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1.
J Infect Public Health ; 15(4): 412-424, 2022 Apr.
Article in English | MEDLINE | ID: covidwho-1796484

ABSTRACT

Over the past two decades, diabetes mellitus (DM) has been receiving increasing attention among autoimmune diseases. The prevalence of type 1 and type 2 diabetes has increased rapidly and has become one of the leading causes of death worldwide. Therefore, a better understanding of the genetic and environmental risk factors that trigger the onset of DM would help develop more efficient therapeutics and preventive measures. The role and mechanism of respiratory viruses in inducing autoimmunity have been frequently reported. On the other hand, the association of DM with respiratory infections might result in severe complications or even death. Since influenza is the most common respiratory infection, DM patients experience disease severity and increased hospitalization during influenza season. Vaccinating diabetic patients against influenza would significantly reduce hospitalization due to disease severity. However, recent studies also report the role of viral vaccines in inducing autoimmunity, specifically diabetes. This review reports causes of diabetes, including genetic and viral factors, with a special focus on respiratory viruses. We further brief the burden of influenza-associated complications and the effectiveness of the influenza vaccine in DM patients.


Subject(s)
Diabetes Mellitus, Type 2 , Influenza Vaccines , Influenza, Human , Respiratory Tract Infections , Viruses , Hospitalization , Humans , Influenza, Human/complications , Influenza, Human/epidemiology , Influenza, Human/prevention & control , Respiratory Tract Infections/complications , Respiratory Tract Infections/epidemiology , Respiratory Tract Infections/prevention & control
3.
PLoS One ; 16(11): e0259910, 2021.
Article in English | MEDLINE | ID: covidwho-1581787

ABSTRACT

BACKGROUND: Clinical observations have shown that there is a relationship between coronavirus disease 2019 (COVID-19) and atypical lymphocytes in the peripheral blood; however, knowledge about the time course of the changes in atypical lymphocytes and the association with the clinical course of COVID-19 is limited. OBJECTIVE: Our purposes were to investigate the dynamics of atypical lymphocytes in COVID-19 patients and to estimate their clinical significance for diagnosis and monitoring disease course. MATERIALS AND METHODS: We retrospectively identified 98 inpatients in a general ward at Kashiwa Municipal Hospital from May 1st, 2020, to October 31st, 2020. We extracted data on patient demographics, symptoms, comorbidities, blood test results, radiographic findings, treatment after admission and clinical course. We compared clinical findings between patients with and without atypical lymphocytes, investigated the behavior of atypical lymphocytes throughout the clinical course of COVID-19, and determined the relationships among the development of pneumonia, the use of supplemental oxygen and the presence of atypical lymphocytes. RESULTS: Patients with atypical lymphocytes had a significantly higher prevalence of pneumonia (80.4% vs. 42.6%, p < 0.0001) and the use of supplemental oxygen (25.5% vs. 4.3%, p = 0.0042). The median time to the appearance of atypical lymphocytes after disease onset was eight days, and atypical lymphocytes were observed in 16/98 (16.3%) patients at the first visit. Atypical lymphocytes appeared after the confirmation of lung infiltrates in 31/41 (75.6%) patients. Of the 13 oxygen-treated patients with atypical lymphocytes, approximately two-thirds had a stable or improved clinical course after the appearance of atypical lymphocytes. CONCLUSION: Atypical lymphocytes frequently appeared in the peripheral blood of COVID-19 patients one week after disease onset. Patients with atypical lymphocytes were more likely to have pneumonia and to need supplemental oxygen; however, two-thirds of them showed clinical improvement after the appearance of atypical lymphocytes.


Subject(s)
COVID-19/diagnosis , Leukocyte Disorders/diagnosis , Pneumonia/diagnosis , Respiratory Tract Infections/diagnosis , Adult , COVID-19/complications , COVID-19/epidemiology , COVID-19/virology , Female , Hospitalization , Humans , Intensive Care Units , Leukocyte Disorders/complications , Leukocyte Disorders/epidemiology , Leukocyte Disorders/virology , Leukocytes, Mononuclear/pathology , Lymphocytes/pathology , Male , Middle Aged , Oxygen/blood , Pneumonia/blood , Pneumonia/epidemiology , Pneumonia/virology , Respiratory Tract Infections/complications , Respiratory Tract Infections/epidemiology , Respiratory Tract Infections/virology , SARS-CoV-2/pathogenicity
4.
Microbiol Spectr ; 9(2): e0083121, 2021 10 31.
Article in English | MEDLINE | ID: covidwho-1476399

ABSTRACT

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), the etiological agent of coronavirus disease 2019 (COVID-19), has infected all age groups and disproportionately impacted vulnerable populations globally. Polymicrobial infections may play an important role in the development of SARS-CoV-2 infection in susceptible hosts. These coinfections may increase the risk of disease severity and pose challenges to the diagnosis, treatment, and prognosis of COVID-19. There have been limited SARS-CoV-2 coinfection studies. In this retrospective study, residual nucleic acid extracts from 796 laboratory-confirmed COVID-19-positive specimens, collected between March 2020 and February 2021, were analyzed using a Luminex NxTAG respiratory pathogen panel (RPP). Of these, 745 returned valid results and were used for analysis; 53 (7.1%) were positive for one or more additional pathogens. Six different respiratory viruses were detected among the 53 SARS-CoV-2-positive patient specimens, and 7 of those specimens tested positive for more than one additional respiratory virus. The most common pathogens include rhinovirus/enterovirus (RV/EV) (n = 22, 41.51%), human metapneumovirus (hMPV) (n = 18, 33.9%), and adenovirus (n = 12, 22.6%). Interestingly, there were no SARS-CoV-2 coinfections involving influenza A or influenza B in the study specimens. The median age of the SARS-CoV-2-positive patients with coinfections was 38 years; 53% identified as female, and 47% identified as male. Based on our retrospective analysis, respiratory coinfections associated with SARS-CoV-2-positive patients were more common in young children (≤9 years old), with white being the most common race. Our findings will likely prompt additional investigation of polymicrobial infection associated with SARS-CoV-2 during seasonal respiratory pathogen surveillance by public health laboratories. IMPORTANCE This examination of respiratory pathogen coinfections in SARS-CoV-2 patients will likely shed light on our understanding of polymicrobial infection associated with COVID-19. Our results should prompt public health authorities to improve seasonal respiratory pathogen surveillance practices and address the risk of disease severity.


Subject(s)
COVID-19/complications , Coinfection/virology , Respiratory Tract Infections/complications , Respiratory Tract Infections/virology , Adenoviridae/genetics , Adenoviridae/isolation & purification , Adolescent , Adult , Aged , Aged, 80 and over , Child , Enterovirus/genetics , Enterovirus/isolation & purification , Female , Humans , Male , Metapneumovirus/genetics , Metapneumovirus/isolation & purification , Middle Aged , Retrospective Studies , Rhinovirus/genetics , Rhinovirus/isolation & purification , SARS-CoV-2/genetics , Wisconsin , Young Adult
5.
Diagn Microbiol Infect Dis ; 102(1): 115558, 2022 Jan.
Article in English | MEDLINE | ID: covidwho-1446562

ABSTRACT

The primary objectives were to determine the prevalence of and identify variables associated with respiratory bacterial co-infection in COVID-19 inpatients. Secondary outcomes included length of stay and in-hospital mortality. Eighty-two (11.2%) of 735 COVID-19 inpatients had respiratory bacterial co-infection. Fifty-seven patients met inclusion criteria and were matched to three patients lacking co-infection (N = 228 patients). Patients with co-infection were more likely to receive antibiotics [57 (100%) vs 130 (76%), P < 0.0001] and for a longer duration [19 (13-33) vs 8 (4-13) days, P < 0.0001]. The multi-variable logistic regression model revealed risk factors of respiratory bacterial co-infection to be admission from SNF/LTAC/NH (AOR 6.8, 95% CI 2.6-18.2), severe COVID-19 (AOR 3.03, 95% CI 0.78-11.9), and leukocytosis (AOR 3.03, 95% CI 0.99-1.16). Although respiratory bacterial co-infection is rare in COVID-19 inpatients, antibiotic use is common. Early recognition of respiratory bacterial coinfection predictors in COVID-19 inpatients may improve empiric antibiotic prescribing.


Subject(s)
Bacterial Infections/complications , COVID-19/complications , Coinfection , Respiratory Tract Infections/complications , SARS-CoV-2 , Aged , Female , Humans , Inpatients , Male , Middle Aged , Respiratory Tract Infections/microbiology , Risk Factors
7.
Sci Rep ; 11(1): 16355, 2021 08 11.
Article in English | MEDLINE | ID: covidwho-1354115

ABSTRACT

Rapid diagnostic tests are tools of paramount impact both for improving patient care and in antimicrobial management programs. Particularly in the case of respiratory infections, it is of great importance to quickly confirm/exclude the involvement of pathogens, be they bacteria or viruses, while obtaining information about the presence/absence of a genetic target of resistance to modulate antibiotic therapy. In this paper, we present our experiences with the use of the Biofire® FilmArray® Pneumonia Panel Plus (FAPP; bioMérieux; Marcy l'Etoile, France) to assess coinfection in COVID-19 patients. A total of 152 respiratory samples from consecutive patients were examined, and 93 (61%) were found to be FAPP positive, with the detection of bacteria and/or viruses. The patients were 93 males and 59 females with an average age of 65 years who were admitted to our hospital due to moderate/severe acute respiratory symptoms. Among the positive samples were 52 from sputum (SPU) and 41 from bronchoalveolar lavage (BAL). The most representative species was S. aureus (most isolates were mecA positive; 30/44, 62%), followed by gram-negative pathogens such as P. aeruginosa, K. pneumoniae, and A. baumannii. Evidence of a virus was rare. Cultures performed from BAL and SPU samples gave poor results. Most of the discrepant negative cultures were those in which FAPP detected pathogens with a microbial count ≤ 105 CFU/mL. H. influenzae was one of the most common pathogens lost by the conventional method. Despite the potential limitations of FAPP, which detects a defined number of pathogens, its advantages of rapid detection combined with predictive information regarding the antimicrobial resistance of pathogens through the detection of some relevant markers of resistance could be very useful for establishing empirical targeted therapy for the treatment of patients with respiratory failure. In the COVID era, we understand the importance of using antibiotics wisely to curb the phenomenon of antibiotic resistance.


Subject(s)
COVID-19/complications , Coinfection , Diagnostic Tests, Routine , Respiratory Tract Infections/complications , Respiratory Tract Infections/diagnosis , Aged , Female , Humans , Male , Multiplex Polymerase Chain Reaction/methods , Respiratory Tract Infections/microbiology , Respiratory Tract Infections/virology
9.
Indian Heart J ; 73(5): 565-571, 2021.
Article in English | MEDLINE | ID: covidwho-1312426

ABSTRACT

OBJECTIVE: To evaluate the prevalence and impact of respiratory infections in cardiogenic shock complicating acute myocardial infarction (AMI-CS). METHODS: Using the National Inpatient Sample (2000-2017), this study identified adult (≥18 years) admitted with AMI-CS complicated by respiratory infections. Outcomes of interest included in-hospital mortality of AMI-CS admissions with and without respiratory infections, hospitalization costs, hospital length of stay, and discharge disposition. Temporal trends of prevalence, in-hospital mortality and cardiac procedures were evaluated. RESULTS: Among 557,974 AMI-CS admissions, concomitant respiratory infections were identified in 84,684 (15.2%). Temporal trends revealed a relatively stable trend in prevalence of respiratory infections over the 18-year period. Admissions with respiratory infections were on average older, less likely to be female, with greater comorbidity, had significantly higher rates of NSTEMI presentation, and acute non-cardiac organ failure compared to those without respiratory infections (all p < 0.001). These admissions received lower rates of coronary angiography (66.8% vs 69.4%, p < 0.001) and percutaneous coronary interventions (44.8% vs 49.5%, p < 0.001), with higher rates of mechanical circulatory support, pulmonary artery catheterization, and invasive mechanical ventilation compared to AMI-CS admissions without respiratory infections (all p < 0.001). The in-hospital mortality was lower among AMI-CS admissions with respiratory infections (31.6% vs 38.4%, adjusted OR 0.58 [95% CI 0.57-0.59], p < 0.001). Admissions with respiratory infections had longer lengths of hospital stay (127-20 vs 63-11 days, p < 0.001), higher hospitalization costs and less frequent discharges to home (27.1% vs 44.7%, p < 0.001). CONCLUSIONS: Respiratory infections in AMI-CS admissions were associated with higher resource utilization but lower in-hospital mortality.


Subject(s)
Myocardial Infarction , Percutaneous Coronary Intervention , Respiratory Tract Infections , Adult , Female , Hospital Mortality , Humans , Myocardial Infarction/complications , Myocardial Infarction/epidemiology , Myocardial Infarction/therapy , Respiratory Tract Infections/complications , Respiratory Tract Infections/epidemiology , Shock, Cardiogenic/epidemiology , Shock, Cardiogenic/etiology , Shock, Cardiogenic/therapy
10.
Sci Rep ; 11(1): 13580, 2021 06 30.
Article in English | MEDLINE | ID: covidwho-1291169

ABSTRACT

In the DECODE project, data were collected from 3,114 surveys filled by symptomatic patients RT-qPCR tested for SARS-CoV-2 in a single university centre in March-September 2020. The population demonstrated balanced sex and age with 759 SARS-CoV-2( +) patients. The most discriminative symptoms in SARS-CoV-2( +) patients at early infection stage were loss of taste/smell (OR = 3.33, p < 0.0001), body temperature above 38℃ (OR = 1.67, p < 0.0001), muscle aches (OR = 1.30, p = 0.0242), headache (OR = 1.27, p = 0.0405), cough (OR = 1.26, p = 0.0477). Dyspnea was more often reported among SARS-CoV-2(-) (OR = 0.55, p < 0.0001). Cough and dyspnea were 3.5 times more frequent among SARS-CoV-2(-) (OR = 0.28, p < 0.0001). Co-occurrence of cough, muscle aches, headache, loss of taste/smell (OR = 4.72, p = 0.0015) appeared significant, although co-occurrence of two symptoms only, cough and loss of smell or taste, means OR = 2.49 (p < 0.0001). Temperature > 38℃ with cough was most frequent in men (20%), while loss of taste/smell with cough in women (17%). For younger people, taste/smell impairment is sufficient to characterise infection, whereas in older patients co-occurrence of fever and cough is necessary. The presented study objectifies the single symptoms and interactions significance in COVID-19 diagnoses and demonstrates diverse symptomatology in patient groups.


Subject(s)
COVID-19/diagnosis , COVID-19/epidemiology , Respiratory Tract Infections/diagnosis , Respiratory Tract Infections/epidemiology , SARS-CoV-2 , Symptom Assessment/statistics & numerical data , Academic Medical Centers/statistics & numerical data , Adolescent , Adult , Aged , Aged, 80 and over , Ageusia/etiology , COVID-19/complications , Child , Child, Preschool , Cough/etiology , Diagnosis, Differential , Dyspnea/etiology , Female , Fever/etiology , Headache/etiology , Humans , Infant , Male , Middle Aged , Odds Ratio , Olfaction Disorders/etiology , Pilot Projects , Poland/epidemiology , Respiratory Tract Infections/complications , Respiratory Tract Infections/microbiology , Surveys and Questionnaires , Symptom Assessment/classification , Young Adult
11.
Arch Argent Pediatr ; 119(3): e252-e255, 2021 06.
Article in English, Spanish | MEDLINE | ID: covidwho-1242314

ABSTRACT

Coronavirus infections (CoV) are common in pediatric patients. In general, they produce a mild clinical presentation consisting of an upper respiratory tract infection that does not usually infect the lungs, with the exception of preterm infants and children with chronic diseases. These infections exceptionally affect other organs (heart, brain, gastrointestinal tract), thus increasing their severity. In relation to the temporal coincidence with the beginning of the current situation of pandemic by the new beta coronavirus SARS-CoV-2 responsible for its associated disease (COVID-19), this study presents a clinical case of a 5-year-old patient showing multiple-organ failure and neurological sequelae due to bulbar injury and vascular thrombosis caused by an alpha coronavirus (CoV-NL63) due to its severity and exceptionality.


Las infecciones por coronavirus son habituales en los pacientes pediátricos. Por lo general, producen un cuadro clínico leve de infección del tracto respiratorio superior que no suele afectar a los pulmones, salvo en prematuros y niños con enfermedades crónicas de base. Excepcionalmente, afectan a otros órganos (corazón, cerebro, tracto gastrointestinal) e incrementan su gravedad. En relación con la coincidencia temporal con el inicio de la actual pandemia por el nuevo beta coronavirus (SARSCoV- 2), responsable de su enfermedad asociada (COVID-19), se presenta el caso clínico de un paciente de 5 años con fracaso multiorgánico y secuelas neurológicas por afectación bulbar y trombosis vascular ocasionados por un alfa coronavirus (CoVNL63) debido a su gravedad y excepcionalidad.


Subject(s)
Coronavirus Infections/diagnosis , Coronavirus NL63, Human/isolation & purification , Multiple Organ Failure/virology , Respiratory Tract Infections/diagnosis , COVID-19/diagnosis , Child, Preschool , Coronavirus Infections/complications , Diagnosis, Differential , Humans , Multiple Organ Failure/diagnosis , Respiratory Tract Infections/complications
12.
Virol J ; 18(1): 89, 2021 04 30.
Article in English | MEDLINE | ID: covidwho-1209064

ABSTRACT

BACKGROUND: A novel coronavirus (SARS-CoV-2) emerging has put global public health institutes on high alert. Little is known about the epidemiology and clinical characteristics of human coronaviruses infections in relation to infections with other respiratory viruses. METHODS: From February 2017 to December 2019, 3660 respiratory samples submitted to Zhejiang Children Hospital with acute respiratory symptoms were tested for four human coronaviruses RNA by a novel two-tube multiplex reverse transcription polymerase chain reaction assays. Samples were also screened for the occurrence of SARS-CoV-2 by reverse transcription-PCR analysis. RESULTS: Coronavirus RNAs were detected in 144 (3.93%) specimens: HCoV-HKU1 in 38 specimens, HCoV-NL63 in 62 specimens, HCoV-OC43 in 38 specimens and HCoV-229E in 8 specimens. Genomes for SARS-CoV-2 were absent in all specimens by RT-PCR analysis during the study period. The majority of HCoV infections occurred during fall months. No significant differences in gender, sample type, year were seen across species. 37.5 to 52.6% of coronaviruses detected were in specimens testing positive for other respiratory viruses. Phylogenic analysis identified that Zhejiang coronaviruses belong to multiple lineages of the coronaviruses circulating in other countries and areas. CONCLUSION: Common HCoVs may have annual peaks of circulation in fall months in the Zhejiang province, China. Genetic relatedness to the coronaviruses in other regions suggests further surveillance on human coronaviruses in clinical samples are clearly needed to understand their patterns of activity and role in the emergence of novel coronaviruses.


Subject(s)
COVID-19/diagnosis , Multiplex Polymerase Chain Reaction/methods , Respiratory Tract Infections/virology , SARS-CoV-2/genetics , Adolescent , Betacoronavirus/genetics , Betacoronavirus/isolation & purification , COVID-19/complications , COVID-19/genetics , COVID-19/physiopathology , Child , Child, Preschool , China/epidemiology , Coronavirus/genetics , Coronavirus/isolation & purification , Coronavirus 229E, Human/genetics , Coronavirus 229E, Human/isolation & purification , Coronavirus NL63, Human/genetics , Coronavirus NL63, Human/isolation & purification , Coronavirus OC43, Human/genetics , Coronavirus OC43, Human/isolation & purification , Female , Hospitalization , Humans , Infant , Infant, Newborn , Male , Phylogeny , Respiratory Tract Infections/complications , Respiratory Tract Infections/etiology , SARS-CoV-2/isolation & purification , Spike Glycoprotein, Coronavirus/genetics
13.
Dermatology ; 238(1): 53-59, 2022.
Article in English | MEDLINE | ID: covidwho-1153758

ABSTRACT

BACKGROUND: Mycoplasma pneumoniae atypical pneumonia is frequently associated with erythema multiforme. Occasionally, a mycoplasma infection does not trigger any cutaneous but exclusively mucosal lesions. The term mucosal respiratory syndrome is employed to denote the latter condition. Available reviews do not address the possible association of mucosal respiratory syndrome with further atypical bacterial pathogens such as Chlamydophila pneumoniae, Chlamydophila psittaci, Coxiella burnetii, Francisella tularensis, or Legionella species. We therefore performed a systematic review of the literature addressing this issue in the National Library of Medicine, Excerpta Medica, and Web of Science databases. SUMMARY: We found 63 patients (≤18 years, n = 36; >18 years, n = 27; 54 males and 9 females) affected by a mucosal respiratory syndrome. Fifty-three cases were temporally associated with a M. pneumoniae and 5 with a C. pneumoniae infection. No cases temporally associated with C. psittaci, C. burnetii, F. tularensis, or Legionella species infection were found. Two cases were temporally associated with Epstein-Barr virus or influenzavirus B, respectively.


Subject(s)
Mucositis/complications , Mucositis/microbiology , Respiratory Tract Infections/complications , Respiratory Tract Infections/microbiology , Chlamydophila pneumoniae , Humans , Mucositis/diagnosis , Mycoplasma pneumoniae , Respiratory Tract Infections/diagnosis , Syndrome
14.
Cells ; 10(3)2021 03 07.
Article in English | MEDLINE | ID: covidwho-1143461

ABSTRACT

The novel coronavirus severe acute respiratory syndrome-CoV-2 (SARS-CoV-2) is responsible for COVID-19 infection. The COVID-19 pandemic represents one of the worst global threats in the 21st century since World War II. This pandemic has led to a worldwide economic recession and crisis due to lockdown. Biomedical researchers, pharmaceutical companies, and premier institutes throughout the world are claiming that new clinical trials are in progress. During the severe phase of this disease, mechanical ventilators are used to assist in the management of outcomes; however, their use can lead to the development of pneumonia. In this context, mesenchymal stem cell (MSC)-derived exosomes can serve as an immunomodulation treatment for COVID-19 patients. Exosomes possess anti-inflammatory, pro-angiogenic, and immunomodulatory properties that can be explored in an effort to improve the outcomes of SARS-CoV-2-infected patients. Currently, only one ongoing clinical trial (NCT04276987) is specifically exploring the use of MSC-derived exosomes as a therapy to treat SARS-CoV-2-associated pneumonia. The purpose of this review is to provide insights of using exosomes derived from mesenchymal stem cells in management of the co-morbidities associated with SARS-CoV-2-infected persons in direction of improving their health outcome. There is limited knowledge of using exosomes in SARS-CoV-2; the clinicians and researchers should exploit exosomes as therapeutic regime.


Subject(s)
COVID-19/therapy , Exosomes/metabolism , Extracellular Vesicles/metabolism , Immunomodulation , Mesenchymal Stem Cells/metabolism , Pneumonia, Viral/therapy , COVID-19/complications , COVID-19/metabolism , COVID-19/pathology , Cytokines/metabolism , Cytokines/pharmacology , Exosomes/chemistry , Exosomes/genetics , Humans , Inflammation/immunology , Inflammation/therapy , Inflammation/virology , Mesenchymal Stem Cells/immunology , Neovascularization, Physiologic/immunology , Pneumonia, Viral/complications , Pneumonia, Viral/virology , Respiratory Tract Infections/complications , Respiratory Tract Infections/therapy , Respiratory Tract Infections/virology
15.
Curr Opin Pulm Med ; 27(2): 79-87, 2021 03 01.
Article in English | MEDLINE | ID: covidwho-1109364

ABSTRACT

PURPOSE OF REVIEW: Mineworkers in South Africa experience a triple burden of disease due to their distinct work experience. Silicosis increases their risk of tuberculosis (TB), exacerbated by the HIV epidemic. Work-related factors are likely to increase transmission, severity, and post infection sequelae of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection. Understanding these relationships is important to control the impact of the epidemic. RECENT FINDINGS: SARS-CoV-2 infection rates among mineworkers exceed the population rates in the provinces in which those mines are located. Migrant work, living in crowded hostels, working in narrow poorly ventilated shafts mainly underground constitute important factors that increase transmission risk. Mineworkers continue to experience high levels of silica exposure. The prevalences of silicosis, HIV and pulmonary TB, remain high. Interstitial lung disease, pulmonary TB, and HIV have all been associated with poorer outcomes of SARS-CoV-2 infections. Mineworkers with post infection respiratory sequelae are likely to lose their jobs or lose income, due to the physically demanding nature of underground minework. SUMMARY: Further research into the unique work-related risk factors in mining that influence the COVID-19 epidemic is crucial for optimizing current interventions. Reducing SARS-CoV-2 infection transmission, health monitoring of infected and vulnerable workers, and following up of postinfection outcomes is essential to protect the respiratory health of miners.


Subject(s)
COVID-19/epidemiology , Miners , Occupational Diseases/epidemiology , HIV Infections/epidemiology , Humans , Lung Diseases, Interstitial/epidemiology , Prevalence , Respiratory Tract Infections/complications , Risk Factors , Silicosis/epidemiology , South Africa/epidemiology , Tuberculosis/epidemiology
16.
Diagn Microbiol Infect Dis ; 100(2): 115352, 2021 Jun.
Article in English | MEDLINE | ID: covidwho-1086876

ABSTRACT

The emergence of SARS-CoV-2 and subsequent COVID-19 pandemic highlights the morbidity and potential disease severity caused by respiratory viruses. To elucidate pathogen prevalence, etiology of coinfections and URIs from symptomatic adult Emergency department patients in a pre-SARS-CoV-2 environment, we evaluated specimens from four geographically diverse Emergency departments in the United States from 2013-2014 utilizing ePlex RP RUO cartridges (Genmark Diagnostics). The overall positivity was 30.1% (241/799), with 6.6% (16/241) coinfections. Noninfluenza pathogens from most to least common were rhinovirus/enterovirus, coronavirus, human metapneumovirus and RSV, respectively. Broad differences in disease prevalence and pathogen distributions were observed across geographic regions; the site with the highest detection rate (for both mono and coinfections) demonstrated the greatest pathogen diversity. A variety of respiratory pathogens and geographic variations in disease prevalence and copathogen type were observed. Further research is required to evaluate the clinical relevance of these findings, especially considering the SARS-CoV-2 pandemic and related questions regarding SARS-CoV-2 disease severity and the presence of co-infections.


Subject(s)
Coinfection/virology , Emergency Service, Hospital , Influenza, Human/complications , Respiratory Tract Infections/virology , Adolescent , Adult , Aged , Aged, 80 and over , Coronavirus Infections/complications , Coronavirus Infections/virology , Emergency Service, Hospital/statistics & numerical data , Enterovirus Infections/complications , Enterovirus Infections/virology , Female , Humans , Influenza, Human/virology , Male , Metapneumovirus , Middle Aged , Paramyxoviridae Infections/complications , Paramyxoviridae Infections/virology , Picornaviridae Infections/complications , Picornaviridae Infections/virology , Prevalence , Respiratory Tract Infections/complications , Rhinovirus , Risk Factors , United States/epidemiology , Young Adult
17.
Viruses ; 13(1)2021 Jan 18.
Article in English | MEDLINE | ID: covidwho-1059594

ABSTRACT

BACKGROUND: Co-infections of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) with respiratory viruses, bacteria and fungi have been reported to cause a wide range of illness. OBJECTIVES: We assess the prevalence of co-infection of SARS-CoV-2 with seasonal respiratory viruses, document the respiratory viruses detected among individuals tested for SARS-CoV-2, and describe characteristics of individuals with respiratory virus co-infection detected. METHODS: Specimens included in this study were submitted as part of routine clinical testing to Public Health Ontario Laboratory from individuals requiring testing for SARS-CoV-2 and/or seasonal respiratory viruses. RESULTS: Co-infection was detected in a smaller proportion (2.5%) of individuals with laboratory confirmed SARS-CoV-2 than those with seasonal respiratory viruses (4.3%); this difference was not significant. Individuals with any respiratory virus co-infection were more likely to be younger than 65 years of age and male than those with single infection. Those with SARS-CoV-2 co-infection manifested mostly mild respiratory symptoms. CONCLUSIONS: Findings of this study may not support routine testing for seasonal respiratory viruses among all individuals tested for SARS-CoV-2, as they were rare during the study period nor associated with severe disease. However, testing for seasonal respiratory viruses should be performed in severely ill individuals, in which detection of other viruses may assist with patient management.


Subject(s)
COVID-19/epidemiology , Coinfection/epidemiology , Respiratory Tract Infections/epidemiology , Adolescent , Adult , Aged , Aged, 80 and over , COVID-19/complications , Canada/epidemiology , Child , Child, Preschool , Coinfection/virology , Cross-Sectional Studies , Female , Humans , Male , Middle Aged , Ontario/epidemiology , Prevalence , Respiratory Tract Infections/complications , Respiratory Tract Infections/virology , SARS-CoV-2/isolation & purification , Young Adult
18.
BMJ Case Rep ; 14(1)2021 Jan 28.
Article in English | MEDLINE | ID: covidwho-1054632

ABSTRACT

We report an interesting case of a 38-year-old woman presenting with reverse Takotsubo syndrome (TTS) secondary to an Addisonian crisis, her second such episode. A few years prior, she had presented with typical TTS in the setting of Addisonian crisis; diagnostic work-up revealing Auto-Immune Polyglandular Syndrome Type II (APS II). We believe this to be the first case report of typical and variant phenotypes of TTS in a patient with APS II. The pathogenic link between these two conditions is explored. In patients presenting with Addisonian crises and refractory shock, the possibility of concurrent TTS should be considered. TTS muddies the diagnostic waters and poses therapeutic challenges as outlined.


Subject(s)
Addison Disease/drug therapy , Hydrocortisone/therapeutic use , Medication Adherence , Polyendocrinopathies, Autoimmune/drug therapy , Takotsubo Cardiomyopathy/physiopathology , Addison Disease/complications , Adult , Disease Progression , Echocardiography , Female , Humans , Hypothyroidism/complications , Hypothyroidism/drug therapy , Polyendocrinopathies, Autoimmune/complications , Recurrence , Respiratory Tract Infections/complications , Takotsubo Cardiomyopathy/diagnosis , Takotsubo Cardiomyopathy/etiology , Thyroxine/therapeutic use
19.
Am Heart J ; 235: 54-64, 2021 05.
Article in English | MEDLINE | ID: covidwho-1051398

ABSTRACT

OBJECTIVE: The MITIGATE study aims to evaluate the real-world clinical effectiveness of pre-treatment with icosapent ethyl (IPE), compared with usual care, on laboratory-confirmed viral upper respiratory infection (URI)-related morbidity and mortality in adults with established atherosclerotic cardiovascular disease (ASCVD). BACKGROUND: IPE is a highly purified and stable omega-3 fatty acid prescription medication that is approved for cardiovascular risk reduction in high-risk adults on statin therapy with elevated triglycerides. Preclinical data and clinical observations suggest that IPE may have pleiotropic effects including antiviral and anti-inflammatory properties that may prevent or reduce the downstream sequelae and cardiopulmonary consequences of viral URIs. METHODS: MITIGATE is a virtual, electronic health record-based, open-label, randomized, pragmatic clinical trial enrolling ∼16,500 participants within Kaiser Permanente Northern California - a fully integrated and learning health care delivery system with 21 hospitals and >255 ambulatory clinics serving ∼4.5 million members. Adults ≥50 years with established ASCVD and no prior history of coronavirus disease 2019 (COVID-19) will be prospectively identified and pre-randomized in a 1:10 allocation ratio (∼ 1,500 IPE: ∼15,000 usual care) stratified by age and previous respiratory health status to the intervention (IPE 2 grams by mouth twice daily with meals) vs the control group (usual care) for a minimum follow-up duration of 6 months. The co-primary endpoints are moderate-to-severe laboratory-confirmed viral URI and worst clinical status due to a viral URI at any point in time. CONCLUSION: The MITIGATE study will inform clinical practice by providing evidence on the real-world clinical effectiveness of pretreatment with IPE to prevent and/or reduce the sequelae of laboratory-confirmed viral URIs in a high-risk cohort of patients with established ASCVD.


Subject(s)
Atherosclerosis/complications , COVID-19/complications , Cardiovascular Diseases/prevention & control , Eicosapentaenoic Acid/analogs & derivatives , Platelet Aggregation Inhibitors/therapeutic use , Aged , Cardiovascular Diseases/complications , Eicosapentaenoic Acid/therapeutic use , Female , Humans , Hydroxymethylglutaryl-CoA Reductase Inhibitors/therapeutic use , Intention to Treat Analysis , Male , Middle Aged , Prospective Studies , Respiratory Tract Infections/complications , Respiratory Tract Infections/virology
20.
J Heart Lung Transplant ; 39(4): 379-388, 2020 04.
Article in English | MEDLINE | ID: covidwho-783270

ABSTRACT

BACKGROUND: Respiratory viral infections can increase the risk of chronic lung allograft dysfunction after lung transplantation, but the mechanisms are unknown. In this study, we determined whether symptomatic respiratory viral infections after lung transplantation induce circulating exosomes that contain lung-associated self-antigens and assessed whether these exosomes activate immune responses to self-antigens. METHODS: Serum samples were collected from lung transplant recipients with symptomatic lower- and upper-tract respiratory viral infections and from non-symptomatic stable recipients. Exosomes were isolated via ultracentrifugation; purity was determined using sucrose cushion; and presence of lung self-antigens, 20S proteasome, and viral antigens for rhinovirus, coronavirus, and respiratory syncytial virus were determined using immunoblot. Mice were immunized with circulating exosomes from each group and resulting differential immune responses and lung histology were analyzed. RESULTS: Exosomes containing self-antigens, 20S proteasome, and viral antigens were detected at significantly higher levels (p < 0.05) in serum of recipients with symptomatic respiratory viral infections (n = 35) as compared with stable controls (n = 32). Mice immunized with exosomes from recipients with respiratory viral infections developed immune responses to self-antigens, fibrosis, small airway occlusion, and significant cellular infiltration; mice immunized with exosomes from controls did not (p < 0.05). CONCLUSIONS: Circulating exosomes isolated from lung transplant recipients diagnosed with respiratory viral infections contained lung self-antigens, viral antigens, and 20S proteasome and elicited immune responses to lung self-antigens that resulted in development of chronic lung allograft dysfunction in immunized mice.


Subject(s)
Exosomes/metabolism , Graft Rejection/etiology , Graft Rejection/metabolism , Lung Transplantation/adverse effects , Respiratory Tract Infections/metabolism , Virus Diseases/metabolism , Aged , Animals , Antigens, Viral/metabolism , Autoantigens/metabolism , Case-Control Studies , Female , HLA Antigens/metabolism , Humans , Male , Mice , Mice, Inbred C57BL , Middle Aged , Proteasome Endopeptidase Complex/metabolism , Respiratory Tract Infections/complications , Respiratory Tract Infections/virology , Virus Diseases/complications
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