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2.
Sci Total Environ ; 892: 164495, 2023 Sep 20.
Article in English | MEDLINE | ID: covidwho-2328312

ABSTRACT

Wastewater-based surveillance can be a valuable tool to monitor viral circulation and serve as an early warning system. For respiratory viruses that share similar clinical symptoms, namely SARS-CoV-2, influenza, and respiratory syncytial virus (RSV), identification in wastewater may allow differentiation between seasonal outbreaks and COVID-19 peaks. In this study, to monitor these viruses as well as standard indicators of fecal contamination, a weekly sampling campaign was carried out for 15 months (from September 2021 to November 2022) in two wastewater treatment plants that serve the entire population of Barcelona (Spain). Samples were concentrated by the aluminum hydroxide adsorption-precipitation method and then analyzed by RNA extraction and RT-qPCR. All samples were positive for SARS-CoV-2, while the positivity rates for influenza virus and RSV were significantly lower (10.65 % for influenza A (IAV), 0.82 % for influenza B (IBV), 37.70 % for RSV-A and 34.43 % for RSV-B). Gene copy concentrations of SARS-CoV-2 were often approximately 1 to 2 logarithmic units higher compared to the other respiratory viruses. Clear peaks of IAV H3:N2 in February and March 2022 and RSV in winter 2021 were observed, which matched the chronological incidence of infections recorded in the Catalan Government clinical database. In conclusion, the data obtained from wastewater surveillance provided new information on the abundance of respiratory viruses in the Barcelona area and correlated favorably with clinical data.


Subject(s)
COVID-19 , Influenza, Human , Respiratory Syncytial Virus Infections , Viruses , Humans , Influenza, Human/epidemiology , Respiratory Syncytial Viruses/genetics , Wastewater , COVID-19/epidemiology , SARS-CoV-2 , Wastewater-Based Epidemiological Monitoring , Respiratory Syncytial Virus Infections/epidemiology
3.
BMC Infect Dis ; 23(1): 231, 2023 Apr 14.
Article in English | MEDLINE | ID: covidwho-2320842

ABSTRACT

BACKGROUND: Community-acquired pneumonia (CAP) is a major public health challenge worldwide. However, the aetiological and disease severity-related pathogens associated with CAP in adults in China are not well established based on the detection of both viral and bacterial agents. METHODS: A multicentre, prospective study was conducted involving 10 hospitals located in nine geographical regions in China from 2014 to 2019. Sputum or bronchoalveolar lavage fluid (BALF) samples were collected from each recruited CAP patient. Multiplex real-time PCR and bacteria culture methods were used to detect respiratory pathogens. The association between detected pathogens and CAP severity was evaluated. RESULTS: Among the 3,403 recruited eligible patients, 462 (13.58%) had severe CAP, and the in-hospital mortality rate was 1.94% (66/3,403). At least one pathogen was detected in 2,054 (60.36%) patients, with two or more pathogens were co-detected in 725 patients. The ten major pathogens detected were Mycoplasma pneumoniae (11.05%), Haemophilus influenzae (10.67%), Klebsiella pneumoniae (10.43%), influenza A virus (9.49%), human rhinovirus (9.02%), Streptococcus pneumoniae (7.43%), Staphylococcus aureus (4.50%), adenovirus (2.94%), respiratory syncytial viruses (2.35%), and Legionella pneumophila (1.03%), which accounted for 76.06-92.52% of all positive detection results across sampling sites. Klebsiella pneumoniae (p < 0.001) and influenza viruses (p = 0.005) were more frequently detected in older patients, whereas Mycoplasma pneumoniae was more frequently detected in younger patients (p < 0.001). Infections with Klebsiella pneumoniae, Staphylococcus aureus, influenza viruses and respiratory syncytial viruses were risk factors for severe CAP. CONCLUSIONS: The major respiratory pathogens causing CAP in adults in China were different from those in USA and European countries, which were consistent across different geographical regions over study years. Given the detection rate of pathogens and their association with severe CAP, we propose to include the ten major pathogens as priorities for clinical pathogen screening in China.


Subject(s)
Community-Acquired Infections , Legionella pneumophila , Pneumonia, Bacterial , Pneumonia , Humans , Adult , Aged , Pneumonia, Bacterial/diagnosis , Pneumonia, Bacterial/epidemiology , Pneumonia, Bacterial/complications , Prospective Studies , Pneumonia/diagnosis , Pneumonia/epidemiology , Pneumonia/etiology , Streptococcus pneumoniae , Mycoplasma pneumoniae , Respiratory Syncytial Viruses , Klebsiella pneumoniae , Community-Acquired Infections/diagnosis , Community-Acquired Infections/epidemiology , Community-Acquired Infections/etiology
5.
Int J Mol Sci ; 24(9)2023 Apr 29.
Article in English | MEDLINE | ID: covidwho-2316276

ABSTRACT

Rapid and reliable techniques for virus identification are required in light of recurring epidemics and pandemics throughout the world. Several techniques have been distributed for testing the flow of patients. Polymerase chain reaction with reverse transcription is a reliable and sensitive, though not rapid, tool. The antibody-based strip is a rapid, though not reliable, and sensitive tool. A set of alternative tools is being developed to meet all the needs of the customer. Surface-enhanced Raman spectroscopy (SERS) provides the possibility of single molecule detection taking several minutes. Here, a multiplex lithographic SERS aptasensor was developed aiming at the detection of several respiratory viruses in one pot within 17 min. The four labeled aptamers were anchored onto the metal surface of four SERS zones; the caught viruses affect the SERS signals of the labels, providing changes in the analytical signals. The sensor was able to decode mixes of SARS-CoV-2 (severe acute respiratory syndrome coronavirus two), influenza A virus, respiratory syncytial virus, and adenovirus within a single experiment through a one-stage recognition process.


Subject(s)
Biosensing Techniques , COVID-19 , Humans , SARS-CoV-2 , Spectrum Analysis, Raman/methods , Oligonucleotides/chemistry , Respiratory Syncytial Viruses , Biosensing Techniques/methods
6.
Eur Rev Med Pharmacol Sci ; 27(8): 3777-3783, 2023 Apr.
Article in English | MEDLINE | ID: covidwho-2316118

ABSTRACT

OBJECTIVE: Respiratory viral diseases are common in children. A viral diagnostic test is necessary, because COVID-19 shows signs and symptoms similar to those of common respiratory viruses. The article aims at analyzing the presence of respiratory viruses that were common before the pandemic in children who were tested for suspected COVID-19, and is also concerned with how common respiratory viruses were impacted by COVID-19 measures during the second year of pandemic. PATIENTS AND METHODS: Nasopharyngeal swabs were examined to detect the presence of respiratory viruses. The respiratory panel kit included SARS-CoV-2, influenza A and B, rhinovirus/enterovirus, parainfluenza 1, 2, 3 and 4, coronaviruses NL 63, 229E, OC43, and HKU1, human metapneumovirus A/B, human bocavirus, respiratory syncytial virus (RSV) A/B, human parechovirus, and adenovirus. Virus scans were compared during and after the restricted period. RESULTS: No virus was isolated from the 86 patients. SARS-CoV-2 was the most frequently observed virus, as expected, and rhinovirus was the second, and coronavirus OC43 was the third. Influenza viruses and RSV were not detected in the scans. CONCLUSIONS: Influenza and RSV viruses disappeared during the pandemic period and rhinovirus was the second most common virus after the CoVs during and after the restriction period. Non-pharmaceutical interventions should be established as a precaution to prevent infectious diseases even after the pandemic.


Subject(s)
COVID-19 , Enterovirus Infections , Influenza, Human , Metapneumovirus , Orthomyxoviridae , Respiratory Tract Infections , Vaccines , Viruses , Humans , Child , Respiratory Syncytial Viruses , Influenza, Human/epidemiology , Pandemics , Respiratory Tract Infections/diagnosis , COVID-19/epidemiology , COVID-19/prevention & control , SARS-CoV-2 , Rhinovirus
7.
Sci Total Environ ; 889: 164261, 2023 Sep 01.
Article in English | MEDLINE | ID: covidwho-2315264

ABSTRACT

A multiplex quantitative reverse transcription polymerase chain reaction (RT-qPCR)-based method was designed for the simultaneous detection of influenza A, SARS-CoV-2, respiratory syncytial virus, and measles virus. The performance of the multiplex assay was compared to four monoplex assays for relative quantification using standard quantification curves. Results showed that the multiplex assay had comparable linearity and analytical sensitivity to the monoplex assays, and the quantification parameters of both assays demonstrated minimal differences. Viral reporting recommendations for the multiplex method were estimated based on the corresponding limit of quantification (LOQ) and the limit of detection at 95 % confidence interval (LOD) values for each viral target. The LOQ was determined by the lowest nominal RNA concentrations where %CV values were ≤35 %. Corresponding LOD values for each viral target were between 15 and 25 gene copies per reaction (GC/rxn), and LOQ values were within 10 to 15 GC/rxn. The detection performance of a new multiplex assay was validated in the field by collecting composite wastewater samples from a local treatment facility and passive samples from three sewer shed locations. Results indicated that the assay could accurately estimate viral loads from various sample types, with samples collected from passive samplers showing a greater range of detectable viral concentrations than composite wastewater samples. This suggests that the sensitivity of the multiplex method may be improved when paired with more sensitive sampling methods. Laboratory and field results demonstrate the robustness and sensitivity of the multiplex assay and its applicability to detect the relative abundance of four viral targets among wastewater samples. Conventional monoplex RT-qPCR assays are suitable for diagnosing viral infections. However, multiplex analysis using wastewater provides a fast and cost-effective way to monitor viral diseases in a population or environment.


Subject(s)
COVID-19 , Influenza, Human , Measles , Virus Diseases , Humans , Respiratory Syncytial Viruses , SARS-CoV-2 , Wastewater , Sensitivity and Specificity , Multiplex Polymerase Chain Reaction/methods
8.
Ann N Y Acad Sci ; 1522(1): 60-73, 2023 04.
Article in English | MEDLINE | ID: covidwho-2313313

ABSTRACT

Respiratory viruses are a common cause of morbidity and mortality around the world. Viruses like influenza, RSV, and most recently SARS-CoV-2 can rapidly spread through a population, causing acute infection and, in vulnerable populations, severe or chronic disease. Developing effective treatment and prevention strategies often becomes a race against ever-evolving viruses that develop resistance, leaving therapy efficacy either short-lived or relevant for specific viral strains. On June 29 to July 2, 2022, researchers met for the Keystone symposium "Respiratory Viruses: New Frontiers." Researchers presented new insights into viral biology and virus-host interactions to understand the mechanisms of disease and identify novel treatment and prevention approaches that are effective, durable, and broad.


Subject(s)
COVID-19 , Influenza, Human , Respiratory Syncytial Virus Infections , Humans , COVID-19/pathology , COVID-19/virology , Host Microbial Interactions , Influenza, Human/pathology , Influenza, Human/virology , SARS-CoV-2 , Respiratory Syncytial Viruses , Respiratory Syncytial Virus Infections/pathology , Respiratory Syncytial Virus Infections/virology
10.
N Engl J Med ; 388(16): 1451-1464, 2023 Apr 20.
Article in English | MEDLINE | ID: covidwho-2297440

ABSTRACT

BACKGROUND: Whether vaccination during pregnancy could reduce the burden of respiratory syncytial virus (RSV)-associated lower respiratory tract illness in newborns and infants is uncertain. METHODS: In this phase 3, double-blind trial conducted in 18 countries, we randomly assigned, in a 1:1 ratio, pregnant women at 24 through 36 weeks' gestation to receive a single intramuscular injection of 120 µg of a bivalent RSV prefusion F protein-based (RSVpreF) vaccine or placebo. The two primary efficacy end points were medically attended severe RSV-associated lower respiratory tract illness and medically attended RSV-associated lower respiratory tract illness in infants within 90, 120, 150, and 180 days after birth. A lower boundary of the confidence interval for vaccine efficacy (99.5% confidence interval [CI] at 90 days; 97.58% CI at later intervals) greater than 20% was considered to meet the success criterion for vaccine efficacy with respect to the primary end points. RESULTS: At this prespecified interim analysis, the success criterion for vaccine efficacy was met with respect to one primary end point. Overall, 3682 maternal participants received vaccine and 3676 received placebo; 3570 and 3558 infants, respectively, were evaluated. Medically attended severe lower respiratory tract illness occurred within 90 days after birth in 6 infants of women in the vaccine group and 33 infants of women in the placebo group (vaccine efficacy, 81.8%; 99.5% CI, 40.6 to 96.3); 19 cases and 62 cases, respectively, occurred within 180 days after birth (vaccine efficacy, 69.4%; 97.58% CI, 44.3 to 84.1). Medically attended RSV-associated lower respiratory tract illness occurred within 90 days after birth in 24 infants of women in the vaccine group and 56 infants of women in the placebo group (vaccine efficacy, 57.1%; 99.5% CI, 14.7 to 79.8); these results did not meet the statistical success criterion. No safety signals were detected in maternal participants or in infants and toddlers up to 24 months of age. The incidences of adverse events reported within 1 month after injection or within 1 month after birth were similar in the vaccine group (13.8% of women and 37.1% of infants) and the placebo group (13.1% and 34.5%, respectively). CONCLUSIONS: RSVpreF vaccine administered during pregnancy was effective against medically attended severe RSV-associated lower respiratory tract illness in infants, and no safety concerns were identified. (Funded by Pfizer; MATISSE ClinicalTrials.gov number, NCT04424316.).


Subject(s)
Respiratory Syncytial Virus Infections , Respiratory Syncytial Virus Vaccines , Respiratory Tract Infections , Female , Humans , Infant , Infant, Newborn , Pregnancy , Antibodies, Viral , Communicable Diseases/therapy , Double-Blind Method , Injections, Intramuscular , Respiratory Syncytial Virus Infections/epidemiology , Respiratory Syncytial Virus Infections/prevention & control , Respiratory Syncytial Virus Vaccines/administration & dosage , Respiratory Syncytial Virus Vaccines/adverse effects , Respiratory Syncytial Virus Vaccines/therapeutic use , Respiratory Syncytial Viruses , Treatment Outcome , Vaccination/adverse effects , Vaccination/methods , Vaccine Efficacy , Vaccines, Combined/administration & dosage , Vaccines, Combined/adverse effects , Vaccines, Combined/therapeutic use , Respiratory Tract Infections/epidemiology , Respiratory Tract Infections/prevention & control
11.
Rural Remote Health ; 23(1): 8088, 2023 01.
Article in English | MEDLINE | ID: covidwho-2272243

ABSTRACT

BACKGROUND AND AIMS: Breastfeeding practices have demonstrated a protective effect against severe respiratory syncytial virus (RSV) disease outcomes. RSV is the principal cause of lower respiratory tract infections in infants worldwide, and an important cause of morbidity, hospitalization, and mortality. The primary aim is to determine the impact of breastfeeding on the incidence and severity of RSV bronchiolitis in infants. Secondly, the study aims to determine if breastfeeding contributes to reduction of hospitalization rates, length of stay and oxygen use in confirmed cases. METHODS: A preliminary database search was conducted using agreed keywords and MeSH headings in MEDLINE, PubMed, Google Scholar, EMBASE, MedRχiv and Cochrane Reviews. Articles were screened based on inclusion/exclusion criteria for infants aged 0-12 months. Full text, abstract and conference articles published in English were included from 2000 to 2021. Covidence® software was used for evidence extraction using paired investigator agreement and PRISMA guidelines were followed. RESULTS: 1368 studies were screened and 217 were eligible for full text review. 188 were excluded. Twenty-nine articles were selected for data extraction: RSV-bronchiolitis (18) and viral bronchiolitis (13), with two articles discussing both. Results showed that non-breastfeeding practices are a significant risk factor for hospitalization. Exclusive breastfeeding for >4-6 months significantly lowered admission rates, length of stay and supplemental oxygen use, reducing unscheduled GP visits and emergency department presentation. DISCUSSION: Exclusive and partial breastfeeding reduce severity of RSV bronchiolitis, length of hospital stay and supplemental oxygen requirement. Breastfeeding practices should be supported and encouraged as a cost-effective method to prevent infant hospitalization and severe bronchiolitis infection.


Subject(s)
Bronchiolitis , Respiratory Syncytial Virus Infections , Female , Infant , Humans , Breast Feeding , Incidence , Respiratory Syncytial Virus Infections/epidemiology , Respiratory Syncytial Virus Infections/prevention & control , Hospitalization , Bronchiolitis/epidemiology , Respiratory Syncytial Viruses , Oxygen
12.
Transpl Infect Dis ; 25(1): e13998, 2023 Feb.
Article in English | MEDLINE | ID: covidwho-2271880

ABSTRACT

BACKGROUND: Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic has been raging since the end of 2019 and has shown worse outcomes in solid organ transplant (SOT) recipients. The clinical differences as well as outcomes between respiratory viruses have not been well defined in this population. METHODS: This is a retrospective cohort study of adult SOT recipients with nasopharyngeal swab or bronchoalveolar lavage PCR positive for either SARS-CoV-2, seasonal coronavirus, respiratory syncytial virus (RSV) or influenza virus from January 2017 to October 2020. The follow up period was 3 months. Clinical characteristics and outcomes were evaluated. RESULTS: A total of 377 recipients including 157 SARS-CoV-2, 70 seasonal coronavirus, 50 RSV and 100 influenza infections were identified. The most common transplanted organ was kidney 224/377 (59.4%). Lower respiratory tract infection (LRTI) was found in 210/377 (55.7%) and the risk factors identified with multivariable analysis were SARS-CoV-2 infection, steroid use, and older age. Co- and secondary infections were seen in 77/377 (20.4%) recipients with bacterial pathogens as dominant. Hospital admission was seen in 266/377 (67.7%) recipients without significant statistical difference among viruses, however, ICU admission, mechanical ventilation and mortality were higher with SARS-CoV-2 infection. In the multivariable model, the risk factors for mortality were SARS-CoV-2 infection and older age. CONCLUSIONS: We found higher incidence of ICU admission, mechanical ventilation, and mortality among SARS-CoV-2 infected recipients. Older age was found to be the risk factor for lower respiratory tract infection and mortality for SARS-CoV-2, coronaviruses, RSV and influenza virus groups.


Subject(s)
COVID-19 , Influenza, Human , Organ Transplantation , Respiratory Syncytial Virus Infections , Respiratory Tract Infections , Adult , Humans , SARS-CoV-2 , Influenza, Human/etiology , Retrospective Studies , Seasons , Organ Transplantation/adverse effects , Respiratory Syncytial Viruses , Transplant Recipients
14.
J Nephrol ; 36(5): 1349-1359, 2023 06.
Article in English | MEDLINE | ID: covidwho-2281334

ABSTRACT

BACKGROUND: Acute Kidney Injury (AKI) complicates a substantial part of patients with COVID-19. Direct viral penetration of renal cells through the Angiotensin Converting Enzyme 2 receptor, and indirect damage by the aberrant inflammatory response characteristic of COVID-19 are likely mechanisms. Nevertheless, other common respiratory viruses such as Influenza and Respiratory Syncytial Virus (RSV) are also associated with AKI. METHODS: We retrospectively compared the incidence, risk factors and outcomes of AKI among patients who were admitted to a tertiary hospital because of infection with COVID-19, influenza (A + B) or RSV. RESULTS: We collected data of 2593 patients hospitalized with COVID-19, 2041 patients with influenza and 429 with RSV. Patients affected by RSV were older, had more comorbidities and presented with higher rates of AKI at admission and within 7 days (11.7% vs. 13.3% vs. 18% for COVID-19, influenza and RSV, respectively p = 0.001). Nevertheless, patients hospitalized with COVID-19 had higher mortality (18% with COVID-19 vs. 8.6% and 13.5% for influenza and RSV, respectively P < 0.001) and higher need of mechanical ventilation (12.4% vs. 6.5% vs.8.2% for COVID-19, influenza and RSV, respectively, P = 0.002). High ferritin levels and low oxygen saturation were independent risk factors for severe AKI only in the COVID-19 group. AKI in the first 48 h of admission and in the first 7 days of hospitalization were strong independent risk factors for adverse outcome in all groups. CONCLUSION: Despite many reports of direct kidney injury by SARS-COV-2, AKI was less in patients with COVID-19 compared to influenza and RSV patients. AKI was a prognostic marker for adverse outcome across all viruses.


Subject(s)
Acute Kidney Injury , COVID-19 , Influenza, Human , Orthomyxoviridae , Respiratory Syncytial Virus Infections , Humans , Respiratory Syncytial Viruses , Prognosis , Influenza, Human/complications , Influenza, Human/diagnosis , Influenza, Human/epidemiology , Retrospective Studies , Respiratory Syncytial Virus Infections/complications , Respiratory Syncytial Virus Infections/diagnosis , Respiratory Syncytial Virus Infections/epidemiology , COVID-19/complications , COVID-19/epidemiology , SARS-CoV-2 , Hospitalization , Risk Factors , Acute Kidney Injury/diagnosis , Acute Kidney Injury/epidemiology , Acute Kidney Injury/etiology
15.
Int J Environ Res Public Health ; 20(6)2023 03 22.
Article in English | MEDLINE | ID: covidwho-2267111

ABSTRACT

The emergence of the COVID-19 pandemic has led to significant progress in the field of wastewater-based surveillance (WBS) of respiratory pathogens and highlighted its potential for a wider application in public health surveillance. This study aimed to evaluate whether monitoring of respiratory syncytial virus (RSV) in wastewater can provide a comprehensive picture of disease transmission at the community level. The study was conducted in Larissa (Central Greece) between October 2022 and January 2023. Forty-six wastewater samples were collected from the inlet of the wastewater treatment plant of Larissa and analyzed with a real-time reverse transcription polymerase chain reaction (RT-PCR) based method. RSV and SARS-CoV-2 wastewater viral loads (genome copies/100,000 inhabitants) were analyzed against sentinel surveillance data on influenza-like illness (ILI) to identify potential associations. Univariate linear regression analysis revealed that RSV wastewater viral load (lagged by one week) and ILI notification rates in children up to 14 years old were strongly associated (std. Beta: 0.73 (95% CI: 0.31-1.14), p = 0.002, R2 = 0.308). A weaker association was found between SARS-CoV-2 viral load and ILI rates in the 15+ age group (std. Beta: 0.56 (95% CI: 0.06-1.05), p = 0.032, R2 = 0.527). The results support the incorporation of RSV monitoring into existing wastewater-based surveillance systems.


Subject(s)
COVID-19 , Influenza, Human , Respiratory Syncytial Virus Infections , Sexually Transmitted Diseases , Virus Diseases , Humans , Child , Respiratory Syncytial Viruses/genetics , Wastewater , Influenza, Human/epidemiology , Respiratory Syncytial Virus Infections/epidemiology , Greece/epidemiology , Pandemics , COVID-19/epidemiology , SARS-CoV-2 , Virus Diseases/epidemiology , Sexually Transmitted Diseases/epidemiology
16.
Int J Environ Res Public Health ; 20(5)2023 03 04.
Article in English | MEDLINE | ID: covidwho-2255354

ABSTRACT

Respiratory Syncytial Virus (RSV) is a known cause of acute lower respiratory infections in infants and young children. The present study aims to analyze the temporal trends and characteristics of hospitalization related to RSV in the Veneto region (Italy) in the period between 2007 and 2021. The analysis is performed on all the hospital discharge records (HDRs) of public and accredited private hospitals corresponding to hospitalizations occurring in the Veneto region (Italy). HDRs are considered if they included at least one of the following ICD9-CM codes: 079.6-Respiratory Syncytial Virus (RSV); 466.11-acute bronchiolitis due to RSV; and 480.1-pneumonia due to RSV. Total annual cases, sex, and age-specific rates and trends are evaluated. Overall, an increasing trend in the number of hospitalizations due to RSV was observed between 2007 and 2019, with a slight drop in RSV seasons 2013-2014 and 2014-2015. From March 2020 to September 2021, almost no hospitalization was registered, but in the last quarter of 2021, the number of hospitalizations reached its highest value in the series. Our data confirm the preponderance of RSV hospitalizations in infants and young children, the seasonality of RSV hospitalizations, and acute bronchiolitis as the most frequent diagnosis. Interestingly, the data also show the existence of a significant burden of disease and a non-negligible number of deaths also in older adults. The present study confirms RSV is associated with high rates of hospitalization in infants and sheds light on the burden in the 70+ age group in which a considerable number of deaths was observed, as well as the parallelism with other countries, which is consistent with a wide underdiagnoses issue.


Subject(s)
Bronchiolitis , Respiratory Syncytial Virus Infections , Respiratory Tract Infections , Infant , Child , Humans , Aged , Child, Preschool , Respiratory Syncytial Viruses , Respiratory Syncytial Virus Infections/diagnosis , Hospitalization
18.
J Clin Virol ; 161: 105402, 2023 04.
Article in English | MEDLINE | ID: covidwho-2240340

ABSTRACT

BACKGROUND: Influenza and respiratory syncytial (RSV) viruses are expected to co-circulate with SARS-CoV-2 in the upcoming seasons and clinical differential diagnosis between them is difficult. Laboratory-based RT-PCR is a gold standard diagnostic method for influenza, RSV and SARS-CoV-2. The objective of this study was to estimate the diagnostic performance of a novel point-of-care RT-PCR assay STANDARD M10 Flu/RSV/SARS-CoV-2 (SD Biosensor) in a large number of clinical specimens with diversified (co)-infection patterns and viral loads. METHODS: This was a retrospective study, in which all samples were tested in both STANDARD M10 Flu/RSV/SARS-CoV-2 index and Allplex SARS-CoV-2/Respiratory Panel 1 (Seegene) reference kits. Samples with discordant results were further processed in a third resolver test (Resp-4-Plex, Abbott). RESULTS: A total of 1,019 naso-/oropharyngeal samples (50.3% positive for at least one virus) were processed in both STANDARD M10 Flu/RSV/SARS-CoV-2 and Allplex assays and the overall between-assay agreement was as high as 94.6%. Positive percent agreement of the STANDARD M10 Flu/RSV/SARS-CoV-2 was 100%, 96.6%, 97.3% and 99.4% for influenza A, B, RSV and SARS-CoV-2, respectively. The corresponding negative percent agreement was 99.7%. 100%, 100% and 98.4%, respectively. The expected positive and negative predictive values for all viruses were constantly above 96% in a reasonable range of disease prevalence. CONCLUSIONS: STANDARD M10 Flu/RSV/SARS-CoV-2 is a reliable RT-PCR assay able to detect influenza A, influenza B, RSV and SARS-CoV-2 in one hour or less, fostering a rapid differential diagnosis of common respiratory viruses.


Subject(s)
COVID-19 , Coinfection , Influenza A virus , Influenza, Human , Respiratory Syncytial Virus Infections , Respiratory Syncytial Virus, Human , Humans , Influenza, Human/diagnosis , Respiratory Syncytial Viruses , SARS-CoV-2/genetics , Respiratory Syncytial Virus Infections/diagnosis , Influenza B virus/genetics , Diagnosis, Differential , Reverse Transcriptase Polymerase Chain Reaction , Retrospective Studies , Sensitivity and Specificity , Influenza A virus/genetics , Molecular Diagnostic Techniques/methods , Real-Time Polymerase Chain Reaction/methods , COVID-19/diagnosis , Coinfection/diagnosis , Respiratory Syncytial Virus, Human/genetics
19.
BMJ Glob Health ; 8(2)2023 02.
Article in English | MEDLINE | ID: covidwho-2233321

ABSTRACT

BACKGROUND: Respiratory syncytial virus (RSV) is the principal cause of acute lower respiratory infections (ALRI) among infants worldwide, and an important cause of morbidity, hospitalisation and mortality. While infants are universally exposed to RSV, most mortality occurs among normal term infants from low-income and middle-income countries. Breastfeeding has been suggested to have a protective effect against RSV infection. This study aims to determine the association of breastfeeding on the frequency and severity of RSV-associated ALRI among infants. METHODS: A systematic review was conducted using keywords and Medical Subject Headings on MEDLINE, PubMed, Google Scholar, EMBASE, MedRxiv and Cochrane Central Register of Controlled Trials. Full-text articles published in English from 2000 to 2021 that studied exclusively or partially breastfed infants who developed RSV-associated ALRI <12 months of age were included. Covidence software-based evidence extraction and Preferred Reporting Items for Systematic Reviews and Meta-Analyses Protocol guidelines were followed. Quality of evidence was analysed using UK National Service Framework grading and the risk-of-bias assessment using Robvis. RESULTS: Among 1368 studies screened, 217 qualified full-text review and 198 were excluded based on pre-agreed criteria. Nineteen articles published from 12 countries that included 16 787 infants from 31 countries (of which 8 middle-income) were retained for analysis. Results indicate that non-breastfeeding practices pose a significant risk for severe RSV-associated ALRI and hospitalisation. Exclusive breastfeeding for >4-6 months significantly lowered hospitalisation, length of stay, supplemental oxygen demand and admission to intensive care units. CONCLUSION: In the context of no effective or standardised treatment for established RSV-associated ALRI, available evidence suggest that breastfeeding is associated with lower frequency and severity of RSV-associated ALRI, based on observational studies of variable grades of evidence and risk-of-bias. With both exclusive and partial breastfeeding benefiting infants who develop RSV-associated ALRI, breastfeeding should be promoted globally as an adjunct primary prevention; in addition to emerging immunoprophylaxis and maternal immunisation strategies.


Subject(s)
Respiratory Syncytial Viruses , Respiratory Tract Infections , Female , Infant , Humans , Breast Feeding , Incidence , Respiratory Tract Infections/epidemiology , Respiratory Tract Infections/prevention & control , Primary Prevention
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