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1.
Virol J ; 18(1): 174, 2021 08 23.
Article in English | MEDLINE | ID: covidwho-1770553

ABSTRACT

BACKGROUND: Human rhinovirus (HRV) is one of the major viruses of acute respiratory tract disease among infants and young children. This work aimed to understand the epidemiological and phylogenetic features of HRV in Guangzhou, China. In addition, the clinical characteristics of hospitalized children infected with different subtype of HRV was investigated. METHODS: Hospitalized children aged < 14 years old with acute respiratory tract infections were enrolled from August 2018 to December 2019. HRV was screened for by a real-time reverse-transcription PCR targeting the viral 5'UTR. RESULTS: HRV was detected in 6.41% of the 655 specimens. HRV infection was frequently observed in children under 2 years old (57.13%). HRV-A and HRV-C were detected in 18 (45%) and 22 (55%) specimens. All 40 HRV strains detected were classified into 29 genotypes. The molecular evolutionary rate of HRV-C was estimated to be 3.34 × 10-3 substitutions/site/year and was faster than HRV-A (7.79 × 10-4 substitutions/site/year). Children who experienced rhinorrhoea were more common in the HRV-C infection patients than HRV-A. The viral load was higher in HRV-C detection group than HRV-A detection group (p = 0.0148). The median peak symptom score was higher in patients with HRV-C infection as compared to HRV-A (p = 0.0543), even though the difference did not significance. CONCLUSION: This study revealed the molecular epidemiological characteristics of HRV in patients with respiratory infections in southern China. Children infected with HRV-C caused more severe disease characteristics than HRV-A, which might be connected with higher viral load in patients infected with HRV-C. These findings will provide valuable information for the pathogenic mechanism and treatment of HRV infection.


Subject(s)
Picornaviridae Infections , Respiratory Tract Infections , Rhinovirus , Adolescent , Child , Child, Preschool , China/epidemiology , Enterovirus , Genetic Variation , Humans , Infant , Phylogeny , Picornaviridae Infections/epidemiology , Respiratory Tract Infections/epidemiology , Respiratory Tract Infections/virology , Rhinovirus/genetics
2.
BMC Infect Dis ; 22(1): 253, 2022 Mar 14.
Article in English | MEDLINE | ID: covidwho-1741929

ABSTRACT

BACKGROUND: Human rhinovirus (HRV) is the predominant etiological agent of the common cold in children and adults. A recent study showed that the inhibitory effect of face masks on viral shedding of HRV was less prominent than that on other respiratory viruses. Considering that most Chinese people have worn face masks in public area since the outbreak of coronavirus disease 2019, we aimed to find out whether HRV prevailed among children in 2020 and demonstrate the details of the epidemiological features of HRV under such a special circumstance. METHODS: We summarized the incidences of various respiratory virus infections in patients who visited the Children's Hospital of Fudan University during 2018-2020, and genotyped HRV positive nasopharyngeal specimens collected from 316 inpatients and 72 outpatients that visited the hospital in 2020. RESULTS: There was a major prevalence of HRV among children in the latter half of 2020, with a clear seasonality that HRV-As prevailed in summer while HRV-Cs in autumn. HRV-As were more prone to cause severe lower respiratory tract infections (LRTI), while HRV-Cs were closely associated with childhood wheezing. The predominant genotypes were A11, A28, A47, A82, A101, C40 and C43. Notably, A21, A82 and A101 took up larger proportions in severe cases than in non-severe cases. CONCLUSIONS: Our findings described a major prevalence of HRVs among children in 2020, which highlight the unique transmitting pattern of HRV and help to narrow the targets for antiviral strategies.


Subject(s)
COVID-19 , Picornaviridae Infections , Adult , Child , China/epidemiology , Humans , Masks , Picornaviridae Infections/epidemiology , Picornaviridae Infections/prevention & control , Rhinovirus/genetics
3.
Pediatr Infect Dis J ; 41(3): e95-e101, 2022 03 01.
Article in English | MEDLINE | ID: covidwho-1615776

ABSTRACT

BACKGROUND: The clinical impact of common human coronavirus (cHCoV) remains unclear. We studied the clinical manifestations of pediatric cHCoV infections and the possible modifying effects of codetected human rhinovirus (RV) and respiratory syncytial virus (RSV). METHODS: We used data from an 11-year-long prospective study of hospitalized children with community-acquired respiratory tract infections. Nasopharyngeal aspirates were analyzed with real-time polymerase chain reaction assay for cHCoV OC43, NL63, HKU1 and 229E, and 15 other respiratory viruses. We assessed disease severity based on the clinical factors hospitalization length, oxygen requirement, other respiratory support and supplementary fluids. RESULTS: cHCoV was detected in 341 (8%) of 4312 children. Among 104 children with single cHCoV detections, 58 (56%) had lower respiratory tract infection (LRTI) and 20 (19%) developed severe disease. The proportion with severe disease was lower among single cHCoV detections compared with single RSV detections (338 of 870; 39%), but similar to single RV detections (136 of 987; 14%). Compared with single cHCoV, codetected cHCoV-RSV was more often associated with LRTI (86 of 89; 97%) and severe disease (adjusted odds ratio, 3.3; 95% confidence interval: 1.6-6.7). LRTI was more frequent in codetected cHCoV-RV (52 of 68; 76%) than single cHCoV, but the risk of severe disease was lower (adjusted odds ratios, 0.3; 95% confidence interval: 0.1-1.0). CONCLUSIONS: cHCoV was associated with severe LRTI in hospitalized children. Viral codetections were present in two-thirds. Codetections of cHCoV-RV were associated with lower proportions of severe disease, suggesting a modifying effect of RV on HCoV.


Subject(s)
Coinfection/virology , Coronavirus Infections/virology , Picornaviridae Infections/virology , Respiratory Syncytial Virus Infections/virology , Adolescent , Child , Child, Hospitalized , Child, Preschool , Coinfection/epidemiology , Coinfection/therapy , Coronavirus Infections/epidemiology , Coronavirus Infections/therapy , Female , Humans , Infant , Infant, Newborn , Male , Norway/epidemiology , Picornaviridae Infections/epidemiology , Picornaviridae Infections/therapy , Prospective Studies , Respiratory Syncytial Virus Infections/epidemiology , Respiratory Syncytial Virus Infections/therapy
4.
Viruses ; 13(12)2021 12 16.
Article in English | MEDLINE | ID: covidwho-1580428

ABSTRACT

BACKGROUND: We aimed to compare the clinical severity in patients who were coinfected with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and rhinovirus or monoinfected with a single one of these viruses. METHODS: The study period ranged from 1 March 2020 to 28 February 2021 (one year). SARS-CoV-2 and other respiratory viruses were identified by real-time reverse-transcription-PCR as part of the routine work at Marseille University hospitals. Bacterial and fungal infections were detected by standard methods. Clinical data were retrospectively collected from medical files. This study was approved by the ethical committee of our institute. RESULTS: A total of 6034/15,157 (40%) tested patients were positive for at least one respiratory virus. Ninety-three (4.3%) SARS-CoV-2-infected patients were coinfected with another respiratory virus, with rhinovirus being the most frequent (62/93, 67%). Patients coinfected with SARS-CoV-2 and rhinovirus were significantly more likely to report a cough than those with SARS-CoV-2 monoinfection (62% vs. 31%; p = 0.0008). In addition, they were also significantly more likely to report dyspnea than patients with rhinovirus monoinfection (45% vs. 36%; p = 0.02). They were also more likely to be transferred to an intensive care unit and to die than patients with rhinovirus monoinfection (16% vs. 5% and 7% vs. 2%, respectively) but these differences were not statistically significant. CONCLUSIONS: A close surveillance and investigation of the co-incidence and interactions of SARS-CoV-2 and other respiratory viruses is needed. The possible higher risk of increased clinical severity in SARS-CoV-2-positive patients coinfected with rhinovirus warrants further large scale studies.


Subject(s)
COVID-19/epidemiology , Coinfection/epidemiology , Coinfection/virology , Picornaviridae Infections/epidemiology , Adolescent , Adult , Aged , COVID-19/diagnosis , Child , Coinfection/diagnosis , Female , Humans , Incidence , Male , Middle Aged , Picornaviridae Infections/diagnosis , Picornaviridae Infections/virology , Real-Time Polymerase Chain Reaction , Respiratory Tract Infections/epidemiology , Respiratory Tract Infections/virology , Retrospective Studies , Rhinovirus , SARS-CoV-2 , Severity of Illness Index , Young Adult
5.
J Investig Med ; 69(6): 1230-1237, 2021 08.
Article in English | MEDLINE | ID: covidwho-1342804

ABSTRACT

The impact of HIV on influenza-like illness (ILI) has been incompletely described in the era of combination antiretroviral therapy, particularly in the post-H1N1 pandemic period. This analysis informs on ILI in an otherwise healthy, predominantly outpatient cohort of adults with HIV in the USA. From September 2010 to March 2015, this multisite observational cohort study enrolled otherwise healthy adults presenting to a participating US military medical center with ILI, a subset of whom were HIV positive. Demographics, clinical data, and self-reported symptom severity were ascertained, and enrollees completed a daily symptom diary for up to 10 days. 510 men were included in the analysis; 50 (9.8%) were HIV positive. Subjects with HIV were older and less likely to be on active duty. Rhinovirus and influenza A were the most commonly identified pathogens. Moderate-severe diarrhea (p<0.001) and fatigue (p=0.01) were more frequently reported by HIV-positive men. HIV positivity was associated with higher gastrointestinal scores, but not other measures of ILI symptom severity, after controlling for age, race, military status, and influenza season. Few were hospitalized. HIV-positive subjects had more influenza B (p=0.04) and were more likely to receive antivirals (32% vs 6%, p<0.01). Antiviral use was not significantly associated with symptom scores when accounting for potential confounders. In this predominantly outpatient cohort of adult men, HIV had minimal impact on ILI symptom severity. Despite similar illness severity, a higher percentage of subjects with HIV reported undergoing antiviral treatment for ILI, likely reflecting differences in prescribing practices.Trial registration number: NCT01021098.


Subject(s)
HIV Infections , Influenza, Human , Adult , Antiviral Agents , Cohort Studies , HIV Infections/complications , Humans , Influenza, Human/epidemiology , Influenza, Human/pathology , Male , Outpatients , Picornaviridae Infections/epidemiology , Picornaviridae Infections/pathology
6.
Microbiol Spectr ; 9(2): e0043021, 2021 10 31.
Article in English | MEDLINE | ID: covidwho-1398597

ABSTRACT

Measures intended to limit the spread of the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) virus at the start of the coronavirus disease 2019 (COVID-19) pandemic resulted in a rapid decrease in other respiratory pathogens. Herein, we describe the trends of respiratory pathogens in a major metropolitan health care system central microbiology reference laboratory before and during the COVID-19 pandemic, with attention to when COVID-19 mitigation measures were implemented and relaxed. During the initial lockdown period, COVID-19 was the primary respiratory pathogen detected by multiplex respiratory panels. As COVID-19 containment measures were relaxed, the first non-COVID respiratory viruses to return to prepandemic levels were members of the rhinovirus/enterovirus family. After the complete removal of COVID-19 precautions at the state level, including an end to mask mandates, we observed the robust return of seasonal coronaviruses, parainfluenza virus, and respiratory syncytial virus. Inasmuch as COVID-19 has dominated the landscape of respiratory infections since early 2020, it is important for clinicians to recognize that the return of non-COVID respiratory pathogens may be rapid and significant when COVID-19 containment measures are removed. IMPORTANCE We describe the return of non-COVID respiratory viruses after the removal of COVID-19 mitigation measures. It is important for the public and physicians to recognize that, after months of COVID-19 being the primary driver of respiratory infection, more typical seasonal respiratory illnesses have returned, and this return is out of the normal season for some of these pathogens. Thus, clinicians and the public must now consider both COVID-19 and other respiratory illnesses when a patient presents with symptomatic respiratory illness.


Subject(s)
COVID-19/epidemiology , COVID-19/prevention & control , Communicable Disease Control , Respiratory Tract Infections/epidemiology , Respiratory Tract Infections/prevention & control , Coxsackievirus Infections/epidemiology , Coxsackievirus Infections/prevention & control , Enterovirus/isolation & purification , Humans , Mandatory Programs/statistics & numerical data , Orthomyxoviridae/isolation & purification , Orthomyxoviridae Infections/epidemiology , Orthomyxoviridae Infections/prevention & control , Picornaviridae Infections/epidemiology , Picornaviridae Infections/prevention & control , Rhinovirus/isolation & purification , SARS-CoV-2/growth & development , Texas/epidemiology
7.
Influenza Other Respir Viruses ; 15(6): 711-720, 2021 11.
Article in English | MEDLINE | ID: covidwho-1340182

ABSTRACT

BACKGROUND: Respiratory syncytial virus (RSV) and human rhinovirus (HRV) commonly cause influenza-like illness in young children. The global coronavirus pandemic beginning in 2020 altered the seasonality and prevalence of these respiratory infections in Thailand. We aimed to characterize the upsurge of HRV and the subsequent RSV infection observed among young children who sought medical care at a hospital in Bangkok. METHODS: From July to December 2020, nasopharyngeal swabs from children ≤5 years of age presented with influenza-like illness were tested for RSV and HRV using reverse-transcription polymerase chain reaction. Positive samples were Sanger sequenced. Genotyping was performed using sequence and phylogenetic analysis. RESULTS: Upsurge of HRV infection began in July and was subsequently replaced by a surge of RSV infection from September onward. In 6 months, HRV was detected in 27.5% (158/574) of the samples, of which 44% (69/158) were HRV-A, 7% (11/158) were HRV-B, and 36% (57/158) were HRV-C. Meanwhile, RSV was detected in 40.4% (232/574) of the samples, of which 78% (181/232) were RSV-A and 6% (14/232) were RSV-B. RSV peaked in October 2020, approximately 2 months later than typically seen in previous years. All RSV-A were of subgenotype ON1. Codetection of HRV and RSV was found in 5.1% (29/574). CONCLUSIONS: HRV and RSV infection among young children coincided with relaxed local coronavirus public health measures, including the return to in-class schooling. The delayed RSV season in 2020 was predominantly associated with RSV-A.


Subject(s)
Coronavirus , Picornaviridae Infections , Respiratory Syncytial Virus Infections , Respiratory Syncytial Virus, Human , Respiratory Tract Infections , Child , Child, Preschool , Humans , Infant , Pandemics , Phylogeny , Picornaviridae Infections/epidemiology , Respiratory Syncytial Virus Infections/epidemiology , Respiratory Tract Infections/epidemiology , Rhinovirus/genetics , Seasons , Thailand/epidemiology
8.
J Med Virol ; 93(10): 6063-6067, 2021 Oct.
Article in English | MEDLINE | ID: covidwho-1296838

ABSTRACT

Social restrictions during the coronavirus disease 2019 pandemic strongly affected the epidemiology of influenza and respiratory syncytial virus (RSV). As rhinovirus seemed to spread despite the restrictions, we aimed to analyze rhinovirus epidemiology in children during the pandemic. This register-based study used data from the Finnish Infectious Disease Register. Nationwide rhinovirus findings from July 2015 to March 2021 were included and stratified by age (0-4, 5-9, and 10-14). Cumulative 14-day incidence per 100000 children was calculated. Four thousand five hundred and seventy six positive rhinovirus findings were included, of which 3788 (82.8%) were among children aged 0-4. The highest recorded incidence was 36.2 among children aged 0-4 in October 2017. The highest recorded incidence during the pandemic period was 13.6 in November 2020. The impact of the restrictions was mostly seen among children aged 0-4 years of age in weeks 14-22 in 2020. The incidence has since remained near reference levels in all age groups. Strict restrictions temporarily interrupted the circulation of rhinovirus in spring 2020. Rhinovirus incidence returned to normal levels soon after the harsh restrictions were lifted. These looser social restrictions prevented RSV and influenza seasons but failed to prevent the spread of rhinovirus.


Subject(s)
Picornaviridae Infections/epidemiology , Picornaviridae Infections/prevention & control , Rhinovirus , Adolescent , Age Factors , COVID-19 , Child , Child, Preschool , Finland/epidemiology , Humans , Infant , Infant, Newborn , Pandemics , Physical Distancing , Respiratory Syncytial Virus, Human , Respiratory Tract Infections/epidemiology , Respiratory Tract Infections/prevention & control , Respiratory Tract Infections/virology
11.
Influenza Other Respir Viruses ; 15(4): 488-494, 2021 07.
Article in English | MEDLINE | ID: covidwho-1132956

ABSTRACT

BACKGROUND: Coronavirus disease (COVID-19), which is caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), was first detected in Japan in January 2020 and has spread throughout the country. Previous studies have reported that viral interference among influenza virus, rhinovirus, and other respiratory viruses can affect viral infections at the host and population level. METHODS: To investigate the impact of COVID-19 on influenza and other respiratory virus infections, we analyzed clinical specimens collected from 2244 patients in Japan with respiratory diseases between January 2018 and September 2020. RESULTS: The frequency of influenza and other respiratory viruses (coxsackievirus A and B; echovirus; enterovirus; human coronavirus 229E, HKU1, NL63, and OC43; human metapneumovirus; human parainfluenza virus 1, 2, 3, and 4; human parechovirus; human respiratory syncytial virus; human adenovirus; human bocavirus; human parvovirus B19; herpes simplex virus type 1; and varicella-zoster virus) was appreciably reduced among all patients during the COVID-19 pandemic except for that of rhinovirus in children younger than 10 years, which was appreciably increased. COVID-19 has not spread among this age group, suggesting an increased risk of rhinovirus infection in children. CONCLUSIONS: Rhinovirus infections should be continuously monitored to understand their increased risk during the COVID-19 pandemic and viral interference with SARS-CoV-2.


Subject(s)
COVID-19/epidemiology , Picornaviridae Infections/epidemiology , Rhinovirus/isolation & purification , Adult , Child , Child, Preschool , Coinfection/diagnosis , Coinfection/epidemiology , Coinfection/virology , Female , Humans , Infant , Infant, Newborn , Japan/epidemiology , Male , Picornaviridae Infections/diagnosis , Picornaviridae Infections/virology , Respiratory Tract Infections/diagnosis , Respiratory Tract Infections/epidemiology , Respiratory Tract Infections/virology , Risk , SARS-CoV-2 , Virus Diseases/diagnosis , Virus Diseases/epidemiology , Virus Diseases/virology , Viruses/isolation & purification
13.
Seizure ; 84: 69-77, 2021 Jan.
Article in English | MEDLINE | ID: covidwho-1065589

ABSTRACT

OBJECTIVE: There are limited data on the pathogen-related and host-related factors in the pathogenesis of febrile seizures (FS). We designed a controlled study to compare the role of different respiratory viruses and febrile response in FS. METHODS: In a prospective cohort study of 1899 pediatric emergency room patients aged 6 months-6 years with a positive respiratory virus multiplex PCR, we identified 225 patients with FSs. We first compared the distribution of respiratory viruses in age-stratified patients with FSs with that in other patients. In an embedded case-control study, we compared the febrile response in patients with FSs with that in the controls matched for age, season and the same respiratory virus. RESULTS: The relative risk for FS was the highest for coronavirus OC43, 229E, and NL63 infections [RR: 3.2, 95 % confidence interval (CI): 1.4-7.2) and influenza A and B [RR: 2.5, 95 % CI: 1.4-4.7] as compared to those with other respiratory viral infections. The patients with FSs had a stronger febrile response of 39.2 °C (difference: 0.8 °C, 95 % CI: 0.5-1.2) later during hospitalization after acute care than the controls matched for the same respiratory virus. CONCLUSIONS: Influenza and coronaviruses caused relatively more FS-related emergency room visits than other respiratory viruses. Furthermore, the febrile response was stronger in the patients with FSs than in the controls matched for the same respiratory virus. The results suggest that the pathomechanism of FSs includes modifiable pathogen-related and host-related factors with possible potential in the prevention of FSs.


Subject(s)
Coronavirus Infections/epidemiology , Enterovirus Infections/epidemiology , Influenza, Human/epidemiology , Paramyxoviridae Infections/epidemiology , Respiratory Tract Infections/epidemiology , Seizures, Febrile/epidemiology , Adenovirus Infections, Human/epidemiology , Adenovirus Infections, Human/virology , Case-Control Studies , Child , Child, Preschool , Cohort Studies , Coronavirus 229E, Human , Coronavirus Infections/virology , Coronavirus NL63, Human , Coronavirus OC43, Human , Emergency Service, Hospital , Enterovirus Infections/virology , Female , Fever/physiopathology , Finland/epidemiology , Humans , Infant , Inflammation , Influenza A virus , Influenza B virus , Influenza, Human/virology , Male , Multiplex Polymerase Chain Reaction , Paramyxoviridae Infections/virology , Picornaviridae Infections/epidemiology , Picornaviridae Infections/virology , Prospective Studies , Respiratory Syncytial Virus Infections/epidemiology , Respiratory Syncytial Virus Infections/virology , Respiratory Tract Infections/physiopathology , Respiratory Tract Infections/virology , Rhinovirus , Risk , Seizures, Febrile/virology
14.
J Clin Lab Anal ; 34(4): e23127, 2020 Apr.
Article in English | MEDLINE | ID: covidwho-826348

ABSTRACT

BACKGROUND: The information regarding viral epidemiology and clinical characteristics in hospitalized children with acute respiratory tract infection (ARTI) in central Fujian is limited. In this study, we aimed at analyzing the viral epidemiology and clinical characteristics of ARTI in hospitalized children admitted to The First Affiliated Hospital of Fujian Medical University. METHODS: Cohort of 386 hospitalized children (31 days to 15 years) diagnosed with ARTI admitted to the Department of Pediatrics from January 1, 2018, to December 31, 2018, was enrolled in this study. Nasopharyngeal swab or sputum samples on the day of hospitalization were tested for 11 viruses via a GeXP-based multiplex-PCR assay. The viral profiles and clinical characteristics were analyzed. RESULTS: The overall positive rate of the samples was 43.26% (167/386). Among the 167 positive samples, 134 (80.24%, 134/167) had a single virus and 33 (19.76%, 33/167) had multiple viruses. There was a significant difference in the frequency of single vs mixed infections among positive samples (80.24% vs 19.76%; χ2  = 122.168, P = .000) as well as among the total examined samples (34.72% vs 8.55%; χ2  = 77.945, P = .000). Human rhinovirus was the most prevalent virus (17.36%, 67/386), followed by influenza A (5.96%, 23/386) and human adenovirus (5.70%, 22/386). There was no significant difference in the etiological distribution of viral pathogens between males and females (χ2  = 0.480, P = .489). Viral infections were more likely to occur in the winter-spring months than in the summer-autumn months (52.51% vs 33.53%, χ2  = 13.830, P = .000). CONCLUSIONS: The GeXP-based multiplex PCR is an accurate and high-throughput assay allows us to quickly detect multiple respiratory viruses simultaneously in pediatric patients. Our study provides information on the viral profiles and clinical characteristics in hospitalized children with ARTI, which would help better effective prevention strategies.


Subject(s)
Multiplex Polymerase Chain Reaction/methods , Respiratory Tract Infections/epidemiology , Respiratory Tract Infections/virology , Adenovirus Infections, Human/epidemiology , Adenovirus Infections, Human/virology , Adolescent , Age Distribution , Child , Child, Hospitalized/statistics & numerical data , Child, Preschool , China/epidemiology , Female , Humans , Infant , Influenza, Human/epidemiology , Influenza, Human/virology , Male , Picornaviridae Infections/epidemiology , Picornaviridae Infections/virology , Respiratory Tract Infections/genetics , Seasons , Sex Distribution , Sputum/virology
16.
J Allergy Clin Immunol Pract ; 8(10): 3378-3387.e11, 2020.
Article in English | MEDLINE | ID: covidwho-773574

ABSTRACT

BACKGROUND: The coronavirus disease 2019 (COVID-19) pandemic caused dramatic changes in daily routines and health care utilization and delivery patterns in the United States. Understanding the influence of these changes and associated public health interventions on asthma care is important to determine effects on patient outcomes and identify measures that will ensure optimal future health care delivery. OBJECTIVE: We sought to identify changes in pediatric asthma-related health care utilization, respiratory viral testing, and air pollution during the COVID-19 pandemic. METHODS: For the time period January 17 to May 17, 2015 to 2020, asthma-related encounters and weekly summaries of respiratory viral testing data were extracted from Children's Hospital of Philadelphia electronic health records, and pollution data for 4 criteria air pollutants were extracted from AirNow. Changes in encounter characteristics, viral testing patterns, and air pollution before and after Mar 17, 2020, the date public health interventions to limit viral transmission were enacted in Philadelphia, were assessed and compared with data from 2015 to 2019 as a historical reference. RESULTS: After March 17, 2020, in-person asthma encounters decreased by 87% (outpatient) and 84% (emergency + inpatient). Video telemedicine, which was not previously available, became the most highly used asthma encounter modality (61% of all visits), and telephone encounters increased by 19%. Concurrently, asthma-related systemic steroid prescriptions and frequency of rhinovirus test positivity decreased, although air pollution levels did not substantially change, compared with historical trends. CONCLUSIONS: The COVID-19 pandemic in Philadelphia was accompanied by changes in pediatric asthma health care delivery patterns, including reduced admissions and systemic steroid prescriptions. Reduced rhinovirus infections may have contributed to these patterns.


Subject(s)
Air Pollution/statistics & numerical data , Anti-Asthmatic Agents/therapeutic use , Asthma/drug therapy , Child Health Services/statistics & numerical data , Coronavirus Infections/epidemiology , Pneumonia, Viral/epidemiology , Adenovirus Infections, Human/diagnosis , Adenovirus Infections, Human/epidemiology , Adolescent , Adrenal Cortex Hormones/therapeutic use , Ambulatory Care/statistics & numerical data , Asthma/physiopathology , Betacoronavirus , COVID-19 , COVID-19 Testing , Child , Child, Preschool , Clinical Laboratory Techniques , Coronaviridae Infections/diagnosis , Coronaviridae Infections/epidemiology , Coronavirus Infections/diagnosis , Coronavirus Infections/prevention & control , Emergency Service, Hospital/statistics & numerical data , Female , Hospitalization/statistics & numerical data , Hospitals, Pediatric , Humans , Influenza, Human/diagnosis , Influenza, Human/epidemiology , Male , Nitrogen Dioxide , Ozone , Pandemics/prevention & control , Paramyxoviridae Infections/diagnosis , Paramyxoviridae Infections/epidemiology , Particulate Matter , Philadelphia/epidemiology , Picornaviridae Infections/diagnosis , Picornaviridae Infections/epidemiology , Pneumonia, Viral/diagnosis , Pneumonia, Viral/prevention & control , Respiratory Syncytial Virus Infections/diagnosis , Respiratory Syncytial Virus Infections/epidemiology , SARS-CoV-2 , Telemedicine/statistics & numerical data , Telephone , Videoconferencing
17.
Curr Opin Pulm Med ; 26(3): 197-202, 2020 05.
Article in English | MEDLINE | ID: covidwho-726094

ABSTRACT

PURPOSE OF REVIEW: Mass gathering events bring people from across all continents increasing the risk of spread of aerosol transmissible respiratory tract infections. Respiratory tract infections for instance in pilgrims attending the world's largest recurring annual pilgrimage, the Hajj are common. We review recent literature on viral and bacterial infectious diseases with special focus on the Hajj. RECENT FINDINGS: The prevalence of bacterial and viral infections continue to increase, because of the acquisition of rhinovirus, coronaviruses (229E, HKU1, OC43), influenza A H1N1, Streptococcus pneumoniae, Haemophilus influenzae and Staphylococcus aureus during Hajj. Whilst MERS-CoV continues to circulate in the Middle East, no cases of MERS-CoV have yet been identified in pilgrims during Hajj. SUMMARY: Respiratory tract infections are a major cause of morbidity in pilgrims attending mass gathering events. The management of severe respiratory infections should consider investigation and empirical coverage for the most likely agents based on syndromic surveillance data from hosting country and /or other relevant exposure history during events. Pneumococcal and Pertussis vaccines should be recommended for Hajj pilgrims.


Subject(s)
Coronavirus Infections/transmission , Influenza, Human/transmission , Islam , Measles/transmission , Pneumonia, Pneumococcal/transmission , Respiratory Tract Infections/transmission , Travel , Tuberculosis/transmission , Bacterial Infections/epidemiology , Bacterial Infections/transmission , Coronavirus , Coronavirus Infections/epidemiology , Haemophilus Infections/epidemiology , Haemophilus Infections/transmission , Humans , Influenza A Virus, H1N1 Subtype , Influenza, Human/epidemiology , Influenza, Human/prevention & control , Measles/epidemiology , Measles/prevention & control , Middle East/epidemiology , Picornaviridae Infections/epidemiology , Picornaviridae Infections/transmission , Pneumococcal Vaccines/therapeutic use , Pneumonia, Pneumococcal/epidemiology , Pneumonia, Pneumococcal/prevention & control , Prevalence , Respiratory Tract Infections/epidemiology , Respiratory Tract Infections/prevention & control , Streptococcus pneumoniae , Tuberculosis/epidemiology , Virus Diseases/epidemiology , Virus Diseases/transmission , Whooping Cough/epidemiology , Whooping Cough/prevention & control , Whooping Cough/transmission
18.
Influenza Other Respir Viruses ; 15(1): 91-98, 2021 01.
Article in English | MEDLINE | ID: covidwho-688947

ABSTRACT

BACKGROUND: Respiratory viral infections account for a substantial fraction of pediatric emergency department (ED) visits. We examined the epidemiological patterns of seven common respiratory viruses in children presenting to EDs with influenza-like illness (ILI). Additionally, we examined the co-occurrence of viral infections in the accompanying adults and risk factors associated with the acquisition of these viruses. METHODS: Nasopharyngeal swab were collected from children seeking medical care for ILI and their accompanying adults (Total N = 1315). Study sites included New York Presbyterian, Bellevue, and Tisch hospitals in New York City. PCR using a respiratory viral panel was conducted, and data on symptoms and medical history were collected. RESULTS: Respiratory viruses were detected in 399 children (62.25%) and 118 (17.5%) accompanying adults. The most frequent pathogen detected was human rhinovirus (HRV) (28.81%). Co-infection rates were 14.79% in children and 8.47% in adults. Respiratory syncytial virus (RSV) and parainfluenza infections occurred more often in younger children. Influenza and HRV occurred more often in older children. Influenza and coronavirus were mostly isolated in winter and spring, RSV in fall and winter and HRV in fall and spring. Children with HRV were more likely to have history of asthma. Adults with the same virus as their child often accompanied ≤ 2-year-old-positive children and were more likely to be symptomatic compared to adults with different viruses. CONCLUSIONS: Respiratory viruses, while presenting the same suite of symptoms, possess distinct seasonal cycles and affect individuals differently based on a number of identifiable factors, including age and history of asthma.


Subject(s)
Emergency Service, Hospital , Respiratory Tract Infections/epidemiology , Virus Diseases/epidemiology , Adolescent , Adult , Asthma/virology , Child , Coinfection/epidemiology , Female , Humans , Infant , Infant, Newborn , Influenza, Human/epidemiology , Male , Paramyxoviridae Infections/epidemiology , Picornaviridae Infections/epidemiology , Respiratory Syncytial Virus Infections/epidemiology , Rhinovirus , Seasons , Young Adult
19.
Pediatr Infect Dis J ; 39(8): 653-657, 2020 08.
Article in English | MEDLINE | ID: covidwho-388714

ABSTRACT

BACKGROUND: Human coronaviruses (HCoVs) have been recognized as causative agents of respiratory tract infections.Our aim was to describe HCoV infections in hospitalized children in a prospective surveillance study for 14 years and compare them with other respiratory viruses. METHODS: As a part of an ongoing prospective study to identify the etiology of viral respiratory infections in Spain, we performed the analysis of HCoV infections in children hospitalized in a secondary hospital in Madrid, between October 2005 and June 2018. Clinical data of HCoV patients were compared with those infected by rhinovirus, respiratory syncytial virus and influenza. RESULTS: The study population consisted of 5131 hospitalizations for respiratory causes in children. A total of 3901 cases (75.9%) had a positive viral identification and 205 cases (4.1%) were positive for HCoV. Only 41 cases (20%) of HCoV infection were detected as single infections. Episodes of recurrent wheezing were the most common diagnosis, and 112 children (54%) had hypoxia. Clinical data in HCoV cases were similar to those associated with rhinovirus; however, patients with HCoV were younger. Other viruses were associated with hypoxia more frequently than cases with HCoV; high fever was more common in influenza infections and bronchiolitis in respiratory syncytial virus group. Although a slight peak of circulation appears mostly in winter, HCoV has been detected throughout the year as well. CONCLUSIONS: HCoV infections represent a small fraction of respiratory infections that require hospitalization in children and their characteristics do not differ greatly from other respiratory viral infections.


Subject(s)
Bronchiolitis, Viral/epidemiology , Coronavirus Infections/epidemiology , Hospitalization , Pneumonia, Viral/epidemiology , Adolescent , Age Distribution , Betacoronavirus , Bronchiolitis, Viral/physiopathology , Bronchiolitis, Viral/virology , COVID-19 , Child , Child, Preschool , Coronavirus Infections/physiopathology , Coronavirus Infections/virology , Coronavirus NL63, Human , Coronavirus OC43, Human , Female , Fever/physiopathology , Humans , Hypoxia/physiopathology , Infant , Infant, Newborn , Influenza, Human/epidemiology , Influenza, Human/physiopathology , Influenza, Human/virology , Male , Middle East Respiratory Syndrome Coronavirus , Pandemics , Picornaviridae Infections/epidemiology , Picornaviridae Infections/physiopathology , Picornaviridae Infections/virology , Pneumonia, Viral/physiopathology , Pneumonia, Viral/virology , Prospective Studies , Respiratory Sounds/physiopathology , Respiratory Syncytial Virus Infections/epidemiology , Respiratory Syncytial Virus Infections/physiopathology , Respiratory Syncytial Virus Infections/virology , Respiratory Tract Infections/epidemiology , Respiratory Tract Infections/physiopathology , Respiratory Tract Infections/virology , Rhinovirus , SARS Virus , SARS-CoV-2 , Seasons , Severe Acute Respiratory Syndrome , Severity of Illness Index , Spain/epidemiology
20.
Annu Rev Virol ; 7(1): 83-101, 2020 09 29.
Article in English | MEDLINE | ID: covidwho-35145

ABSTRACT

The seasonal cycle of respiratory viral diseases has been widely recognized for thousands of years, as annual epidemics of the common cold and influenza disease hit the human population like clockwork in the winter season in temperate regions. Moreover, epidemics caused by viruses such as severe acute respiratory syndrome coronavirus (SARS-CoV) and the newly emerging SARS-CoV-2 occur during the winter months. The mechanisms underlying the seasonal nature of respiratory viral infections have been examined and debated for many years. The two major contributing factors are the changes in environmental parameters and human behavior. Studies have revealed the effect of temperature and humidity on respiratory virus stability and transmission rates. More recent research highlights the importance of the environmental factors, especially temperature and humidity, in modulating host intrinsic, innate, and adaptive immune responses to viral infections in the respiratory tract. Here we review evidence of how outdoor and indoor climates are linked to the seasonality of viral respiratory infections. We further discuss determinants of host response in the seasonality of respiratory viruses by highlighting recent studies in the field.


Subject(s)
Coronavirus Infections/epidemiology , Influenza, Human/epidemiology , Pandemics , Picornaviridae Infections/epidemiology , Pneumonia, Viral/epidemiology , Respiratory Tract Infections/epidemiology , Severe Acute Respiratory Syndrome/epidemiology , Betacoronavirus/pathogenicity , Betacoronavirus/physiology , COVID-19 , Coronavirus Infections/transmission , Coronavirus Infections/virology , Humans , Humidity , Infectious Disease Incubation Period , Influenza, Human/transmission , Influenza, Human/virology , Orthomyxoviridae/pathogenicity , Orthomyxoviridae/physiology , Picornaviridae Infections/transmission , Picornaviridae Infections/virology , Pneumonia, Viral/transmission , Pneumonia, Viral/virology , Respiratory Tract Infections/transmission , Respiratory Tract Infections/virology , Rhinovirus/pathogenicity , Rhinovirus/physiology , SARS Virus/pathogenicity , SARS Virus/physiology , SARS-CoV-2 , Seasons , Severe Acute Respiratory Syndrome/transmission , Severe Acute Respiratory Syndrome/virology , Severity of Illness Index , Temperature
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