of laboratory resources, the overload on the service network, and the broad clinical spectrum of the disease make it difficult to document all the deaths due to COVID-19. The aim of this study was to assess the mortality rate in Brazilian capitals with a high incidence of COVID-19. METHODS: We assessed the weekly mortality between epidemiological week 1 and 16 in 2020 and the corresponding period in 2019. We estimated the expected mortality at 95% confidence interval by projecting the mortality in 2019 to the population in 2020, using data from the National Association of Civil Registrars (ARPEN-Brasil). RESULTS: In the five capitals with the highest incidence of COVID-19, we identified excess deaths during the pandemic. The age group above 60 years was severely affected, while 31% of the excess deaths occurred in the age group of 20-59 years. There was a strong correlation (r = 0.94) between excess deaths and the number of deaths confirmed by epidemiological monitoring. The epidemiological surveillance captured only 52% of all mortality associated with the COVID-19 pandemic in the cities examined. CONCLUSIONS: Considering the simplicity of the method and its low cost, we believe that the assessment of excess mortality associated with the COVID-19 pandemic should be used as a complementary tool for regular epidemiological surveillance.

Mechanisms of Ertong Huichun Granules in treatment of respiratory virus infection diseases by network pharmacology and molecular docking / 中草药

Objective: To explore the mechanism of Ertong Huichun Granules in treatment of respiratory virus infection diseases by network pharmacology and molecular docking. Methods: TCMIP, TCMSP and BATMAN-TCM databases were used to search and summarize the meridian and components of medicinal materials from Ertong Huichun Granules. PubChem and Swiss Target Prediction database were used to query the targets corresponding to the active components, and the respiratory virus infection-related targets were inquired in the GeneCards database. The KEGG pathway and GO biological process enrichment were analyzed by DAVID database, and the relevant network was constructed by Cytoscape software. According to the analysis results of the network diagram, components and targets were selected for molecular docking. Results: The herbs in Ertong Huichun Granules were most attributed to lung, stomach, liver meridian; combining database and literature retrieval. A total of 126 Chinese native medicine ingredients and 55 targets were ensured for constructing network. KEGG pathways mainly included cancer, hepatitis related pathways, PI3K-Akt signaling pathway, TNF signaling pathway, and HIF-1 signaling pathway, which were mainly involved in inflammatory response, transmembrane receptor protein tyrosine kinase signaling pathway, hypoxia response, and other biological processes. Molecular docking results showed that 7,8-didehydrocimigenol, cimicifugoside, and cimigenol from Cimicifuga foetida had good binding capacity with PTGS2, MAPK, ACE2, and 3CL hydrolase (3CLpro), and maybe have potential anti-respiratory virus effects. Conclusion: Gallic acid, 7,8-didehydrocimigenoll, ccimicifugoside, baicalin, and other ingredients from Ertong Huichun Granules can be through PTGS2, EGFR, MAPK, IL2, ACE2, and 3CLpro targets for reducing inflammatory reaction, interference virus invasion of the host and inhibiting the virus replication to play the role of treating the respiratory virus infection diseases.

Etiology spectrum of virus in acute upper respiratory infection in children from 2017 to 2018 in Qingdao / 中华疾病控制杂志

Objective To understand the prevalence and epidemiological characteristics of respiratory viruses in influenza-like illness in children during March 2017 to March 2018 in Qingdao. Methods A random selection of influenza surveillance cases (influenza-like illness, ILI) among children in Qingdao area was selected as the research object, and 359 cases were detected. Nasopharyngeal swabs were collected for multiple-fluorescence real-time reverse transcription-polymerase chain reaction nucleic acid detection to screen 9 kinds of respiratory viruses. Results Among the 359 Cases, 200 cases were positive for at least 1 kinds of viruses, and the positive rate was 55.71%(200/359). Among these 200 cases, the most positive numbers were influenza B Yamagata (IVB Yamagata) 29.50%(59/200), followed by enterovirus 15.00%(30/200), respiratory adenovirus (AdV) 13.50%(27/200), respiratory syncytial virus A (RSVA) 12.5%(25/200), influenza A H1N1(IVA H1N1) 10.00%(20/200), etc. 2 cases were 3 kinds of mixed viruses infected and 1 case was 4 kinds of mixed viruses infected. Conclusions Nine kinds of respiratory viruses are prevalent in Qingdao during March 2017 -March 2018. The main prevalence viruses contain influenza B Yamagata, enterovirus, respiratory adenovirus, respiratory syncytial virus A, influenza A H1N1. There is obvious seasonal distribution of influenza, respiratory syncytial virus, enterovirus, metapneumovirus. A mixed infection exists between 9 kinds of respiratory viruses, and mixed infection occurs in the month of the virus epidemic.

Evaluation of the Real-Q RV Detection Kit for the Identification of Viruses That Result in Respiratory Infections

Viral respiratory infections are one of the most common infections worldwide. It is important to detect the virus early and precisely. In this study, we evaluated the limit of detection (LoD) and usefulness of the Real-Q RV Detection kit (BioSewoom, Seoul, Korea). We measured the LoD of the Real-Q RV Detection kit using 10 strains of standard viruses. We then compared the detection results by the Allplex Respiratory Panel Assay kit (Seegene, Seoul, Korea) using 123 clinical specimens. The discrepant results were confirmed by sequencing. Among the 10 standard viruses, the LoD of human rhinovirus (HRV) was the lowest and that of parainfluenza virus 2 and 3 was relatively high as detected by Real-Q RV Detection kit. Agreements of the two kits ranged from 95.9% to 100%. Three specimens detected negative by the Allplex Respiratory Panel kit were detected as adenovirus (AdV) by the Real-Q RV Detection kit and were confirmed by sequencing. Similarly, a specimen detected negative by the Allplex Respiratory Panel kit was detected as HRV by the Real-Q RV Detection kit and was confirmed by sequencing. A specimen detected as human enterovirus by the Allplex Respiratory Panel kit was detected as HRV by the Real-Q RV Detection kit and was confirmed by sequencing. Real-Q RV Detection kit showed good diagnostic performance and can be useful for detecting major viruses that cause respiratory infections.

Etiological analysis of virus in children with respiratory tract infection during spring in Shenyang regions / 中国小儿急救医学

Objective To investigate the distribution of respiratory viruses in the throat swabs from children with respiratory tract infection in Shenyang and provide reference for the diagnosis and treatment of clinical diseases. Methods A total of 756 children with respiratory tract infection who were admitted to Shengjing Hospital of China Medical University in Shenyang from February 2018 to May 2018 were enrolled in this study. The antigens of influenza virus A ( INF￣A),influenza virus B ( INF￣B),adenovirus (ADV), respiratory syncytial virus (RSV),and parainfluenza virus types I,Ⅱ,andⅢ(PIV￣Ⅰ,PIV￣Ⅱand PIV￣Ⅲ) in nasopharyngeal swabs were detected by direct immunofluorescence. Results Of all the 756 throat swabs from hospitalized children,214 ( 28. 31%) had positive virus detection results. RSV ( 11. 38%) had the highest detection rate in single￣positive cases,accounting for 47. 78% of single positive cases. In mixed virus infection,RSV combined with other viral infections accounted for 73. 53% of mixed virus infections, and RSV was the main pathogen found in the study population. Analysis of the detection rate of virus infection re￣lated with age and gender showed that the younger the age,the higher the detection rate(χ2 ＝14. 216,P＝0. 007). The detection rate of patients younger than 6 months was 39. 73% and RSV was the mostly detected pathogen (75. 86%). The detection rate of male patients was 30. 07%,which was higher than that of female patients with 25. 99%(χ2 ＝3. 982,P＝0. 046),and RSV infection and mixed infection were the major. There was no significant difference in virus detection rates between patients with different clinical diagnoses. Conclusion RSV is the main pathogen during spring from February 2018 to May 2018 in Shenyang. The virus detection rate of patients younger than 6 months is higher and RSV is the mostly detected pathogen.

Characteristics and Outcomes of Patients with Pulmonary Acute Respiratory Distress Syndrome Infected with Influenza versus Other Respiratory Viruses / 결핵

BACKGROUND: Although the frequency of respiratory viral infection in patients with pulmonary acute respiratory distress syndrome (ARDS) is not uncommon, clinical significance of the condition remains to be further elucidated. The purpose of this study was to compare characteristics and outcomes of patients with pulmonary ARDS infected with influenza and other respiratory viruses. METHODS: Clinical data of patients with pulmonary ARDS infected with respiratory viruses January 2014–June 2018 were reviewed. Respiratory viral infection was identified by multiplex reverse transcription–polymerase chain reaction (RT-PCR). RESULTS: Among 126 patients who underwent multiplex RT-PCR, respiratory viral infection was identified in 46% (58/126): 28 patients with influenza and 30 patients with other respiratory viruses. There was no significant difference in baseline and clinical characteristics between patients with influenza and those with other respiratory viruses. The use of extracorporeal membrane oxygenation (ECMO) was more frequent in patients with influenza than in those with other respiratory viruses (32.1% vs 3.3%, p=0.006). Co-bacterial pathogens were more frequently isolated from respiratory samples of patients with pulmonary ARDS infected with influenza virus than those with other respiratory viruses. (53.6% vs 26.7%, p=0.036). There were no significant differences regarding clinical outcomes. In multivariate analysis, acute physiology and chronic health evaluation II was associated with 30-mortality (odds ratio, 1.158; 95% confidence interval, 1.022–1.312; p=0.022). CONCLUSION: Respiratory viral infection was not uncommon in patients with pulmonary ARDS. Influenza virus was most commonly identified and was associated with more co-bacterial infection and ECMO therapy.