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Objective: To explore the pathogen composition and distribution characteristics of pathogens in respiratory samples from patients with fever of unknown origin. Methods: A total of 96 respiratory samples of patients with unknown cause fever with respiratory symptoms were collected from four hospitals above grade II in Shijiazhuang area (Hebei Provincial Hospital of Traditional Chinese Medicine, Luancheng District People's Hospital, Luquan District People's Hospital, Shenze County Hospital) from January to April 2020, and multiplex-fluorescent polymerase chain reaction(PCR)was used to detect influenza A virus, influenza B virus, enterovirus, parainfluenza virus I/II/III/IV, respiratory adenovirus, human metapneumovirus, respiratory syncytial virus, human rhinovirus, human bocavirus, COVID-19, Mycoplasma pneumoniae, Chlamydia pneumoniae, Legionella pneumophila, Pseudomonas aeruginosa, Streptococcus pneumoniae, Klebsiella pneumoniae, Group A streptococcus, Haemophilus influenzae, Staphylococcus aureus nucleic acid detection, the results were analyzed for chi-square. Results: A total of 8 pathogens were detected in the upper respiratory tract samples of 96 fever patients, including 1 kind of virus, 6 kinds of bacterias, and Mycoplasma pneumoniae. There were 12 viruses including influenza virus and parainfluenza virus, Legionella pneumophila and Chlamydia pneumoniae were not detected. The pathogen detection rates in descending order were Streptococcus pneumoniae (58/96, 60.42%), Haemophilus influenzae(38/96, 39.58%), Klebsiella pneumoniae (14/96, 14.58%), Staphylococcus aureus (10/96, 10.42%), Mycoplasma pneumoniae (8/96, 8.33%), Pseudomonas aeruginosa (6/96, 6.25%), Group A streptococcus (4/96, 4.17%) and human rhinovirus (2/96, 2.08%). The proportions of single-pathogen infection and multi-pathogen mixed infection in fever clinic patients were similar, 41.67% (40/96) and 45.83% (44/96), respectively, and 12.50% (12/96)of the cases had no pathogens detected. The infection rate of Mycoplasma pneumoniae in female patients with fever (21.43%) was higher than that in male patients with fever (2.94%) (P < 0.05). There was no statistical difference between the distribution of of other pathogens and gender and age(P > 0.05). Conclusions: The upper respiratory tract pathogens were mainly bacterial infections, and occasional human rhinovirus and Mycoplasma pneumonia infections. In clinical diagnosis and treatment, comprehensive consideration should be given to the pathogen detection.
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Background: Acute respiratory tract infections (ARTIs) are common and may lead to complications. Most children experience between three and six ARTIs annually. Although most infections are self-limiting, symptoms can be distressing. Many treatments are used to control symptoms and shorten illness duration. Most treatments have minimal benefit and may lead to adverse events. Oral homeopathic medicinal products could play a role in childhood ARTI management if evidence for their effectiveness is established. This is an update of a review first published in 2018. Objectives: To assess the effectiveness and safety of oral homeopathic medicinal products compared with placebo or conventional therapy to prevent and treat ARTIs in children. Search methods: We searched CENTRAL (2022, Issue 3), including the Cochrane Acute Respiratory Infections Specialised Register, MEDLINE (1946 to 16 March 2022), Embase (2010 to 16 March 2022), CINAHL (1981 to 16 March 2022), AMED (1985 to 16 March 2022), CAMbase (searched 16 March 2022), and British Homeopathic Library (searched 26 June 2013- no longer operating). We also searched the WHO ICTRP and ClinicalTrials.gov (16 March 2022), checked references, and contacted study authors to identify additional studies. Selection criteria: We included double-blind randomised controlled trials (RCTs) or double-blind cluster-RCTs comparing oral homeopathy medicinal products with identical placebo or self-selected conventional treatments to prevent or treat ARTIs in children aged 0 to 16 years. Data collection and analysis: We used standard methodological procedures expected by Cochrane. Main results: In this 2022 update, we identified three new RCTs involving 251 children, for a total of 11 included RCTs with 1813 children receiving oral homeopathic medicinal products or a control treatment (placebo or conventional treatment) for ARTIs. All studies focused on upper respiratory tract infections (URTIs), with only one study including some lower respiratory tract infections (LRTIs). Six treatment studies examined the effect on URTI recovery, and five studies investigated the effect on preventing URTIs after one to four months of treatment. Two treatment and three prevention studies involved homeopaths individualising treatment. The other studies used predetermined, non-individualised treatments. All studies involved highly diluted homeopathic medicinal products, with dilutions ranging from 1 x 10-4 to 1 x 10-200. We identified several limitations to the included studies, in particular methodological inconsistencies and high attrition rates, failure to conduct intention-to-treat analysis, selective reporting, and apparent protocol deviations. We assessed three studies as at high risk of bias in at least one domain, and many studies had additional domains with unclear risk of bias. Four studies received funding from homeopathy manufacturers;one study support from a non-government organisation;two studies government support;one study was co-sponsored by a university;and three studies did not report funding support. Methodological inconsistencies and significant clinical and statistical heterogeneity precluded robust quantitative meta-analysis. Only four outcomes were common to more than one study and could be combined for analysis. Odds ratios (OR) were generally small with wide confidence intervals (CI), and the contributing studies found conflicting effects, so there was little certainty that the efficacy of the intervention could be ascertained. All studies assessed as at low risk of bias showed no benefit from oral homeopathic medicinal products, whilst trials at unclear or high risk of bias reported beneficial effects. For the comparison of individualised homeopathy versus placebo or usual care for the prevention of ARTIs, two trials reported on disease severity;due to heterogeneity the data were not combined, but neither study demonstrated a clinically significant difference. We combined data from two trials for the outcome need for antibiotics (OR 0.79, 95% CI 0.35 to 1.76;low-certainty evi
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The coronaviruses belong to the family Coronaviridae in the order Nidovirales. CoVs are found globally and infect a variety of animals, causing illnesses that range from gastrointestinal tract infections, encephalitis and demyelination;and can be fatal. Humans coronaviruses (hCoVs) have traditionally been associated with self-limiting upper respiratory tract infections and gastrointestinal tract infections. In recent years, however, it has become increasingly evident that the hCoVs can cause more severe lower respiratory tract infections such as bronchitis, pneumonia and even acute respiratory distress syndrome (ARDS), and can lead to death. Seven CoVs are known to infect humans, with the four "common cold” CoVs circulating globally on a yearly basis. The remaining three are more pathogenic and have resulted in outbreaks with high mortality rates. This review focussed on the three pathogenic CoVs. © 2022 Elsevier Inc. All rights reserved.
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Whole-genome sequencing of upper respiratory tract specimens from patients with confirmed COVID-19 in Henan Province was performed to compare the performance of the Illumina and Oxford Nanopore sequencing platforms, thus providing a reference for whole-genome monitoring of the novel coronavirus (SARS-CoV-2). Ten samples from COVID-19 cases in Henan Province from June 2021 to January 2022 were collected and sequenced with Illumina and Nanopore high-through-put sequencing technology to obtain full genome sequences of the novel coronavirus, which were compared with the Wuhan reference sequence (Wuhan-Hu-1). Bioinformatics software (CLC) was used for sequence alignment analysis. Three of the ten samples were Omicron (BA.1) variants with 55,61 nucleotide variation sites. One sample was an Alpha (B.1.1.7) variant with 41 nucleotide variation sites. Six samples were Delta (8.1.617.2) variants with 35,42,47 nucleotide variation sites. The sequence identity of mutation sites in six samples was 100%, and the mutation sites in the S genome segment of seven samples were consistent. For samples with a Ct value < 33, both next-generation and third-generation sequencing achieved high genome coverage and sequencing depth. A significant difference in coverage was observed between second-generation sequencing and third-generation sequencing (t=-2.037, P < 0.06). However, the coverage at different time points of the third-generation sequencing did not significantly differ (F=2.498, P > 0.05). The needs for SARS-CoV-2 mutant detection could be met through use of either high-throughput sequencing platform. The identification of mutations in the novel coronavirus through Illumina high-throughput sequencing was more accurate, whereas Nanopore high-throughput sequencing technology could be used for rapid detection and typing of different novel coronaviruses.
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Background: Patients diagnosed with influenza and upper respiratory tract infections (URTIs) have similar clinical manifestations and biochemical indices and a low detection rate of viral pathogens, mixed infection with diverse respiratory viruses, and targeted antiviral treatment difficulty in the early stage. According to the treatment strategy of "homotherapy for heteropathy" in traditional Chinese medicine (TCM), different diseases with the same clinical symptoms can be treated with the same medicines. Qingfei Dayuan granules (QFDY), a type of Chinese herbal preparation included in the TCM Diagnosis and Treatment Protocol for COVID-19 of Hubei Province issued by the Health Commission of Hubei Province in 2021, are recommended for patients suffering from COVID-19 with symptoms of fever, cough, and fatigue, among others. Additionally, recent studies have shown that QFDY effectively alleviates fever, cough, and other clinical symptoms in patients with influenza and URTIs. Materials and methods: The study was designed as a multicenter, randomized, double-blind, placebo-controlled clinical trial for treatment for influenza and URTIs manifested by pulmonary heat-toxin syndrome (PHTS) with QFDY. A total of 220 eligible patients were enrolled from eight first-class hospitals in five cities of Hubei Province in China and randomly assigned to receive either 15 g of QFDY or a placebo three times a day for 5 days. The primary outcome was the complete fever relief time. Secondary outcomes included efficacy evaluation of TCM syndromes, scores of TCM syndromes, cure rate of each single symptom, incidence of comorbidities and progression to severe conditions, combined medications, and laboratory tests. Safety evaluations mainly involved adverse events (AEs) and changes in vital signs during the study. Results: Compared with the placebo group, the complete fever relief time was shorter in the QFDY group, 24 h (12.0, 48.0) in the full analysis set (FAS) and 24 h (12.0, 49.5) in the per-protocol set (PPS) (p ≤ 0.001). After a 3-day treatment, the clinical recovery rate (22.3% in the FAS and 21.6% in the PPS) and cure rate of cough (38.6% in the FAS and 37.9% in the PPS), a stuffy and running nose, and sneezing (60.0% in the FAS and 59.5% in the PPS) in the QFDY group were higher than those in the placebo group (p < 0.05). The number of patients taking antibiotics for more than 24 h in the placebo group (nine cases) was significantly higher than that in the QFDY group (one case) (p < 0.05). There were no significant differences between the two groups in terms of scores of TCM syndromes, incidence of comorbidities or progression to severe conditions, combined use of acetaminophen tablets or phlegm-resolving medicines, and laboratory tests (p > 0.05). Meanwhile, no significant difference was found in the incidence of AEs and vital signs between the two groups (p > 0.05). Conclusion: The trial showed that QFDY was an effective and safe treatment modality for influenza and URTIs manifested by PHTS because it shortened the complete fever relief time, accelerated clinical recovery, and alleviated symptoms such as cough, a stuffy and running nose, and sneezing during the course of treatment. Clinical trial registration: https://www.chictr.org.cn/showproj.aspx?proj=131702, identifier ChiCTR2100049695.
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BACKGROUND: When children have a preoperative fever, anesthesiologists must help determine whether to postpone or proceed with surgery, as fever may be a sign of upper respiratory tract infection (URTI). Such infections are a known risk factor for perioperative respiratory adverse events (PRAEs), which are still one of the prime causes of anesthetic mortality and morbidity in pediatric patients. Since the COVID-19 pandemic, preoperative assessments have become drastically more complex as hospitals strive to balance practicality and safety. In our facility, if pediatric patients presented with preoperative fever, we used the FilmArray® Respiratory Panel 2.1 to determine whether to postpone or proceed with surgery. METHODS: This is a single-center retrospective observational study evaluating the efficacy of the FilmArray® Respiratory Panel 2.1 as a preoperative screening test. This study included pediatric patients scheduled for elective surgeries between March 2021 and February 2022. FilmArray was used if a patient had a preoperative fever (determined by axillary temperature, ≥38°C for <1-year-old, ≥37.5°C for ≥1-year-old) between hospital admission and before surgery. We excluded patients if they had apparent symptoms of URTI. RESULTS: In the FilmArray positive group, 11 of 25 (44%) cases developed subsequent symptoms after surgery was canceled. No patients in the negative group developed symptoms. The proportion of the development of subsequent symptoms between the FilmArray positive and negative groups was statistically significant (p < .001, odds ratio: 29.6, 95% confidence interval: [3.80-1356.01]). CONCLUSIONS: Our retrospective observational study revealed that 44% of the FilmArray positive group subsequently developed symptoms, and no PRAEs were observed in the FilmArray negative group. We suggest that FilmArray could be useful as a screening test for pediatric patients with preoperative fever.
Subject(s)
COVID-19 , Respiratory Tract Infections , Child , Humans , Infant , Multiplex Polymerase Chain Reaction , Pandemics , Hospitalization , COVID-19 TestingABSTRACT
Asthma is a non-communicable and long-term condition affecting children and adults. The air passages in the lungs become narrow due to inflammation and tightening of the muscles around the small airways. Symptoms of asthma are intermittent and include cough, wheeze, shortness of breath, and chest tightness. Asthma is very often underdiagnosed and under-treated in many regions, especially in developing countries. While many studies show that viral infections can precipitate asthmatic attacks, very few studies have been conducted to see if history or current asthmatic attack increases the risk of viral infections. Our study aims to determine the predisposition of asthmatics to develop various viral infections and susceptibility toward certain viruses that cause upper respiratory tract infections. We performed a literature review of both published and unpublished articles. We included case reports, case series, reviews, clinical trials, cohort, and case-control studies, written only in English. Commentaries, letters to editors, and book chapters were excluded. Our initial search yielded 948 articles, of which 826 were rejected either because they were irrelevant or because they did not meet our inclusion criteria. We finally screened 122 abstracts and identified 24 relevant articles. People with a history of asthma have an abnormal innate immune response, making them potentially slower in clearing the infection and susceptible to both infections and virus-induced cell cytotoxicity. Also, in these studies, deficiencies in the interferon alpha response of peripheral blood mononuclear cells and plasmacytoid dendritic cells have been observed in asthmatics, both adults and children. Asthmatics with a viral infection usually present with an acute exacerbation of asthma, represented by dyspnea and cough, with other prodromal symptoms including vomiting and general malaise. The review includes an update on the relevance of dysregulated immune pathways in causing viral infections in asthmatic populations. It focuses on the evidence to suggest that people with asthma are at increased risk of viral infection, and viral infections in turn are known to precipitate and worsen the asthmatic status, making this a vicious cycle. The authors also suggest that further studies be undertaken to elucidate the pathophysiology and identify the critical therapeutic steps to break this vicious cycle and improve the quality of life for people with asthma.
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SARS Cov-2 virus has spread rapidly all over the world, and since March 2020, it has been declared a worldwide pandemic by the World Health Organization (WHO). The general symptoms of COVID-19 are fever, fatigue, cough, myalgia, dyspnea, headache, sore throat and pneumonia. The most common oral symptom in COVID-19 is taste disorders, which is seen in 45% of patents. In addition, various oral mucosal lesions such as herpetiform and aphthous-like lesions, candidiasis and Kawasak-like lesions can be observed in patents. The purpose of this revew study is to examine the mouth findings seen in COVID-19 disease.
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Upper respiratory tract is directly connected with the external environment, and its natural immune system is the first line of defense against pathogens. In antiviral infection, interferon (IFN) is the main component of the antiviral natural immune system and IFN-a is a newly discovered immune effector molecule that is mainly produced in the mucosal barrier. IFN-a exerts a biological role through Janus kinase (JAK) and signal transducer and activator of transcription (STAT) signaling pathway, and plays an important part in regulating innate and acquired immunity of respiratory mucosa. IFN-a principally expresses on the mucosal barrier with a long-lasting antiviral impact and controls immune-inflammatory damage, which is becoming a new focus of antiviral immunity research in the upper respiratory tract, especially in fighting against 2019 novel coronavirus diseases (COVID-19). Thus, we summarize the research progress of IFN-a antiviral immunity in the upper respiratory tract to provide new insight in the prevention and treatment of viral infection in the upper respiratory tract.
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Objective: To compare the clinical features of patients with breakthrough infection after getting different kinds of COVID-19 vaccines, in order to provide reference for clinical diagnosis and treatment of such patients.
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A literature review on the features of residual phenomena and consequences of COVID-19 is analyzed on the basis of data published so far. By the beginning of January 2021, COVID-19, accompanied by severe acute respiratory syndrome caused by coronavirus 2 (SARS-CoV-2), led to more than 83 million confirmed cases and more than 1.8 million deaths. The clinical spectrum of SARS-CoV-2 infection is wide, including asymptomatic infection, fever, fatigue, myalgia, mild upper respiratory tract disease, severe and life-threatening viral pneumonia requiring hospitalization, and death. COVID-19 is a new disease, and uncertainty remains about possible long-term health consequences. To date, it is known that the majority of infected people, especially at a young age, have a mild course of the disease, compared with older people. In some patients, the disease progresses rapidly and various complications develop, including multiple organ failure. Therefore, early detection and timely treatment of critical cases is crucial.
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Background: Population-based clinical data on COVID-19 is scarce. This study analyzed distinct clinical characteristics of COVID-19 and relationships with lethality among adults.
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Introduction: The tiring, persistent cough of a child is one of the most common reasons for visiting a primary health care physician. It is usually a symptom of an upper respiratory tract infection, so it is not a serious illness. However, the doctor, without examining the child, cannot guarantee that the cough is only associated with a banal infection. We know that it accompanies many diseases, but the lack of studies assessing the extent to which acute coughing in a child with a cold disease indicates infection in the lower respiratory tract. Aim: The aim of the study was to establish the causes of acute awakening and/or tiring cough in children suffering from upper respiratory tract infection. Material and methods: A retrospective analysis of data from the medical history of children examined due to cough interrupting sleeping and/or tiring cough upon awakening. 112 children up to six years of age (median age 2.8 years) with an upper respiratory tract infection were included in the study. Based on information obtained from parents, it was determined whether the family had SARS-CoV-2 virus infection in the 10 days before or after the test. The group of children with the acute nonobstructive bronchitis was analyzed in an additional analysis. In these patients, the number of days with coughing before diagnosis and the nature of percussion and auscultation changes were assessed.
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This study aimed to evaluate the etiological and clinical characteristics of acute upper respiratory tract infections in children from GuangZhou, China. A total of 2 665 nose swabs specimen collected from children with acute upper respiratory tract infections from Zhujiang Hospital, Southern Medical University, Guangzhou, China during November 2009 to September 2015 were enrolled in this study. There were 1 566 virus positive responses were detected in samples from 2665 child patients with acute upper respiratory infections, with the positive rate of 58.8%. The positive rates were 22.5% for respiratory sycytial virus (RSV), 13.0% for rhinovirus (HRV), 9.0% for influenza virus (FLU), 7.6% for parainfluenza virus (PIV), 6.1% for adenovirus (AdV), 4.0% for human metapneumovirus (HMPV), 3.7% for human coronavirus (HCOV), 3.5% for human Bocavirus (HBOV). There was statistical significant in the detection rates of 8 respiratory viruses in different seasons, with the highest in spring, followed by summer and winter, and lowest in autumn. The respiratory virus infection rate of children gradually decreased with age, with a positive detection rate of 67.0% between children aged 0-3 years. And the respiratory virus detection rate of boys was significantly higher than that of girls. The co-infection rates were higher in child patients aged 0-3 years, and were higher during spring and summer than that of autumn and winter. Cough is the main clinical symptom of acute upper respiratory virus infection, followed by sputum and runny nose. The clinical symptoms are different in children between 8 respiratory virus infections. This study increases our knowledge of the etiological and clinical characteristics of these 8 common respiratory viruses among children with respiratory tract infections. Which might also provide relevant data to guide clinical treatment and prevention.
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The growth and development of children is very important, as this would form the foundation for the quality of future generations in the nation. The slightest developmental disorders in infancy, if not detected and not handled properly will lead to a bad impact. Various genetic and environmental factors influence Toddler growth and development. Purpose: To distinguish the description of the risk factors related to child growth and development. Method: This research uses quantitative method. The design of the research is based on a cross-sectional approach in the analysis survey design. In the study, all toddlers under 59 month old were collected using a total of 366 samples in 2020 at the Ngalang Village, Gedangsari public health center and Gunungkidul Regency. Data analysis used univariate analysis of frequency distribution.
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The global current scenario shows that COVID-19 has spread worldwide and drugs prescribed to treat the disease are under study. The imperative requirement of drugs to treat COVID-19 has made significant changes in the pharmacological industry. Discovering drugs for such a pandemic has been a crucial target, with standardisation, preclinical and clinical studies being conducted in all possible age groups. Siddha medicines have found their way in the treatment of COVID-19 largely and increasingly been accepted worldwide. Among such constant trials, implementation of the molecular docking process has helped to reveal the importance of different Siddha medicines in the first place as therapeutics to COVID-19. The Government bodies have also recommended these antiviral compounds to treat symptoms such as cold, fever, breathing difficulty and sore throat. This study aims to focus on to gather awareness on the impact of various Siddha medicines and their insights into molecular level to fight against Coronaviruses. As a result of this review, it was found that the phytochemical compounds present in various siddha medicines such as Kabasura Kudineer, Adathodai Kudineer, Maramanjal Kudineer and so on, have been docked with the possible target proteins of SARS-CoV-2 virus to disclose that they have potential action on the virus and declare to act as the candidate drugs in COVID-19 treatment.
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Background: There has been extensive research showing that upper respiratory tract infections (URTIs), such as the common cold and influenza, can impair mental performance. Much of this research has involved studies of experimentally induced URTIs or laboratory studies of naturally occurring illnesses. The results from this research have implications for performance at work and in education. Aims: The present article presents a case study of the association between URTIs and academic performance and reports the use of such information as an extenuating circumstance for poor performance. Methods: The paper describes the poor performance of a primary school student taking the 11+ examination, which determines the choice of the future secondary school. Evidence suggested that it was plausible that the student was incubating an URTI at the time of the examination. Other possible infections, such as COVID, were ruled out. An appeal was made based on the possible association between incubating an URTI and unusually poor examination performance. Results: The appeal was supported by the adjudicating committee and the student was allowed a place in the preferred secondary school. Conclusions: This case study shows that information about the association between URTIs and mental performance can be used as an extenuating circumstance that can plausibly account for poor academic performance. This can form the basis of the future appeals and recommendations for the type of evidence needed to make such claims are made. Relevance for Patients: URTIs are frequent, common, and a cause of absence from education and work. They may also impair performance, with effects not being restricted to the time the person is symptomatic. They may also increase susceptibility to the negative effects of stress and fatigue.
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SARS-CoV-2 is an emerging pathogen first reported in China and rapidly spreads throughout the world. The current study focused on the prevalence of symptoms, leukocytosis, leukocytopenia, thrombocytopenia, and comorbidity in patients resulted positive for COVID-19. About 200 patients were enrolled in the study first screened by ICT and then confirmed by RT-PCR. All the patients have symptoms fever, sore throat and dry cough. However 180 (90%) patients experienced tiredness, aches and pain all over the body in 193 (96%), diarrhea in 160 (80%), conjunctivitis in 64 (32%), headache in 177 (88%), loss of taste and smell in 49 (24%), a rash on skin, or discoloration of fingers or toes in 54 (27%), shortness of breath in 12 (8%), chest pain or pressure in 16 (8%), loss of speech and movement in 4 (2%) patients. 78 (39%) patients were found having co-infections including 23 (29.5%) patients have liver infection, 14 (17.9%) were kidney patients, 16 (20.5%) were heart patients and 25 (32%) were diabetic patients. Leukocytosis were found in 76 (97%) out 78 comorbid patients, while in only 2 (2.6%) non-comorbid patients had leukocytosis. Leukopenia were detected in 122 (61%) non-morbidpatients out of 200 COVID-19 patients. Thrombocytopenia were detected in 118 (59%) COVID-19 patients. The patients with previous cardiovascular diseases and other comorbid conditions may face greater risk of developing the disease into severe form. 51-60 years of individuals are at high risk of getting infection. The hematologic changes are associated with COVID-19 includes thrombocytopenia, leukocytosis, and leukocytopenia.
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Objective: To understand the epidemiological characteristics of an outbreak of respiratory tract infection caused by human metapneumovirus (hMPV) in a primary school in Huzhou City, and to provide scientific reference for the prevention and control of the outbreak of upper respiratory tract infection caused by hMPV in the future.