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Introducción: La bronquiolitis constituye una de las principales causas de Infecciones Respiratorias Agudas Bajas en Pediatría, y es responsable de una proporción significativa de hospitalizaciones en lactantes, fundamentalmente, en menores de 1 año. Su diagnóstico es clínico, caracterizado por síntomas y signos de amplio grado de gravedad. Objetivo: Describir las características clínico-etiológicas de casos de bronquiolitis en menores de 1 año, internados en un hospital de niños de la ciudad de Santa Fe, durante un periodo de un año. Materiales y Métodos: Estudio observacional, transversal. Se analizaron datos demográficos, clínicos y de laboratorio de fichas médicas de vigilancia epidemiológica. Las técnicas diagnósticas usadas según el agente viral fueron RT-PCR en tiempo real, PCR-punto final e Inmunofluorescencia Indirecta. Resultados: Sobre un total de 108 casos, 90,7% tuvo de 1 a 6 meses de edad. La mediana de internación fue de 5 días, y el nacimiento prematuro fue la condición médica previa más frecuente. Un 78,7% (85) tuvo diagnóstico viral positivo, siendo Rinovirus (hRV) y Virus Sincicial Respiratorio (VSR) los agentes más prevalentes, tanto en infección única como en coinfección. El tiempo de oxigenoterapia fue mayor en los pacientes más graves (p<0,001). El 32,4% (35) recibió alguna medicación que fue, en mayor frecuencia, antibiótico. Se encontró asociación positiva y significativa entre la edad menor de 3 meses y una hospitalización mayor a 5 días (OR=2,5; IC: 1,1-5,8; p=0,02); y entre un diagnóstico VSR positivo y un cuadro grave (OR: 7,7; IC: 1,95-39,6; p<0,001). Conclusión: Las características y condiciones médicas consideradas por la literatura como factores de riesgo para el padecimiento y la gravedad de una IRAB, fueron halladas con mayor frecuencia en la población de estudio. El hRV y el VRS fueron los agentes de mayor rescate viral, encontrándose una asociación positiva entre la infección por VSR y la gravedad del cuadro.
Introduction: Bronchiolitis is one of the main causes of Acute Lower Respiratory Infections in pediatrics, and is responsible for a significant proportion of hospitalizations in infants, mainly in children under 1 year of age. Its diagnosis is clinical. The disease is characterized by a wide variety and degree of signs and symptoms. Objective: To describe the clinical-etiological characteristics of cases of bronchiolitis in children under 1 year of age, admitted to a children's hospital in the city of Santa Fe, over a period of one year. Materials and Methods: This was an observational and cross-sectional study. Demographic, clinical and laboratory data from epidemiological surveillance medical records were analyzed. The diagnostic techniques used, based on the viral agent, were real-time RT-PCR, end-point PCR and Indirect Immunofluorescence. Results: Out of a total of 108 cases, 90.7% were between 1 and 6 months old. The median hospital stay was 5 days, and premature birth was the most common prior medical condition. 78.7% (85) had a positive viral diagnosis, with Rhinovirus (hRV) and Respiratory Syncytial Virus (RSV) being the most prevalent agents, both in single infection and coinfection. Oxygen therapy time was longer in the most seriously ill patients (p<0.001). 32.4% (35) received some medication, which was, most frequently, antibiotics. A positive and significant association was found between age less than 3 months and hospitalization longer than 5 days (OR=2.5; CI: 1.1-5.8; p=0.02); and between a positive RSV diagnosis and a severe condition (OR: 7.7; CI: 1.95-39.6; p<0.001). Conclusions: The characteristics and medical conditions considered by the literature as risk factors for the morbidity and severity of a lower respiratory tract infection were found more frequently in the study population. hRV and RSV were the most commonly-detected viral agents. We found a positive association between RSV infection and the severity of the condition.
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Introducción. Los virus son los principales agentes etiológicos en las infecciones respiratorias agudas graves; un alto porcentaje queda sin diagnóstico viral. Objetivo. Describir la frecuencia de rinovirus y metapneumovirus en pacientes pediátricos de una unidad centinela de Mar del Plata con infección respiratoria aguda grave y resultado negativo para virus clásicos por inmunofluorescencia y biología molecular. Población y métodos. Se realizó un estudio descriptivo de corte transversal. Se evaluó la presencia de rinovirus y metapneumovirus por biología molecular en 163 casos negativos para panel respiratorio por técnicas de vigilancia referencial, durante todo el año 2015. Resultados. Se detectó rinovirus en el 51,5 % de los casos, metapneumovirus en el 9,8 % y coinfección rinovirus-metapneumovirus en el 6,1 %. Fueron negativos para ambos virus el 32,5 %. Conclusiones. La selección de muestras sin diagnóstico virológico permitió identificar rinovirus y metapneumovirus como agentes causales de infecciones respiratorias agudas graves pediátricas y su impacto en la morbimortalidad infantil y en nuestro sistema sanitario.
Introduction. Viruses are the main etiologic agents involved in severe acute respiratory tract infections; a viral diagnosis is not established in a high percentage of cases. Objective. To describe the frequency of rhinovirus and metapneumovirus in pediatric patients with severe acute respiratory infection and negative results for typical viruses by immunofluorescence and molecular biology at a sentinel unit of Mar del Plata. Population and methods. This was a descriptive, cross-sectional study. The presence of rhinovirus and metapneumovirus was assessed by molecular biology in 163 cases negative for respiratory panel by referral surveillance techniques throughout 2015. Results. Rhinovirus was detected in 51.5% of cases, metapneumovirus in 9.8%, and coinfection with rhinovirus and metapneumovirus in 6.1%. Results were negative for both viruses in 32.5%. Conclusions. The selection of samples without a viral diagnosis allowed us to identify rhinovirus and metapneumovirus as causative agents of severe acute respiratory infections in children and assess their impact on child morbidity and mortality and on our health care system
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Humans , Infant, Newborn , Infant , Child, Preschool , Child , Pneumonia , Respiratory Tract Infections/diagnosis , Viruses , Metapneumovirus , Enterovirus Infections , Rhinovirus , Cross-Sectional StudiesABSTRACT
La pandemia de COVID-19 enfrentó a la humanidad a un gran desafío y hemos ido aprendiendo a medida que avanzó. La aparición de este virus, su comportamiento por si solo y en conjunto con los otros virus nos mantuvo alerta.. Los pacientes pediátricos asmáticos, a pesar de lo que se pensó en un principio, son menos afectados y hacen un cuadro clínico más leve. Objetivo: presentar un caso clínico de un paciente asmático, con una evolución tortuosa por co-infección SARS-CoV-2 y Rinovirus (RV) y revisión de la litaratura. Se trata de un escolar de 6 años, asmático con mal control, con 2 dosis de vacuna anti SARS-CoV-2, que presento un estado asmático por rinovirus y posterior evolución con neumonía grave por SARS-CoV-2, requiriendo ventilación mecánica invasiva y estadía en UCI Pediátrica. Es probable que la gravedad del caso presentado se deba al mal control del asma antes de la infección, ya que se ha visto que los niños asmáticos alérgicos presentan un factor protector para infección grave por SARS-CoV-2, lo cual esta supeditado a un buen control de su enfermedad basal.
The COVID-19 pandemic presented a great challenge and we have been learning as it has progressed. The appearance of this virus, its behavior by itself and in conjunction with the other viruses kept us alert. Pediatric asthmatic patients, despite what was initially thought, are less affected and present a milder clinical picture. Objective: to present a clinical case of an asthmatic patient, with a tortuous evolution due to SARS-CoV-2 and Rhinovirus (RV) co-infection and a literature review. This is a 6-year-old schoolboy, asthmatic with poor control, with 2 doses of the SARS-CoV-2 vaccine, who presents asthmatic status due to rhinovirus and subsequent evolution with severe pneumonia due to SARS-CoV-2, requiring invasive mechanical ventilation and stay in Pediatric ICU. It is likely that the severity of the case presented is due to poor asthma control before infection, since it has been seen that allergic asthmatic children present a protective factor for severe infection by SARS-CoV-2, which is subject to good control of his basal disease.
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Humans , Male , Child , Asthma/complications , Picornaviridae Infections/complications , COVID-19/complications , Status Asthmaticus , Radiography, Thoracic , Tomography, X-Ray Computed , Picornaviridae Infections/diagnostic imaging , SARS-CoV-2 , COVID-19/diagnostic imagingABSTRACT
Objective:To analyze the clinical and epidemiological features of human rhinovirus (HRV) infection in adult patients with upper respiratory tract infection (URTI) in Nanjing.Methods:Epidemiological data of adult patients with URTI in Nanjing from October 2021 to September 2022 were collected. Clinical specimens were collected and subjected to quantitative reverse transcription polymerase chain reaction (qRT-PCR) for the detection of 14 common respiratory viruses. The VP4/VP2 genes in HRV-positive samples were amplified and sequenced. Then a phylogenetic tree was constructed.Results:A total of 399 pharyngeal swabs were collected from patients with URTI. The overall positive rate of respiratory viruses was 28.07% (112/399) with HRV accounting for most at 9.52% (38/399). Thirty-seven VP4/VP2 sequences were successfully obtained from the 38 HRV-positive specimens. Three genotypes involving 25 serotypes were identified with 13 strains belonging to HRV-A, 14 belonging to HRV-B, and 10 belonging to HRV-C. The three genotypes of HRV showed alternate prevalence or co-prevalence.Conclusions:HRV was the main pathogen causing URTI in adult patients in Nanjing from October 2021 to September 2022, and three genotypes of HRV-A, B and C were prevalent alternatively or together.
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Objective:To analyze the detection rate of respiratory syncytial virus(RSV)and human rhinovirus(HRV), in different months and age groups, and the clinical characteristics in children in eastern Guangdong from 2019 to 2020.Methods:Pharyngeal swabs were collected from 6 658 children with respiratory tract infections hospitalized in the Second Affiliated Hospital of Shantou University Medical College from January 2019 to December 2020, and respiratory pathogen nucleic acid was detected.The detection rate, month distribution, age group distribution, and clinical characteristics of single RSV as well as single HRV positive cases were analyzed and compared.Results:There were 416 single RSV positive cases(6.25%)and 341 single HRV positive cases(5.12%).The detection rates of RSV was higher than those of HRV, and the difference was statistically significant( χ2=7.880, P<0.05).The detection rates of HRV in March, April, November and December were higher than those of RSV, and the detection rates of RSV in July, August and September were higher than those of HRV, with statistically significant difference( P<0.05).The highest detection rate of RSV was in the age group of ≤6 months with a detection rate of 13.47%(192/1 425), which gradually decreased with age, and the difference was statistically significant( P<0.01).The detection rates of HRV fluctuated between 4.21% and 6.13% in each age group, and the differences among the detection rates of each age group were not statistically significant( P>0.05).All RSV-positive cases showed cough, while 77.13%(263/341)of HRV-positive cases showed cough, with a statistically significant difference( P<0.001).The incidence of wheezing in RSV-positive cases was 37.26%(155/416)compared with 28.45%(97/341)in HRV-positive cases, with a higher incidence of wheezing in RSV than that in HRV, and the difference was statistically significant( P<0.05).In terms of indicators to assess severe pneumonia, RSV-positive cases showed a higher proportion of increased respiratory rate, decreased oxygen saturation or dyspnea than HRV-positive cases, and all differences were statistically significant( P<0.05). Conclusion:The detection rate of single RSV is higher than that of single HRV in children with respiratory infections in eastern Guangdong from 2019 to 2020.The epidemic season of RSV is mainly in autumn, and the epidemic season of HRV is mainly in winter and spring.RSV is more susceptible up to 6 months of age, and the detection rate decreases gradually with age, and there is no significant difference in the detection rate of HRV by age.RSV-positive cases are more likely to have cough and wheeze.RSV-positive cases are more likely to have increased respiratory rate, decreased oxygen saturation, or respiratory distress.
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Abstract Objective: Changes in the epidemiology of respiratory infections during the restrictions imposed as a response to the coronavirus disease 2019 (COVID-19) pandemic have been reported elsewhere. The present study's aim was to describe the prevalence of a large array of respiratory pathogens in symptomatic children and adolescents during the pandemic in Southern Brazil. Methods: Hospitalized and outpatients aged 2 months to 18 years with signs and symptoms of acute COVID-19 were prospectively enrolled in the study from May to November 2020 in two hospitals in a large metropolitan area in a Brazilian city. All participants performed a real-time PCR panel assessing 20 respiratory pathogens (three bacteria and 17 viruses). Results: 436 participants were included, with 45 of these hospitalized. Rhinovirus was the most prevalent pathogen (216/436) followed by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2, 97/436), with a coinfection of these two viruses occurring in 31/436 participants. The remaining pathogens were found in 24 symptomatic participants (adenovirus, n = 6; Chlamydophila pneumoniae, n = 1; coronavirus NL63, n = 2; human enterovirus, n = 7; human metapneu-movirus, n = 2; Mycoplasma pneumoniae, n = 6). Hospitalization was more common among infants (p = 0.004) and those with pathogens other than SARS-CoV-2 (p = 0.001). Conclusion: During the period of social distancing in response to COVID-19, the prevalence of most respiratory pathogens was unusually low. Rhinovirus remained as the main virus co-circulating with SARS-CoV-2. COVID-19 in symptomatic children was less associated with hospitalization than with other respiratory infections in children and adolescents.
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Abstract Objectives: To detect RSV or other thirteen respiratory viruses as possible causer agent of bronchiolitis in infants. Method: This is an epidemiological analytical study, conducted using a nasopharyngeal aspirate of 173 hospitalized children younger than two years old with severe bronchiolitis in three hospitals in the Campinas Metropolitan Region (CMR) during 2013-14. The data was statically evaluated by Pearson's chi-squared test with statistical significance of 0.05 and 95% confidence level. Results: As expected, the most prevalent viruses detected were RSV A and B in 47% and 16% of the samples, respectively. However, almost a third of severe bronchiolitis cases there were no detection of RSV, and the viruses more commonly detected were rhinoviruses, which were identified in almost a quarter of all positive samples for at least a viral agent. Conclusions: Although nothing could be concluded from the disease severity and clinicalepidemiological data, the present study's results indicate that severe bronchiolitis is not always related to RSV infections in children younger than two years old, and the rhinoviruses were more prevalent in these cases. These findings reinforce the need to carry out a
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Resumen Introducción: las infecciones respiratorias agudas virales se consideran una de las principales causas de mortalidad y morbilidad en pediatría, El Síndrome Respira torio Agudo Severo o Grave 2 (SARS-CoV-2), se ha convertido en un importante problema para la salud pública mundial por su alta transmisibilidad, el objetivo del estudio es describir el comportamiento de los virus respiratorios detectados por RT-PCR en niños hospitalizados por infección respiratoria aguda (IRA) en tiempos de SARS-CoV-2/COVID-19 en un centro de atención pediátrica de Cali-Colombia. Metodología: Estudio observacional de corte transversal retrospectivo, donde se evaluaron 113 pacientes mayores de 28 días y menores de 18 años entre marzo y noviembre del 2020, hospitalizados con diagnostico confirmado IRA y con Reacción en cadena de la polimerasa en tiempo Real (RT-PCR) positiva para virus respiratorios. Resultados: Predominio del género masculino (64.6%). en 74.3% se diagnosticó con IRA baja, los principales síntomas fueron tos en 92% y fiebre 74.3% Se identificó SARS-CoV-2 en 53%, Human Rhinovirus/Enterovirus en 27.41% y Virus Respiratorio Sincitial en 15%. El 34.5% de los pacientes requirieron unidad de cuidados intensivos y 15.9% ventilación mecánica Conclusiones: La infección por SARS-CoV-2 fue más común en los pacientes hospitalizados tanto en salas generales como en la unidad de cuidados intensivos pediátricos
Abstract Introduction: viral acute respiratory infections have been considered of the main causes of mortality and morbidity in pediatrics, severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), which has become an important problem for global public health for its high transmissibility. The objective of the study is to describe the behavior of respiratory viruses detected by RT-PCR in children hospitalized for acute respiratory infection (ARI) in times of SARS-CoV-2 / COVID19 in pediatric care center in Cali Colombia Methodology: observational with a retrospective cross-sectional study. 113 patients older than 28 days and under 18 years in March to November 2020, hospita lized with a confirmed diagnosis of ARI and Real Time Polymerase Chain Reaction (RT-PCR) positive for respiratory viruses. Results: Predominance of gender male 64.6%. 74.3% with a diagnosis of low ARI, main symptoms presented were cough 92% and fever 74.3%, SARS-CoV-2 identified 53%, Human Rhinovirus / Enterovirus 27.41% and Respiratory Syncytial Virus 15%. 34.5% of the patients required an intensive care unit with mechanical ventilation requirement 15.9% Conclusions: infection by SARS-CoV-2 was more common in hospitalized patients in both general wards as in the pediatric intensive care unit.
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Objective To investigate the epidemiological characteristics of an outbreak of respiratory tract infection caused by human rhinovirus （HRV） in a school in Nanxun District of Huzhou City， and provide scientific evidence for prevention and control of outbreaks of upper respiratory tract infection caused by HRV in the future. Methods The investigation was performed according to the Guidelines for Response to Outbreaks of Influenza-like Illness （2018 version）. It mainly referred to the records of nonattendance due to illness， morning and afternoon examination， and hospital treatment records， to search for cases. Then CDC staffs carried out epidemiological investigation on cases， interviewed the head teacher， and inspected the site. Throat swabs were collected for detection of SARS-CoV-2 and subsequently 14 common viruses that may cause upper respiratory tract infection. Results A total of 68 cases with HRV infection were identified. The first case and last case occurred on May 20 and 30， respectively. After a 3-day longest incubation period， there was no emerging case， suggesting the end of the outbreak. The incidence was 25.00% （11/44） in Class 101， 30.23% （13/43） in Class 109， 25.58% （11/43） in Class 110， 35.26% （16/45） in Class 211， and 39.96% （17/46） in Class 307. There was no significant difference in the incidence among classes （ χ 2=1.67， P >0.05）. The patients aged from 7 to 9 years. The incidence was 27.19% （31 / 114） in male and 34.58% （37/107） in female， with no significant difference （ χ 2=1.41， P >0.05）. The symptoms were mild， with no hospitalization， severe illness or death. The patients had mainly cough （100.00%）， sore throat （61.76%）， and runny nose （47.06%）， whereas had little muscle soreness （4.41%）. Of the patients， 69.12% visited hospitals， 23.53% took medicine by themselves， while 7.35% did not seek any medical treatment or medicine. Throat swabs were collected from 22 cases， testing negative for SARS-CoV-2. Then 14 common respiratory viruses were examined， of which HRV was positive in 16 cases. Conclusion Children with HRV infection have milder symptoms compared to influenza infection， which is difficult to be noticed by school teachers and parents. Students should maintain personal hygiene and develop health habits. Moreover， schools should strength relevant health education， implement morning and afternoon health inspection， and prevent students with illness to routinely go to schools.
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Objective To investigate the epidemiological characteristics of an outbreak of respiratory tract infection caused by human rhinovirus （HRV） in a school in Nanxun District of Huzhou City， and provide scientific evidence for prevention and control of outbreaks of upper respiratory tract infection caused by HRV in the future. Methods The investigation was performed according to the Guidelines for Response to Outbreaks of Influenza-like Illness （2018 version）. It mainly referred to the records of nonattendance due to illness， morning and afternoon examination， and hospital treatment records， to search for cases. Then CDC staffs carried out epidemiological investigation on cases， interviewed the head teacher， and inspected the site. Throat swabs were collected for detection of SARS-CoV-2 and subsequently 14 common viruses that may cause upper respiratory tract infection. Results A total of 68 cases with HRV infection were identified. The first case and last case occurred on May 20 and 30， respectively. After a 3-day longest incubation period， there was no emerging case， suggesting the end of the outbreak. The incidence was 25.00% （11/44） in Class 101， 30.23% （13/43） in Class 109， 25.58% （11/43） in Class 110， 35.26% （16/45） in Class 211， and 39.96% （17/46） in Class 307. There was no significant difference in the incidence among classes （ χ 2=1.67， P >0.05）. The patients aged from 7 to 9 years. The incidence was 27.19% （31 / 114） in male and 34.58% （37/107） in female， with no significant difference （ χ 2=1.41， P >0.05）. The symptoms were mild， with no hospitalization， severe illness or death. The patients had mainly cough （100.00%）， sore throat （61.76%）， and runny nose （47.06%）， whereas had little muscle soreness （4.41%）. Of the patients， 69.12% visited hospitals， 23.53% took medicine by themselves， while 7.35% did not seek any medical treatment or medicine. Throat swabs were collected from 22 cases， testing negative for SARS-CoV-2. Then 14 common respiratory viruses were examined， of which HRV was positive in 16 cases. Conclusion Children with HRV infection have milder symptoms compared to influenza infection， which is difficult to be noticed by school teachers and parents. Students should maintain personal hygiene and develop health habits. Moreover， schools should strength relevant health education， implement morning and afternoon health inspection， and prevent students with illness to routinely go to schools.
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Objective:To analyze the epidemiological characteristics and genotypes of human rhinovirus (HRV) in patients with upper respiratory tract infection in Qingdao in the winter of 2020.Methods:Throat swab samples were collected from 101 patients with upper respiratory tract infection in Qingdao from November 2020 to January 2021. Quantitative PCR was used to detect 15 common respiratory viruses in the samples. HRV-positive samples were further analyzed with RT-PCR to amplify and sequence HRV VP4/VP2 gene. A phylogenetic tree was constructed based on the sequencing results and homology analysis was conducted.Results:Six common respiratory viruses were detected in the 101 patients. Thirty-four cases (34/101, 33.66%) were single pathogen infection and two cases were multiple infection (2/101, 1.98%). The positive rate of HRV was the highest (21.78%, 22/101). Twenty HRV VP4/VP2 sequences were successfully amplified. Phylogenetic analysis showed that there were 16 strains of HRV-A subtype and four strains of HRV-C subtype and 14 serotypes were involved.Conclusions:HRV was one of the leading viral pathogens causing upper respiratory tract infection in Qingdao in the winter of 2020 and the predominant subtype was HRV-A.
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Objective:To investigate the detection, epidemiological and clinical characteristics of human rhinovirus(HRV) in hospitalized children with respiratory tract infections.Methods:The study population comprised of 10 514 children with respiratory tract infections admitted to Department of Respiration, the Children′s Hospital of Soochow University, between January 2013 and December 2019.The nasopharyngeal aspirates and medical history were obtained by qualified medical personnel.Reverse transcription-polymerase chain reaction method was used to test HRV.Results:The total positive rate of human rhinovirus was 14.2%(1 493/10 514), and there was no significant difference between male and female( χ2=2.006, P=0.157). The positive rates from 2013 to 2019 were 9.7%, 14.6%, 19.1%, 18.6%, 18.1%, 11.0%, 11.4% respectively, and there were significant differences among these groups( χ2=116.580, P<0.001). HRV distributed throughout the year with a peak in summer and autumn(June to November), followed by spring, and the lowest in winter.The detection rates of HRV infection rates were 14.2%, 15.5%, 13.5% and 9.8% in the age group of 28 d~6 months, ~2 years, ~7 years and>7 years respectively, and there were significant differences among these age groups( χ2=16.124, P<0.001). The detection rate of HRV in children under 2 years was higher( χ2=7.711, P=0.005). The clinical characteristics of HRV infection were fever, cough, wheezing and even dyspnea.Bronchopneumonia had the highest percentage(68.9%), followed by bronchitis(13.2%). Compared with non-coinfection group, patients with coinfection with other viruses were more prone to wheezing and pulmonary rales( χ2=9.483, 10.821, P=0.024, 0.013), and coinfection with mycoplasma was more likely to cause fever and lobar pneumonia( χ2=51.585、96.060, P all<0.001); 57.8% presented leukocytosis, while 15.6% showed a higher CRP(>15 mg/ml). The increase of CRP and leukocytosis were more obvious in children under 2 years of age( χ2=26.097, 55.973, P all<0.001). Conclusion:HRV was a major viral pathogen of RTIs in recent 7 years, distributing throughout the year with a peak in summer and autumn, mainly involving children under 2 years of age.The clinical features were diverse, and the clinical symptoms were severe in childhood coinfections with other pathogens.
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ABSTRACT This study aims to assess COVID-19 and other respiratory viruses in pediatric patients. Between April 17 and September 30, 2020, we collected 1,566 respiratory samples from 1,044 symptomatic patients who were younger than 18 years old to assess SARS-CoV-2 infection. Of these, 919 were analyzed for other respiratory pathogens (ORP). Patients with laboratory-confirmed COVID-19 or ORP were included. We evaluated 76 pediatric COVID-19 infections and 157 other respiratory virus infections. Rhinovirus occurred in 132/157 (84%). COVID-19 patients who were significantly older, had more fevers, headaches and pneumonia than those with ORP. The median white blood cell count was lower in patients with SARS-CoV-2 than in those with ORP (6,470 versus 8,170; p=0.02). COVID-19 patients had significantly worse symptoms than those with ORP.
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RESUMEN Introducción: La Bronquiolitis se ha asociado a sibilancias recurrentes. Objetivo: analizar la incidencia de sibilancias recurrentes, hospitalizaciones y atopia/asma en pacientes con antecedentes de hospitalización por bronquiolitis por RV antes de los 12 meses de edad. Materiales y Métodos: estudio de cohorte retrospectiva. Ingresaron pacientes de 2 a 4 años con sibilancias recurrentes y antecedentes de hospitalización por bronquiolitis antes de los 12 meses de edad, con retorno viral positivo por estudio molecular. Fueron estudiados los datos demográficos, hospitalizaciones, atopia personal y familiar, asma y exposición al humo. Los datos fueron analizados en SPSS utilizando estadísticas descriptivas e inferenciales. Los resultados se expresaron en RR con IC 95%. El protocolo fue aprobado por el comité de ética institucional. Resultados: Ingresaron 120 pacientes. No hubo diferencias en la incidencia de sibilancias recurrentes en el grupo expuesto y el control50,9% vs 49% respectivamente p=0,85. Las hospitalizaciones por sibilancias y la presencia de atopia fueron más frecuentes en el grupo Rinovirus, RR=1,7 (IC 95% 1,2 -2,9) p=0,03 y RR 1,6 (IC 95% 1,2 -2,2) p= 0,005 respectivamente. Conclusiones: la incidencia de sibilancias recurrentes fue similar en ambas cohortes. Las hospitalizaciones por sibilancias y la atopia/asma fue mayor en el grupo Rinovirus.
ABSTRACT Introduction: Bronchiolitis has been associated with recurrent wheezing. Objective: to analyze the incidence of recurrent wheezing, hospitalizations and atopy / asthma in patients with a history of hospitalization for rhinovirus (RV) bronchiolitis before 12 months of age. Materials and Methods: this was a retrospective cohort study. We included patients aged 2 to 4 years with recurrent wheezing and a history of hospitalization for bronchiolitis before 12 months of age, with a positive viral testing by molecular study. Demographic data, hospitalizations, personal and family history of atopy, asthma and exposure to smoke were studied. The data were analyzed in SPSS using descriptive and inferential statistics. The results were expressed in RR with 95% CI. The protocol was approved by the institutional ethics committee. Results: 120 patients were included. There were no differences in the incidence of recurrent wheezing in the exposed and control groups, 50.9% vs 49%, respectively, p = 0.85. Hospitalizations for wheezing and the presence of atopy were more frequent in the Rhinovirus group, RR = 1.7 (95% CI 1.2 -2.9) p = 0.03 and RR 1.6 (95% CI 1, 2 -2.2) p = 0.005 respectively. Conclusions: the incidence of recurrent wheezing was similar in both cohorts. Hospitalizations for wheezing and atopy / asthma were higher in the Rhinovirus group.
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Objective:To research the metabolomic alterations of human lung bronchial epithelial cells infected with human rhinovirus 1B (HRV1B).Methods:Untargeted metabolomics was used to determine the metabolomic alterations in human lung bronchial epithelial cells (BEAS-2B) 6 h, 12 h and during the dynamic process (6 h∶12 h) after HRV1B infection.Results:A total of 93 differentially significant metabolites (DSMs) (47 DSMs were up-regulated and 46 DSMs were down-regulated) and 88 DSMs (37 DSMs were up-regulated and 51 DSMs were down-regulated) at post infection of HRV1B in BEAS-2B at 6 h or 12 h, respectively. A total of 30 DSMs (12 DSMs were up-regulated and 18 DSMs were down-regulated) in a dynamic process (6 h∶12 h) after HRV1B infection. Unknown metabolites took up most proportions. The trends of fatty acid, lipid, amino acid, nucleotide and carbohydrate were increased along with the prolonging of HRV1B infection. DSMs such as Diisononyl phthalate was co-detected DSMs among three groups.Conclusions:Metabolites such as fatty acid, lipid, amino acid, nucleotide and carbohydrate of BEAS-2B cells are changed induced by HRV1B infection.
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Rhinovirus(RV)is the most common respiratory virus that can cause infectious diseases of the upper and lower respiratory tract, such as the common cold and bronchiolitis.Among them, bronchiolitis is the main cause of wheezing attacks in infants under 2 years old, and the prevalence is increasing year by year.Early research believed that the main etiology was respiratory syncytial virus(RSV), but in recent years, more and more bronchiolitis has been found that caused by rhinovirus infection.This article takes rhinovirus-infected bronchiolitis as the entry point, and reviews its epidemiological characteristics, pathogenesis, clinical manifestations, auxiliary examination, treatment and prevention.
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Respiratory viruses can cause a variety of serious respiratory infections and diseases of tissues and organs outside the respiratory tract, raising a potentially severe threat to the society.Virus replication and survival rely on the internal mechanism of host cells, and the latter also produce a variety of restriction factors that target viral invasion, genome transcription and replication, and assembly and release to block viral infection.Herein, this study reviewed the research progress of the antiviral effects of the host restriction factors of common respiratory viruses and their underlying mechanisms.
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Objective:To analyze the dominant genotypes and epidemic characteristics of human rhinovirus (HRV) in pediatric community-acquired pneumonia (CAP) in China.Methods:Between June 2017 to December 2019, throat swabs or nasopharyngeal aspirates were collected from pediatric CAP patients hospitalized in 6 medical institutions in Southern and Northern China (bounded by Qinling and Huaihe River), respectively.A total of 16 species of common respiratory viruses were screened using respiratory pathogen detection kits.Samples with positive HRV were genotyped for further epidemiological analysis.Results:The total detection rate of HRV in pediatric CAP (2 913 cases) was 12.2%(356 cases) in this study, which was 10.3%(145/1 410 cases) and 14.0%(211/1 503 cases) in Northern and Southern China, respectively.The detection rate of HRV in the Southern region was significantly higher than that in the Northern region, the difference was statistically significant( χ2=9.562, P=0.002). Epidemiological analysis showed that the distribution of HRV-positive cases in the Northern region was similar in all age groups, while 90.5% of positive cases in the Southern region were infants under 3 years.Classified by seasonal distribution, HRV-positive cases in the Northern region were mainly distributed in summer and autumn, while those in the Southern region were mainly distributed in spring and autumn.The coinfection rate of HRV and other pathogens was 40.7%, which was significantly higher in the Southern region than that of Northern region (49.0% vs.28.0%), the difference was statistically significant( χ2=15.801, P<0.001). The most common pathogens mixed with HRV were respiratory syncytial virus (RSV), human boca virus (HBOV) and parainfluenza virus type Ⅲ (PIV3) in the Northern region, with the mixed infection rate of 5.0%, 5.0% and 4.0%, respectively, which were RSV, PIV3 and human metapneumovirus (HMPV) in the Southern region, with the mixed infection rate of 9.0%, 7.0% and 6.0%, respectively.The genotyping results showed that all three HRV genotypes were detected.HRV-A (118/220 cases) was the dominant genotype, followed by HRV-C(82/220 cases). Conclusions:The detection rate of HRV in pediatric CAP cases is 12.2% in this study.There are significant differences in age and seasonal distribution of HRV-positive cases in the Southern and Northern regions.Coinfection of HRV and other pathogens is detected.The coinfection rate is significantly higher in the Southern region than that in the Northern region.HRV-A is the dominant genotype, followed by HRV-C.
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OBJECTIVE: The relationship between viral load and the clinical evolution of bronchiolitis is controversial. Therefore, we aimed to analyze viral loads in infants hospitalized for bronchiolitis. METHODS: We tested for the presence of human respiratory syncytial virus (HRSV) or human rhinovirus (HRV) using quantitative molecular tests of nasopharyngeal secretions and recorded severity outcomes. RESULTS: We included 70 infants [49 (70%) HRSV, 9 (13%) HRV and 12 (17%) HRSV+HRV]. There were no differences among the groups according to the outcomes analyzed individually. Clinical scores showed greater severity in the isolated HRSV infection group. A higher isolated HRSV viral load was associated with more prolonged ventilatory support, oxygen therapy, and hospitalization days, even after adjustment for the age and period of nasopharyngeal secretion collection. In the co-infection groups, there was a longer duration of oxygen therapy when the HRSV viral load was predominant. Isolated HRV infection and co-infection with a predominance of HRV were not associated with severity. CONCLUSION: Higher HRSV viral load in isolated infections and the predominance of HRSV in co-infections, independent of viral load, were associated with greater severity. These results contribute to the development of therapeutic and prophylactic approaches and a greater understanding of the pathophysiology of bronchiolitis.
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Humans , Infant , Bronchiolitis , Bronchiolitis, Viral , Respiratory Syncytial Virus, Human , Coinfection , Oxygen , Viral Load , HospitalizationABSTRACT
Introducción: La idea de exclusión competitiva es indiscutible cuando se trata de animales y bacterias que intentan ocupar el mismo nicho ecológico, pero su aplicación a la coinfección viral no es tan sencilla de interpretar. La interferencia viral es un fenómeno en el que un virus suprime competitivamente la replicación de otros virus coinfectantes y es el resultado más común de las coinfecciones virales. Objetivo: Comprender mejor el comportamiento de las infecciones respiratorias concomitantes en escenarios de brotes comunitarios y de forma individual en entornos hospitalarios e individuos con comorbilidades. Métodos: Se realizó una búsqueda de información en las bases de datos MEDLINE / PubMed, SciELO y LILACS. También se consideraron artículos publicados en el repositorio de preimpresión medRxiv y los informes de los Centros para el Control y Prevención de enfermedades de los Estados Unidos de América. Mediante el gestor de referencias Mendeley, se eliminaron los duplicados y aquellos que no se ajustaban al objetivo del estudio, seleccionando 48 artículos para la revisión. Análisis y síntesis de la in formación: En la literatura científica se encontró evidencia que sustenta la exclusión competitiva viral entre virus relacionados que comparten células susceptibles y permisivas. Conclusión: La exclusión competitiva impide que dos virus que comparten rutas de transmisión similares y el mismo órgano diana, infecten no sólo al mismo tiempo, sino que también se propaguen con éxito. Por lo tanto, la sindemia producida por virus que comparten estas características podría ser un evento improbable(AU)
Introduction: The idea of competitive exclusion is undisputed when it comes to animals and bacteria trying to occupy the same ecological niche, but its application to viral coinfection is not so simple to interpret. Viral interference is a phenomenon in which one virus competitively suppresses the replication of other co-infecting viruses and is the most common outcome of viral co-infections. Objective: To better understand the behavior of concomitant respiratory infections in community outbreak settings and individually in hospital settings and individuals with comorbidities. Methods: A search for information was performed in the MEDLINE / PubMed, SciELO and LILACS databases. Articles published in the preprint repository medRxiv and reports from the US Centers for Disease Control and Prevention were also considered. Using the Mendeley reference manager, duplicates and those that did not fit the study objective were eliminated, selecting 48 articles for the review. Analysis and synthesis of information: Evidence supporting viral competitive exclusion between related viruses sharing susceptible and permissive cells was found in the scientific literature. Conclusion: Competitive exclusion prevents two viruses that share similar transmission routes and the same target organ from infecting not only at the same time, but also from spreading successfully. Therefore, syndemia produced by viruses sharing these characteristics could be an unlikely event(AU)