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1.
CMAJ ; 193(13): E439-E446, 2021 Mar 29.
Artigo em Inglês | MEDLINE | ID: mdl-33782171

RESUMO

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.


Assuntos
Efeitos Psicossociais da Doença , Hospitalização , Infecções Respiratórias/epidemiologia , Viroses/epidemiologia , Adulto , Idoso , Idoso de 80 Anos ou mais , Canadá , Estudos de Coortes , Monitoramento Epidemiológico , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Infecções Respiratórias/virologia
3.
BMC Infect Dis ; 21(1): 306, 2021 Mar 26.
Artigo em Inglês | MEDLINE | ID: mdl-33771128

RESUMO

BACKGROUND: Acute respiratory infections (ARIs) are among the leading causes of hospitalization in children. Understanding the local dominant viral etiologies is important to inform infection control practices and clinical management. This study aimed to investigate the viral etiology and epidemiology of respiratory infections among pediatric inpatients in Macao. METHODS: A retrospective study using electronic health records between 2014 and 2017 at Kiang Wu Hospital was performed. Nasopharyngeal swab specimens were obtained from hospitalized children aged 13 years or younger with respiratory tract diseases. xMAP multiplex assays were employed to detect respiratory agents including 10 respiratory viruses. Data were analyzed to describe the frequency and seasonality. RESULTS: Of the 4880 children enrolled in the study, 3767 (77.1%) were positive for at least one of the 13 viral pathogens tested, of which 2707 (55.5%) being male and 2635 (70.0%) under 2 years old. Among the positive results, there were 3091 (82.0%) single infections and 676 (18.0%) multiple infections. The predominant viruses included human rhinovirus/enterovirus (HRV/EV 27.4%), adenovirus (ADV, 15.8%), respiratory syncytial virus B (RSVB, 7.8%) and respiratory syncytial virus A (RSVA, 7.8%). The detection of viral infection was the most prevalent in autumn (960/1176, 81.6%), followed by spring (1095/1406, 77.9%), winter (768/992, 77.4%), and summer (944/1306, 72.3%), with HRV/EV and ADV being most commonly detected throughout the 4 years of study period. The detection rate of viral infection was highest among ARI patients presented with croup (123/141, 87.2%), followed by lower respiratory tract infection (1924/2356, 81.7%) and upper respiratory tract infection (1720/2383, 72.2%). FluA, FluB and ADV were positive factors for upper respiratory tract infections. On the other hand, infection with RSVA, RSVB, PIV3, PIV4, HMPV, and EV/RHV were positively associated with lower respiratory tract infections; and PIV1, PIV2, and PIV3 were positively associated with croup. CONCLUSIONS: This is the first study in Macao to determine the viral etiology and epidemiology of pediatric patients hospitalized for ARIs. The study findings can contribute to the awareness of pathogen, appropriate preventative measure, accurate diagnosis, and proper clinical management of respiratory viral infections among children in Macao.


Assuntos
Infecções Respiratórias/virologia , Viroses/epidemiologia , Adolescente , Criança , Criança Hospitalizada , Pré-Escolar , Enterovirus , Feminino , Hospitalização , Humanos , Lactente , Macau/epidemiologia , Masculino , Vírus Sincicial Respiratório Humano , Infecções Respiratórias/epidemiologia , Estudos Retrospectivos , Rhinovirus , Estações do Ano
4.
Cell Rep ; 34(11): 108872, 2021 03 16.
Artigo em Inglês | MEDLINE | ID: mdl-33730572

RESUMO

Viruses need to hijack the translational machinery of the host cell for a productive infection to happen. However, given the dynamic landscape of tRNA pools among tissues, it is unclear whether different viruses infecting different tissues have adapted their codon usage toward their tropism. Here, we collect the coding sequences of 502 human-infecting viruses and determine that tropism explains changes in codon usage. Using the tRNA abundances across 23 human tissues from The Cancer Genome Atlas (TCGA), we build an in silico model of translational efficiency that validates the correspondence of the viral codon usage with the translational machinery of their tropism. For instance, we detect that severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is specifically adapted to the upper respiratory tract and alveoli. Furthermore, this correspondence is specifically defined in early viral proteins. The observed tissue-specific translational efficiency could be useful for the development of antiviral therapies and vaccines.


Assuntos
Biossíntese de Proteínas/genética , Viroses/genética , Vírus/genética , Linhagem Celular , Linhagem Celular Tumoral , Uso do Códon/genética , Genes Neoplásicos/genética , Células HCT116 , Células HEK293 , Células HeLa , Células Hep G2 , Humanos , Alvéolos Pulmonares/virologia , RNA de Transferência/genética , Infecções Respiratórias/virologia , Tropismo/genética , Proteínas Virais/genética , Viroses/virologia
5.
Ther Adv Respir Dis ; 15: 1753466621995050, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-33749408

RESUMO

With the global over 60-year-old population predicted to more than double over the next 35 years, caring for this aging population has become a major global healthcare challenge. In 2016 there were over 1 million deaths in >70 year olds due to lower respiratory tract infections; 13-31% of these have been reported to be caused by viruses. Since then, there has been a global COVID-19 pandemic, which has caused over 2.3 million deaths so far; increased age has been shown to be the biggest risk factor for morbidity and mortality. Thus, the burden of respiratory viral infections in the elderly is becoming an increasing unmet clinical need. Particular challenges are faced due to the interplay of a variety of factors including complex multimorbidities, decreased physiological reserve and an aging immune system. Moreover, their atypical presentation of symptoms may lead to delayed necessary care, prescription of additional drugs and prolonged hospital stay. This leads to morbidity and mortality and further nosocomial spread. Clinicians currently have limited access to sensitive detection methods. Furthermore, a lack of effective antiviral treatments means there is little incentive to diagnose and record specific non-COVID-19 viral infections. To meet this unmet clinical need, it is first essential to fully understand the burden of respiratory viruses in the elderly. Doing this through prospective screening research studies for all respiratory viruses will help guide preventative policies and clinical trials for emerging therapeutics. The implementation of multiplex point-of-care diagnostics as a mainstay in all healthcare settings will be essential to understand the burden of respiratory viruses, diagnose patients and monitor outbreaks. The further development of novel targeted vaccinations as well as anti-viral therapeutics and new ways to augment the aging immune system is now also essential.The reviews of this paper are available via the supplemental material section.


Assuntos
/complicações , Infecções Respiratórias/epidemiologia , Infecções Respiratórias/virologia , Fatores Etários , Idoso , Humanos , Pessoa de Meia-Idade , Infecções Respiratórias/diagnóstico
6.
PLoS One ; 16(3): e0248750, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-33750952

RESUMO

BACKGROUND: Severe acute respiratory infection (SARI) results in a tremendous disease burden worldwide. Available research on active surveillance among hospitalized adult patients suffering from SARI in China is limited. This pilot study aimed to identify associated etiologies and describe the demographic, epidemiological and clinical profiles of hospitalized SARI patients aged over 16 years in Jinshan, Shanghai. METHODS: Active surveillance was conducted at 1 sentinel hospital in Jinshan district, Shanghai, from April 2017 to March 2018. Hospitalized SARI patients aged over 16 years old were enrolled, and nasopharyngeal swabs were collected within 24 hours of admission and tested for multiple respiratory viruses (including 18 common viruses) and Mycoplasma pneumoniae with real-time polymerase chain reaction. Demographic, epidemiological and clinical information was obtained from case report forms. RESULTS: In total, 397 SARI patients were enrolled; the median age was 68 years, and 194 (48.9%) patients were male. A total of 278 (70.0%) patients had at least one underlying chronic medical condition. The most frequent symptoms were cough (99.2%) and sputum production (88.4%). The median duration of hospitalization was 10 days. A total of 250 infection patients (63.0%) were positive for at least one pathogen, of whom 198 (49.9%) were positive for a single pathogen and 52 (13.1%) were positive for multiple pathogens. The pathogens identified most frequently were M. pneumoniae (23.9%, 95/397), followed by adenovirus (AdV) (11.6%, 46/397), influenza virus A/H3N2 (Flu A/H3N2) (11.1%, 44/397), human rhinovirus (HRhV) (8.1%, 32/397), influenza virus B/Yamagata (Flu B/Yamagata) (6.3%, 25/397), pandemic influenza virus A/H1N1 (Flu A/pH1N1) (4.0%, 16/397), parainfluenza virus (PIV) type 1 (2.0%, 8/397), human coronavirus (HCoV) type NL63 (2.0%, 8/397), HCoV 229E (1.5%, 6/397), HCoV HKU1 (1.5%, 6/397), PIV 3 (1.5%, 6/397), human metapneumovirus (HMPV) (1.5%, 6/397), PIV 4 (1.3%, 5/397), HCoV OC43 (1.0%, 4/397), influenza virus B/Victoria (Flu B/Victoria) (0.5%, 2/397), respiratory syncytial virus (RSV) type B (0.5%, 2/397), and human bocavirus (HBoV) (0.3%, 1/397). The seasonality of pathogen-confirmed SARI patients had a bimodal distribution, with the first peak in the summer and the second peak in the winter. Statistically significant differences were observed with respect to the rates of dyspnea, radiographically diagnosed pneumonia and the presence of at least one comorbidity in patients who were infected with only M. pneumoniae, AdV, HRhV, Flu A/H3N2, Flu A /pH1N1 or Flu B/Yamagata. The differences in the positivity rates of the above 6 pathogens among the different age groups were nonsignificant. CONCLUSIONS: M. pneumoniae, AdV and Flu A/H3N2 were the main pathogens detected in hospitalized SARI patients aged over 16 years old in Jinshan district, Shanghai. Our findings highlight the importance of sustained multipathogen surveillance among SARI patients in sentinel hospitals, which can provide useful information on SARI etiologies, epidemiology, and clinical characteristics.


Assuntos
Vírus de DNA/isolamento & purificação , Mycoplasma pneumoniae/isolamento & purificação , Vírus de RNA/isolamento & purificação , Infecções Respiratórias/diagnóstico , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Antibacterianos/uso terapêutico , China , Tosse/etiologia , Feminino , Glucocorticoides/uso terapêutico , Hospitais , Humanos , Masculino , Pessoa de Meia-Idade , Nasofaringe/microbiologia , Nasofaringe/virologia , Projetos Piloto , Prognóstico , Infecções Respiratórias/tratamento farmacológico , Infecções Respiratórias/microbiologia , Infecções Respiratórias/virologia , Adulto Jovem
7.
Int J Med Mushrooms ; 23(2): 1-11, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-33639077

RESUMO

This review provides results obtained by scientists from different countries on the antiviral activity of medicinal mushrooms against influenza viruses that can cause pandemics. Currently, the search for antiviral compounds is relevant in connection with the coronavirus disease 2019 (COVID-19) pandemic caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Medicinal mushrooms contain biologically active compounds (polysaccharides, proteins, terpenes, melanins, etc.) that exhibit an antiviral effect. The authors present the work carried out at the State Research Center of Virology and Biotechnology Vector in Russia, whose mission is to protect the population from biological threats. The research center possesses a collection of numerous pathogenic viruses, which allowed screening of water extracts, polysaccharides, and melanins from fruit bodies and fungal cultures. The results of investigations on different subtypes of influenza virus are presented, and special attention is paid to Inonotus obliquus (chaga mushroom). Compounds produced from this mushroom are characterized by the widest range of antiviral activity. Comparative data are presented on the antiviral activity of melanin from natural I. obliquus and submerged biomass of an effective strain isolated in culture against the pandemic strain of influenza virus A/California/07/09 (H1N1 pdm09).


Assuntos
Agaricales/química , Antivirais/farmacologia , Fatores Biológicos/farmacologia , Orthomyxoviridae/efeitos dos fármacos , Animais , Antivirais/isolamento & purificação , Fatores Biológicos/isolamento & purificação , Humanos , Melaninas/isolamento & purificação , Melaninas/farmacologia , Orthomyxoviridae/classificação , Pandemias , Infecções Respiratórias/epidemiologia , Infecções Respiratórias/virologia
8.
Int J Mol Med ; 47(4): 1, 2021 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-33537824

RESUMO

Currently, the world is under a pandemic of severe acute respiratory syndrome coronavirus 2 (SARS­CoV­2), responsible for coronavirus disease 2019 (COVID­19). This disease is characterized by a respiratory syndrome that can progress to an acute respiratory distress syndrome. To date, limited effective therapies are available for the prevention or treatment of COVID­19; therefore, it is necessary to propose novel treatment options with immunomodulatory effects. Vitamin D serves functions in bone health and has been recently reported to exert protective effects against respiratory infections. Observational studies have demonstrated an association between vitamin D deficiency and a poor prognosis of COVID­19; this is alarming as vitamin D deficiency is a global health problem. In Latin America, the prevalence of vitamin D deficiency is unknown, and currently, this region is in the top 10 according to the number of confirmed COVID­19 cases. Supplementation with vitamin D may be a useful adjunctive treatment for the prevention of COVID­19 complications. The present review provides an overview of the current knowledge of the potential immunomodulatory effects of vitamin D in the prevention of COVID­19 and sets out vitamin D recommendations for the Latin American population.


Assuntos
/complicações , Fatores Imunológicos/uso terapêutico , Infecções Respiratórias/virologia , Deficiência de Vitamina D/complicações , Vitamina D/uso terapêutico , Osso e Ossos , Suplementos Nutricionais , Humanos , América Latina , Prevalência , Sistema Renina-Angiotensina
9.
Nutr Res ; 87: 1-12, 2021 03.
Artigo em Inglês | MEDLINE | ID: mdl-33592454

RESUMO

COVID-19 caused by SARS-CoV-2 is an ongoing global pandemic. SARS-CoV-2 affects the human respiratory tract's epithelial cells, leading to a proinflammatory cytokine storm and chronic lung inflammation. With numerous patients dying daily, a vaccine and specific antiviral drug regimens are being explored. Probiotics are live microorganisms with proven beneficial effects on human health. While probiotics as nutritional supplements are long practiced in different cuisines across various countries, the emerging scientific evidence supports the antiviral and general immune-strengthening health effects of the probiotics. Here, we present an overview of the experimental studies published in the last 10 years that provide a scientific basis for unexplored probiotics as a preventive approach to respiratory viral infections. Based on collated insights from these experimental data, we identify promising microbial strains that may serve as lead prophylactic and immune-boosting probiotics in COVID-19 management.


Assuntos
Antivirais/uso terapêutico , Fatores Imunológicos/uso terapêutico , Pulmão/virologia , Probióticos/uso terapêutico , Infecções Respiratórias/tratamento farmacológico , /imunologia , Humanos , Lactobacillus , Pandemias , Infecções Respiratórias/virologia
10.
BMC Infect Dis ; 21(1): 152, 2021 Feb 05.
Artigo em Inglês | MEDLINE | ID: mdl-33546631

RESUMO

BACKGROUND: Knowledge on the etiology of LRTIs is essential for improvement of the clinical diagnosis and accurate treatment. Molecular detection methods were applied to identify a broad range of bacterial and viral pathogens in a large set of bronchial alveolar lavage (BAL) fluid samples. The patterns of detected pathogens were correlated to the clinical symptoms. METHODS: BAL fluid samples and clinical data were collected from 573 hospitalized children between 1 month and 14 years of age with LRTIs, enrolled from January to December 2018. Pathogens were detected using standardized clinical diagnostics, with a sensitive, high-throughput GeXP-based multiplex PCR and with multiplex qPCR. Data were analyzed to describe the correlation between the severity of respiratory tract disease and the pathogens identified. RESULTS: The pathogen detection rate with GeXP-based PCR and multiplex qPCR was significantly higher than by clinical routine diagnostics (76.09% VS 36.13%,χ2 = 8.191, P = 0.004). The most frequently detected pathogens in the BAL fluid were human adenovirus (HADV)(21.82%), Mycoplasma pneumoniae (20.24%), human rhinovirus (13.96%), Streptococcus pneumoniae (8.90%) and Haemophilus influenzae (8.90%). In 16.4% of the cases co-detection with two or three different pathogens was found. Viral detection rates declined with age, while atypical pathogen detection rates increased with age. Oxygen supply in the HADV and Influenza H1N1 infected patients was more frequent (49.43%) than in patients infected with other pathogens. CONCLUSION: Broad range detection of viral and bacterial pathogens using molecular methods is a promising and implementable approach to improve clinical diagnosis and accurate treatment of LRTI in children.


Assuntos
Líquido da Lavagem Broncoalveolar/microbiologia , Líquido da Lavagem Broncoalveolar/virologia , Infecções Respiratórias/diagnóstico , Adolescente , Bactérias/classificação , Bactérias/genética , Bactérias/isolamento & purificação , Criança , Criança Hospitalizada , Pré-Escolar , Coinfecção/diagnóstico , Coinfecção/microbiologia , Coinfecção/virologia , Testes Diagnósticos de Rotina , Feminino , Humanos , Lactente , Masculino , Reação em Cadeia da Polimerase , Infecções Respiratórias/microbiologia , Infecções Respiratórias/virologia , Vírus/classificação , Vírus/genética , Vírus/isolamento & purificação
11.
Nat Commun ; 12(1): 1001, 2021 02 12.
Artigo em Inglês | MEDLINE | ID: mdl-33579926

RESUMO

Stringent nonpharmaceutical interventions (NPIs) such as lockdowns and border closures are not currently recommended for pandemic influenza control. New Zealand used these NPIs to eliminate coronavirus disease 2019 during its first wave. Using multiple surveillance systems, we observed a parallel and unprecedented reduction of influenza and other respiratory viral infections in 2020. This finding supports the use of these NPIs for controlling pandemic influenza and other severe respiratory viral threats.


Assuntos
/epidemiologia , Influenza Humana/epidemiologia , Infecções Respiratórias/epidemiologia , /prevenção & controle , Controle de Doenças Transmissíveis , Monitoramento Epidemiológico , Hospitalização/estatística & dados numéricos , Humanos , Influenza Humana/prevenção & controle , Influenza Humana/virologia , Nova Zelândia/epidemiologia , Pandemias , Saúde Pública , Infecções Respiratórias/prevenção & controle , Infecções Respiratórias/virologia , /isolamento & purificação
12.
JMIR Public Health Surveill ; 7(2): e24341, 2021 02 19.
Artigo em Inglês | MEDLINE | ID: mdl-33605892

RESUMO

BACKGROUND: The Oxford-Royal College of General Practitioners (RCGP) Research and Surveillance Centre (RSC) and Public Health England (PHE) are commencing their 54th season of collaboration at a time when SARS-CoV-2 infections are likely to be cocirculating with the usual winter infections. OBJECTIVE: The aim of this study is to conduct surveillance of influenza and other monitored respiratory conditions and to report on vaccine uptake and effectiveness using nationally representative surveillance data extracted from primary care computerized medical records systems. We also aim to have general practices collect virology and serology specimens and to participate in trials and other interventional research. METHODS: The RCGP RSC network comprises over 1700 general practices in England and Wales. We will extract pseudonymized data twice weekly and are migrating to a system of daily extracts. First, we will collect pseudonymized, routine, coded clinical data for the surveillance of monitored and unexpected conditions; data on vaccine exposure and adverse events of interest; and data on approved research study outcomes. Second, we will provide dashboards to give general practices feedback about levels of care and data quality, as compared to other network practices. We will focus on collecting data on influenza-like illness, upper and lower respiratory tract infections, and suspected COVID-19. Third, approximately 300 practices will participate in the 2020-2021 virology and serology surveillance; this will include responsive surveillance and long-term follow-up of previous SARS-CoV-2 infections. Fourth, member practices will be able to recruit volunteer patients to trials, including early interventions to improve COVID-19 outcomes and point-of-care testing. Lastly, the legal basis for our surveillance with PHE is Regulation 3 of the Health Service (Control of Patient Information) Regulations 2002; other studies require appropriate ethical approval. RESULTS: The RCGP RSC network has tripled in size; there were previously 100 virology practices and 500 practices overall in the network and we now have 322 and 1724, respectively. The Oxford-RCGP Clinical Informatics Digital Hub (ORCHID) secure networks enable the daily analysis of the extended network; currently, 1076 practices are uploaded. We are implementing a central swab distribution system for patients self-swabbing at home in addition to in-practice sampling. We have converted all our primary care coding to Systematized Nomenclature of Medicine Clinical Terms (SNOMED CT) coding. Throughout spring and summer 2020, the network has continued to collect specimens in preparation for the winter or for any second wave of COVID-19 cases. We have collected 5404 swabs and detected 623 cases of COVID-19 through extended virological sampling, and 19,341 samples have been collected for serology. This shows our preparedness for the winter season. CONCLUSIONS: The COVID-19 pandemic has been associated with a groundswell of general practices joining our network. It has also created a permissive environment in which we have developed the capacity and capability of the national primary care surveillance systems and our unique public health institute, the RCGP and University of Oxford collaboration.


Assuntos
Protocolos Clínicos , Influenza Humana/prevenção & controle , Infecções Respiratórias/prevenção & controle , Vacinas/uso terapêutico , /tratamento farmacológico , Feminino , Humanos , Influenza Humana/tratamento farmacológico , Masculino , Pessoa de Meia-Idade , Vigilância da População/métodos , Saúde Pública , Infecções Respiratórias/tratamento farmacológico , Infecções Respiratórias/virologia , Reino Unido
13.
Popul Health Manag ; 24(S1): S26-S34, 2021 02.
Artigo em Inglês | MEDLINE | ID: mdl-33544647

RESUMO

Laboratory testing is an important component in the diagnosis of respiratory tract infections such as with severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2). However, specimen collection not only risks exposure of health care workers and other patients to infection, but also necessitates use of personal protective equipment that may be in short supply during periods of heightened disease activity. Self-collection of nasal or oropharyngeal swabs offers an alternative to address these drawbacks. Although studies in the past decade have demonstrated the utility of this approach for respiratory infections, it has not been widely adopted in routine clinical practice. The rapid spread of coronavirus disease 2019 (COVID-19), caused by SARS-CoV-2, has focused attention on the need for safe, convenient, timely, and scalable methods for collecting upper respiratory specimens for testing. The goals of this article are to highlight the literature regarding self-collected nasal or oropharyngeal specimens for respiratory pathogen testing; discuss the role of self-collection in helping prevent the spread of the COVID-19 disease from infected patients and facilitating a shift toward "virtual" medicine or telemedicine; and describe the current and future state of self-collection for infectious agents, and the impacts these approaches can have on population health management and disease diagnosis and prevention.


Assuntos
Gestão da Saúde da População , Manejo de Espécimes/métodos , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , /prevenção & controle , Criança , Pré-Escolar , Humanos , Lactente , Pessoa de Meia-Idade , Infecções Respiratórias/diagnóstico , Infecções Respiratórias/prevenção & controle , Infecções Respiratórias/virologia , Autocuidado , Telemedicina , Adulto Jovem
14.
BMC Infect Dis ; 21(1): 144, 2021 Feb 04.
Artigo em Inglês | MEDLINE | ID: mdl-33541281

RESUMO

BACKGROUND: The respiratory syncytial virus (RSV) has been established as a leading cause of acute lower respiratory illness (ALRI) in infants and children. In 2015, the global disease burden (GBD) study estimated that the overall RSV-ALRI mortality could be as high as 118,200, with most death occurring in low- and middle-incomes countries (LMIC). This study aimed to assess the burden of RSV infection among children less than 2 years with acute respiratory infections (ARI) in the Littoral region of Cameroon. METHODS: We carried out a cross-sectional study in seven health centres in the Littoral region of Cameroon. Venous blood was collected using serum separation tubes from eligible children who visited these health centres with acute respiratory infections. ELISA (Enzyme-linked immunosorbent assay) testing was used to assess the seroprevalence of anti-IgM RSV for the total population and by selected demographic and health parameters and potential risk factors. RESULTS: The overall RSV-associated ARI seroprevalence was 33% (95%CI:23.6-42.3; 33/100 children). The only demographic factor significantly associated with RSV acquisition was age of 6 months and below (odds ratio: 7.54 (2.62, 23.36); p = 0.000). Children who were clinically diagnosed to be concomitantly infected with malaria had a lower risk of RSV infection (odds ratio: 0.38 (0.14, 0.95; P = 0.03). CONCLUSIONS: The RSV burden is high among children less than 2 years with ARI in the Littoral region of Cameroon. There is a need for an effective public health RSV surveillance system with standard laboratory techniques and equipment to better understand the RSV disease age-specific incidence, seasonality, risk factors and RSV burden among patients in communities in Cameroon.


Assuntos
Infecções por Vírus Respiratório Sincicial/complicações , Vírus Sincicial Respiratório Humano , Infecções Respiratórias/etiologia , Infecções Respiratórias/virologia , Camarões/epidemiologia , Estudos Transversais , Ensaio de Imunoadsorção Enzimática , Feminino , Humanos , Incidência , Lactente , Masculino , Fatores de Risco , População Rural , Estudos Soroepidemiológicos
15.
J Laryngol Otol ; 135(2): 182-184, 2021 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-33593466

RESUMO

OBJECTIVE: This paper reports a rare case of a 61-year-old man with sialodochitis fibrinosa. METHODS: Clinical case report and review of current literature. RESULTS: Sialodochitis fibrinosa is a diagnosis of exclusion and in many cases can be managed conservatively. Conservative management failed for this patient and he was managed successfully with staged bilateral total parotidectomy. CONCLUSION: Sialodochitis fibrinosa should be considered as a differential diagnosis of painful bilateral facial swelling. While conservative management is successful for many patients, staged bilateral total parotidectomy may be necessary for full remission of symptoms; the timing of this is crucial to reduce the risk of facial nerve palsy.


Assuntos
Tratamento Conservador/efeitos adversos , Paralisia Facial/prevenção & controle , Glândula Parótida/cirurgia , Sialadenite/cirurgia , Tratamento Conservador/estatística & dados numéricos , Diagnóstico Diferencial , Humanos , Hipertrofia , Imagem por Ressonância Magnética/métodos , Masculino , Pessoa de Meia-Idade , Glândula Parótida/patologia , Infecções Respiratórias/complicações , Infecções Respiratórias/virologia , Sialadenite/diagnóstico por imagem , Sialadenite/patologia , Resultado do Tratamento
16.
Pediatr Infect Dis J ; 40(4): e164-e166, 2021 04 01.
Artigo em Inglês | MEDLINE | ID: mdl-33464015

RESUMO

In this study, children under 24 months of age hospitalized with respiratory compromise due to COVID-19 were retrospectively analyzed according to the event of coinfection with respiratory syncytial virus. Of 32 patients, 18.7% had coinfection and these had a significantly longer length of stay. There were no differences regarding need for intensive care, mechanical ventilation or mortality rates.


Assuntos
/epidemiologia , Coinfecção , Hospitalização , Vírus Sincicial Respiratório Humano , Infecções Respiratórias/epidemiologia , Brasil/epidemiologia , Comorbidade , Feminino , Humanos , Lactente , Recém-Nascido , Masculino , Infecções Respiratórias/virologia , Estudos Retrospectivos
17.
Int Immunopharmacol ; 92: 107365, 2021 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-33440306

RESUMO

Emerging beta-coronaviruses (ß-CoVs), including Severe Acute Respiratory Syndrome CoV-1 (SARS-CoV-1), Middle East Respiratory Syndrome-CoV (MERS-CoV), and Severe Acute Respiratory Syndrome CoV-2 (SARS-CoV-2, the cause of COVID19) are responsible for acute respiratory illnesses in human. The epidemiological features of the SARS, MERS, and new COVID-19 have revealed sex-dependent variations in the infection, frequency, treatment, and fatality rates of these syndromes. Females are likely less susceptible to viral infections, perhaps due to their steroid hormone levels, the impact of X-linked genes, and the sex-based immune responses. Although mostly inactive, the X chromosome makes the female's immune system more robust. The extra immune-regulatory genes of the X chromosome are associated with lower levels of viral load and decreased infection rate. Moreover, a higher titer of the antibodies and their longer blood circulation half-life are involved in a more durable immune protection in females. The activation rate of the immune cells and the production of TLR7 and IFN are more prominent in females. Although the bi-allelic expression of the immune regulatory genes can sometimes lead to autoimmune reactions, the higher titer of TLR7 in females is further associated with a stronger anti-viral immune response. Considering these sex-related differences and the similarities between the SARS, MERS, and COVID-19, we will discuss them in immune responses against the ß-CoVs-associated syndromes. We aim to provide information on sex-based disease susceptibility and response. A better understanding of the evasion strategies of pathogens and the host immune responses can provide worthful insights into immunotherapy, and vaccine development approaches.


Assuntos
Betacoronavirus , Infecções por Coronavirus/imunologia , Infecções por Coronavirus/virologia , Infecções Respiratórias/imunologia , Infecções Respiratórias/virologia , Antivirais/uso terapêutico , Infecções por Coronavirus/tratamento farmacológico , Feminino , Humanos , Masculino , Infecções Respiratórias/tratamento farmacológico , Fatores Sexuais
18.
Infect Dis (Lond) ; 53(4): 274-280, 2021 04.
Artigo em Inglês | MEDLINE | ID: mdl-33475447

RESUMO

BACKGROUND: The epidemiology of respiratory virus infections (RVI) in patients undergoing autologous haematopoietic stem cell transplantation (auto-SCT) is not well described. METHODS: Our goal was to describe the epidemiology of respiratory virus infections (RVI) in patients undergoing autologous haematopoietic stem cell transplantation (auto-SCT) in a single tertiary centre observation study during two respiratory virus seasons (2015-2017). All symptomatic auto-SCT patients were tested for RVI by nasopharyngeal swab. RESULTS: 156 transplantation episodes were included, 69% were male and, the median age was 57 years. We detected 19 RVIs in 156 transplantation episodes (12%). The median time to RVI after hospitalization was 13 days [IQR 7-13] and 15/19 (79%) had a possible nosocomial origin (occurrence ≥ 5 days after admission). The nosocomial infections included 5/15 (33%) 'severe' RVIs (3 influenza viruses, 1 parainfluenza virus, and 1 adenovirus) as well as 10/15 (66%) non-severe virus infections (including human rhinovirus and human coronavirus). CONCLUSION: In approximately 10% of auto-SCT transplantation episodes, an RVI with likely nosocomial origin was detected and included 'severe viruses' such as influenza. Our study suggests that infection prevention measures in auto-SCT patients can be improved. ABBREVIATIONS: AdV: adenovirus; ALL: acute lymphatic leukaemia; AML: acute myeloid leukaemia; auto-SCT: autologous haematopoietic stem cell transplantation; hCoV: human coronavirus; HD: Hodgkin's disease; hMPV: human metapneumovirus; HRV: human rhinovirus; HSCT: allogeneic haematopoietic stem cell transplantation; IQR: interquartile range; GCT: germ cell tumour; MM: multiple myeloma; NHL: non-Hodgkin lymphoma; PIV: parainfluenza virus; RSV: respiratory syncytial virus.


Assuntos
Transplante de Células-Tronco Hematopoéticas , Infecções Respiratórias , Viroses , Feminino , Transplante de Células-Tronco Hematopoéticas/efeitos adversos , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Prospectivos , Infecções Respiratórias/epidemiologia , Infecções Respiratórias/virologia , Suíça , Centros de Atenção Terciária , Viroses/epidemiologia
19.
Rev Mal Respir ; 38(1): 58-73, 2021 Jan.
Artigo em Francês | MEDLINE | ID: mdl-33461842

RESUMO

INTRODUCTION: The etiological diagnosis of bronchopulmonary infections cannot be assessed with clinical, radiological and epidemiological data alone. Viruses have been demonstrated to cause a large proportion of these infections, both in children and adults. BACKGROUND: The diagnosis of viral bronchopulmonary infections is based on the analysis of secretions, collected from the lower respiratory tract when possible, by techniques that detect either influenza and respiratory syncytial viruses, or a large panel of viruses that can be responsible for respiratory disease. The latter, called multiplex PCR assays, allow a syndromic approach to respiratory infection. Their high cost for the laboratory raises the question of their place in the management of patients in terms of antibiotic economy and isolation. In the absence of clear recommendations, the strategy and equipment are very unevenly distributed in France. OUTLOOK: Medico-economic analyses need to be performed in France to evaluate the place of these tests in the management of patients. The evaluation of the role of the different viruses often detected in co-infection, especially in children, also deserves the attention of virologists and clinicians. CONCLUSIONS: The availability of new diagnostic technologies, the recent emergence of SARS-CoV-2, together with the availability of new antiviral drugs are likely to impact future recommendations for the management of viral bronchopulmonary infections.


Assuntos
Infecções Respiratórias/diagnóstico , Infecções Respiratórias/virologia , Viroses/diagnóstico , Antígenos Virais/análise , Líquido da Lavagem Broncoalveolar/virologia , Coinfecção/diagnóstico , Imunofluorescência , Humanos , Imunoglobulina G/sangue , Imunoglobulina M/sangue , Nasofaringe/virologia , Reação em Cadeia da Polimerase , Vigilância da População , Manejo de Espécimes
20.
JAMA Netw Open ; 4(1): e2035281, 2021 01 04.
Artigo em Inglês | MEDLINE | ID: mdl-33492377

RESUMO

Importance: Public health initiatives that include shelter-in-place orders are expensive and unpopular. Demonstrating the success of these initiatives is essential to justify their systemic or individual cost. Objective: To examine the association of a shelter-in-place order with lower rates of seasonal respiratory viral activity. Design, Setting, and Participants: This cohort study with interrupted time series analysis obtained monthly counts of respiratory virus testing results at UC Davis Health from August 1, 2014, to July 31, 2020. Patients of all ages underwent testing conducted by the laboratory at UC Davis Health, a referral center for a 65 000-square-mile area that includes 33 counties and more than 6 million Northern California residents. Exposures: A statewide shelter-in-place order was instituted on March 19, 2020, restricting residents to their homes except for traveling for essential activities. Large social gatherings were prohibited, schools were closed, and nonessential personnel worked remotely. Those who had to leave their homes were mandated to wear face masks, engage in frequent handwashing, and maintain physical distancing. Main Outcomes and Measures: Positivity rates of common respiratory viruses within the community served by UC Davis Health. Results: A total of 46 128 tests for viral respiratory pathogens over a 6-year period were included in the analysis. For the postexposure period (March 25-July 31), approximately 168 positive test results occurred for the studied organisms in the 2020 virus year, a positivity rate of 9.88 positive results per 100 tests that was much lower than the positivity rate of 29.90 positive results per 100 tests observed for this date range in the previous 5 virus years. In contrast, the positivity rates were similar for the preexposure time frame (August 1-March 24) in the 2020 virus year and for the same time periods in the 5 previous years (30.40 vs 33.68 positive results per 100 tests). In the regression analyses, statistically significant decreases in viral activity were observed in the postexposure period for influenza (93% decrease; incidence rate ratio [IRR], 0.07; 95% CI, 0.02-0.33) and for rhinovirus or enterovirus (81% decrease; IRR, 0.19; 95% CI, 0.09-0.39) infections. Lower rates of postexposure viral activity were seen for respiratory syncytial virus, parainfluenzavirus, coronaviruses, and adenoviruses; however, these associations were not statistically significant. Conclusions and Relevance: Using interrupted time series analysis of testing for viral respiratory pathogens, this study found that statistically significant lower rates of common community respiratory viruses appeared to be associated with a shelter-in-place order during the coronavirus disease 2019 pandemic.


Assuntos
/prevenção & controle , Quarentena/normas , Infecções Respiratórias/virologia , Estações do Ano , Adolescente , Adulto , California/epidemiologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Quarentena/métodos , Quarentena/estatística & dados numéricos , Infecções Respiratórias/epidemiologia
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