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1.
J Pediatr Surg ; 57(5): 829-832, 2022 May.
Article in English | MEDLINE | ID: covidwho-1873173

ABSTRACT

PURPOSE: The benefit of elective resection of congenital lung malformations continues to be debated. Proponents of resection endorse a decreased risk of respiratory complications as one indication for surgery. Our study aimed to compare the prevalence of respiratory infections in cases, before and after resection of congenital lung malformations, to controls without a history of congenital lung malformation. METHODS: We performed a retrospective cohort study of children born from 1991 to 2007 who underwent congenital lung malformation resection. Patients were identified from Winnipeg´s Surgical Database of Outcomes and Management (WiSDOM), and a 10:1 date-of-birth matched control group was generated from a population-based administrative data repository. International Classification of Disease codes were used to assess pulmonary infection outcomes. Relative rates (RR) were calculated to compare the frequency of pneumonia, respiratory infections and influenza between cases and controls. RESULTS: We included 31 congenital lung malformation cases and 310 controls. Cases consisted of 14 (45.16%) congenital pulmonary airway malformations, 9 (29.03%) bronchopulmonary sequestrations and 8 (25.81%) hybrid lesions. Before resection, pneumonia was more common in cases than controls (RR 6.85; 95%CI 3.89, 11.9), while the risk of acute respiratory infections (RR 1.21; 95%CI 0.79, 1.79) and influenza (RR 0.46; 95%CI 0.01, 3.22) were similar to controls. Post-resection, the risk of pneumonia (RR 9.75; 5.06, 18.50) was still higher in cases than controls, and respiratory infections (RR 1.77; 95%CI 1.20, 2.53) and influenza (RR 3.98; 95%CI 1.48, 9.36) were more common in cases than controls. CONCLUSION: Our study demonstrated that after resection of congenital lung malformations, children experience more frequent respiratory infections compared to the general population. Resection does not eliminate the increased risk of pneumonia.


Subject(s)
Bronchopulmonary Sequestration , Cystic Adenomatoid Malformation of Lung, Congenital , Influenza, Human , Lung Diseases , Pneumonia , Respiratory System Abnormalities , Respiratory Tract Infections , Bronchopulmonary Sequestration/surgery , Child , Cohort Studies , Cystic Adenomatoid Malformation of Lung, Congenital/epidemiology , Cystic Adenomatoid Malformation of Lung, Congenital/surgery , Humans , Lung/abnormalities , Lung/surgery , Lung Diseases/congenital , Respiratory System Abnormalities/epidemiology , Respiratory System Abnormalities/surgery , Respiratory Tract Infections/epidemiology , Respiratory Tract Infections/etiology , Retrospective Studies
3.
PLoS One ; 17(3): e0264220, 2022.
Article in English | MEDLINE | ID: covidwho-1745322

ABSTRACT

OBJECTIVE: Assess the IntelliSep Index (ISI) for risk stratification of patients presenting to the Emergency Department (ED) with respiratory symptoms suspected of COVID-19 during the pandemic. METHODS: An observational single-center study of prospective cohort of patients presenting to the ED during the early COVID-19 pandemic with respiratory symptoms and a CBC drawn within 4.5 hours of initial vital signs. A sample of this blood was aliquoted for performance of the ISI, and patients were followed for clinical outcomes. The study required no patient-centered activity beyond standard of care and treating clinicians were unaware of study enrollment and ISI test results. MAIN FINDINGS: 282 patients were included. The ISI ranges 0.1 to 10.0, with three interpretation bands indicating risk of adverse outcome: low (green), 0.1-4.9; intermediate (yellow), 5.0-6.2; and high (red), 6.3-10.0. Of 193 (68.4%) tested for SARS-CoV-2, 96 (49.7%) were positive. The ISI resulted in 182 (64.5%) green, 54 (18.1%) yellow, and 46 (15.6%) red band patients. Green band patients had a 1.1% (n = 2) 3-day mortality, while yellow and red band had 3.7% (n = 2, p > .05) and 10.9% (n = 5, p < .05) 3-day mortalities, respectively. Fewer green band patients required admission (96 [52.7%]) vs yellow (44 [81.5%]) and red (43 [93.5%]). Green band patients had more hospital free days (median 23 (Q1-Q3 20-25) than yellow (median 22 [Q1-Q3 0-23], p < 0.05) and red (median 21 [Q1-Q3 0-24], p < 0.01). SOFA increased with interpretation band: green (2, [Q1-Q3 0-4]) vs yellow (4, [Q1-Q3 2-5], p < 0.001) and red (5, [Q1-Q3 3-6]) p < 0.001). CONCLUSIONS: The ISI rapidly risk-stratifies patients presenting to the ED during the early COVID-19 pandemic with signs or suspicion of respiratory infection.


Subject(s)
COVID-19/diagnosis , Respiratory Tract Infections/etiology , Aged , COVID-19/immunology , COVID-19/mortality , Emergency Service, Hospital , Female , Humans , Immunity, Cellular , Male , Middle Aged , Mortality , Prospective Studies , Respiratory Tract Infections/immunology , Respiratory Tract Infections/mortality
4.
Pediatr Infect Dis J ; 41(4): e146-e148, 2022 04 01.
Article in English | MEDLINE | ID: covidwho-1706949

ABSTRACT

Respiratory viruses were detected by multiplex-polymerase chain reaction from oropharyngeal swabs in 114/168 (67.9%) children with acute respiratory infection presenting to 5 pediatric practices in Germany between November 2020 and April 2021. In contrast to rhino- (48.8%), adeno- (14.3%) and endemic coronaviruses (14.9%), SARS-CoV-2 and influenza virus were detected only once; respiratory syncytial virus was not detected. This demonstrates differing impacts of pandemic infection control measures on the spread of respiratory viruses.


Subject(s)
Primary Health Care , Respiratory Tract Infections/epidemiology , Respiratory Tract Infections/etiology , Virus Diseases/epidemiology , Virus Diseases/etiology , Adolescent , COVID-19/epidemiology , COVID-19/virology , Child , Child, Preschool , Disease Susceptibility , Female , Humans , Incidence , Infant , Infant, Newborn , Influenza, Human/epidemiology , Influenza, Human/virology , Male , Pandemics , Respiratory Syncytial Virus Infections/epidemiology , Respiratory Syncytial Virus Infections/virology , Respiratory Tract Infections/diagnosis , Respiratory Tract Infections/therapy , SARS-CoV-2 , Virus Diseases/diagnosis , Virus Diseases/therapy
5.
J Environ Public Health ; 2021: 7112548, 2021.
Article in English | MEDLINE | ID: covidwho-1622110

ABSTRACT

Background: Most of the households in developing countries burn biomass fuel in traditional stoves with incomplete combustion that leads to high indoor air pollution and acute respiratory infections. Acute respiratory infection is the most common cause of under-five morbidity and mortality accounting for 2 million deaths worldwide and responsible for 18% of deaths among under-five children in Ethiopia. Although studies were done on acute respiratory infections, the majority of studies neither clinically diagnose respiratory infections nor use instant measurement of particulate matter. Methods: The community-based cross-sectional study design was employed among under-five children in Jimma town from May 21 to June 7, 2020. A total of 265 children through systematic random sampling were included in the study. The data were collected using a pretested semistructured questionnaire and laser pm 2.5 meter for indoor particulate matter concentration. Associations among factors were assessed through correlation analysis, and binary logistic regression was done to predict childhood acute respiratory infections. Variables with p-value less than 0.25 in bivariate regression were the candidate for the final multivariate logistic regression. Two independent sample t-tests were done to compare significant mean difference between concentrations of particulate matter. Results: Among 265 under-five children who were involved in the study, 179 (67.5%) were living in households that predominantly use biomass fuel. Prevalence of acute respiratory infections in the study area was 16%. Children living in households that use biomass fuel were four times more likely to develop acute respiratory infections than their counterparts (AOR: 4.348; 95% CI: 1.632, 11.580). The size of household was significantly associated with the prevalence of acute respiratory infections. Under-five children living in households that have a family size of six and greater had odds of 1.7 increased risk of developing acute respiratory infections than their counterparts (AOR: 1.7; 95% CI: 1.299, 2.212). The other factor associated with acute respiratory infection was separate kitchen; children living in households in which there were no separate kitchen were four times at increased risk of developing acute respiratory infection than children living in households which have separate kitchen (AOR: 4.591; 95% CI: 1.849, 11.402). The concentration of indoor particulate matter was higher in households using biomass fuel than clean fuel. There was statistically higher particulate matter concentration in the kitchen than living rooms (t = 4.509, p ≤ 0.001). Particulate matter 2.5 concentrations (µg/m3) of the households that had parental smoking were significantly higher than their counterparts (AOR: 20.224; 95% CI: 1.72, 12.58). Conclusion: There is an association between acute respiratory infections and biomass fuel usage among under-five children. Focusing on improved energy sources is essential to reduce the burden and assure the safety of children.


Subject(s)
Air Pollution, Indoor , Respiratory Tract Infections , Air Pollution, Indoor/statistics & numerical data , Biomass , Child , Cross-Sectional Studies , Ethiopia/epidemiology , Humans , Particulate Matter/analysis , Particulate Matter/toxicity , Respiratory Tract Infections/epidemiology , Respiratory Tract Infections/etiology
6.
J Int Med Res ; 49(9): 3000605211043245, 2021 Sep.
Article in English | MEDLINE | ID: covidwho-1486544

ABSTRACT

OBJECTIVE: Pulmonary complication is common in older patients after surgery. We analyzed risk factors of lower respiratory tract infection after general anesthesia among older patients. METHODS: In this retrospective investigation, we included older patients who underwent surgery with general anesthesia. Logistic regression analyses were performed to determine risk factors of lower respiratory tract infection. RESULTS: A total 418 postoperative patients with general anesthesia were included; the incidence of lower respiratory tract infection was 9.33%. Ten cases were caused by gram-positive bacteria, 26 cases by gram-negative bacteria, and 2 cases by fungus. We found significant differences in age, smoking, diabetes, oral/nasal tracheal intubation, and surgery duration. Logistic regression analysis indicated that age ≥70 years (odds ratio [OR] 2.028, 95% confidence interval [CI] 1.115-3.646), smoking (OR 2.314, 95% CI 1.073-4.229), diabetes (OR 2.185, 95% CI 1.166-4.435), nasotracheal intubation (OR 3.528, 95% CI 1.104-5.074), and duration of surgery ≥180 minutes (OR 1.334, 95% CI 1.015-1.923) were independent risk factors of lower respiratory tract infections. CONCLUSIONS: Older patients undergoing general anesthesia after tracheal intubation have a high risk of lower respiratory tract infections. Clinical interventions should be provided to prevent pulmonary infections in patients with relevant risk factors.


Subject(s)
Anesthesia, General , Respiratory Tract Infections , Aged , Anesthesia, General/adverse effects , Humans , Intubation, Intratracheal , Postoperative Complications/epidemiology , Postoperative Complications/etiology , Respiratory Tract Infections/epidemiology , Respiratory Tract Infections/etiology , Retrospective Studies , Risk Factors
7.
Front Endocrinol (Lausanne) ; 11: 569241, 2020.
Article in English | MEDLINE | ID: covidwho-1389156

ABSTRACT

The clinical hallmarks of infections caused by critical respiratory viruses consist of pneumonia, which can progress to acute lung injury (ALI), and systemic manifestations including hypercoagulopathy, vascular dysfunction, and endotheliitis. The disease outcome largely depends on the immune response produced by the host. The bio-molecular mechanisms underlying certain dire consequences of the infection partly arise from an aberrant production of inflammatory molecules, an event denoted as "cytokine storm". Therefore, in addition to antiviral therapies, molecules able to prevent the injury caused by cytokine excess are under investigation. In this perspective, taking advantage of melanocortin peptides and their receptors, components of an endogenous modulatory system that exerts marked anti-inflammatory and immunomodulatory influences, could be an effective therapeutic strategy to control disease evolution. Exploiting the melanocortin system using natural or synthetic ligands can form a realistic basis to counteract certain deleterious effects of respiratory virus infections. The central and peripheral protective actions exerted following melanocortin receptor activation could allow dampening the harmful events that trigger the cytokine storm and endothelial dysfunction while sustaining the beneficial signals required to elicit repair mechanisms. The long standing evidence for melanocortin safety encourages this approach.


Subject(s)
COVID-19/drug therapy , Receptors, Melanocortin/agonists , Respiratory Tract Infections/drug therapy , Acute Lung Injury/drug therapy , Animals , Anti-Inflammatory Agents/therapeutic use , COVID-19/complications , Cytokine Release Syndrome/drug therapy , Cytokine Release Syndrome/etiology , Cytokines/metabolism , Humans , Melanocyte-Stimulating Hormones/metabolism , Respiratory Tract Infections/etiology , Respiratory Tract Infections/metabolism
9.
J Clin Lab Anal ; 35(8): e23868, 2021 Aug.
Article in English | MEDLINE | ID: covidwho-1312737

ABSTRACT

BACKGROUND: Studies have reported coinfection of severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2), the cause of coronavirus disease-2019 (COVID-19), with other viruses that cause respiratory tract infections (RTIs). We investigated the coinfection rate of SARS-CoV-2 and other RTI-causing viruses, and whether the cycle threshold (Ct) value of a real-time reverse transcriptase PCR (RT-PCR) differed when the coinfection occurred during the first wave of COVID-19 in Daegu, Republic of Korea, in 2020. METHODS: After performing PCR for SARS-CoV-2, we additionally tested for the presence of RTI-causing viruses to check for coinfection. Subsequently, we identified the specific coexisting respiratory viruses and calculated the coinfection rate. In addition, based on the coinfection status, we compared the Ct values obtained from RT-PCR for SARS-CoV-2 in patients who tested positive for COVID-19 PCR. RESULTS: Of 13,717 patients, 123 had positive results on COVID-19 PCR testing and six tested positive for an RTI-causing virus. Thus, the coinfection rate was 4.9%. There were no statistically significant differences in the mean Ct values of SARS-CoV-2 RT-PCR between coinfected and non-coinfected patients. CONCLUSION: This study computed the coinfection rate of SARS-CoV-2 and RTI-causing viruses and revealed that the mean Ct values in SARS-CoV-2 real-time RT-PCR did not differ according to the coinfection status.


Subject(s)
COVID-19 Nucleic Acid Testing/methods , COVID-19/epidemiology , Coinfection/epidemiology , Coinfection/virology , Respiratory Tract Infections/epidemiology , Aged , Aged, 80 and over , Female , Humans , Male , Middle Aged , Real-Time Polymerase Chain Reaction , Republic of Korea/epidemiology , Respiratory Tract Infections/etiology , Respiratory Tract Infections/virology , SARS-CoV-2/genetics , Tertiary Care Centers/statistics & numerical data
10.
J Microbiol Immunol Infect ; 54(5): 801-807, 2021 Oct.
Article in English | MEDLINE | ID: covidwho-1275504

ABSTRACT

BACKGROUND: Coronavirus disease 2019 (COVID-19) manifests symptoms as common etiologies of respiratory tract infections (RTIs). During the pandemic of COVID-19, identifying the etiologies correctly from patients with RTI symptoms was crucial in not only disease control but preventing healthcare system from collapsing. By applying sensitive PCR-based molecular assays, we detected the etiologic agents and delineated the epidemiologic picture of RTIs in the early phase of COVID-19 pandemic. METHODS: From December 2019 to February 2020, we screened patients presented with RTIs using multiplex PCR-based diagnostic assays. Data from pediatric and adult patients were compared with different months and units in the hospital. RESULTS: Of all 1631 patients including 1445 adult and 186 pediatric patients screened, 8 viruses and 4 bacteria were identified. Positive rates were 25% in December, 37% in January, and 20% in February, with pediatric patients having higher positive rates than adults (Ps < 0.001). In pediatric patients, RhV/EnV was the most commonly detected, followed by parainfluenza viruses. Most Mycoplasma pneumoniae infection occurred in pediatric patients. RhV/EnV was the most commonly detected agent in pediatric patients admitted to intensive care units (ICUs), while influenza accounted for the majority of adult cases with critical illness. Noticeably, seasonal coronavirus ranked second in both adult and pediatric patients with ICU admission. CONCLUSION: While we focused on the pandemic of COVID-19, common etiologies still accounted for the majority of RTIs and lead to severe diseases, including other seasonal coronaviruses.


Subject(s)
COVID-19/epidemiology , Disease Outbreaks , Respiratory Tract Infections/epidemiology , Respiratory Tract Infections/etiology , Adult , COVID-19/diagnosis , Child , Humans , Influenza, Human/diagnosis , Influenza, Human/epidemiology , Multiplex Polymerase Chain Reaction , Pandemics , Parainfluenza Virus 1, Human , Parainfluenza Virus 2, Human , Pneumonia, Mycoplasma/diagnosis , Pneumonia, Mycoplasma/epidemiology , Retrospective Studies , SARS-CoV-2/genetics , SARS-CoV-2/isolation & purification , Seasons , Taiwan/epidemiology
11.
J Microbiol Methods ; 186: 106259, 2021 07.
Article in English | MEDLINE | ID: covidwho-1249029

ABSTRACT

The prevalence and microbiology of concomitant respiratory bacterial infections in patients with SARS-CoV-2 infection are not yet fully understood. In this retrospective study, we assessed respiratory bacterial co-infections in lower respiratory tract samples taken from intensive care unit-hospitalized COVID-19 patients, by comparing the conventional culture approach to an innovative molecular diagnostic technology. A total of 230 lower respiratory tract samples (i.e., bronchial aspirates or bronchoalveolar lavages) were taken from 178 critically ill COVID-19 patients. Each sample was processed by a semi-quantitative culture and by a multiplex PCR panel (FilmArray Pneumonia Plus panel), allowing rapid detection of a wide range of clinically relevant pathogens and a limited number of antimicrobial resistance markers. More than 30% of samples showed a positive bacterial culture, with Pseudomonas aeruginosa, Klebsiella pneumoniae and Staphylococcus aureus the most detected pathogens. FilmArray showed an overall sensitivity and specificity of 89.6% and 98.3%, respectively, with a negative predictive value of 99.7%. The molecular test significantly reduced the turn-around-time (TAT) and increased the rates of microbial detection. Most cases missed by culture were characterized by low bacterial loads (104-105 copies/mL). FilmArray missed a list of pathogens not included in the molecular panel, especially Stenotrophomonas maltophilia (8 cases). FilmArray can be useful to detect bacterial pathogens in lower respiratory tract specimens of COVID-19 patients, with a significant decrease of TAT. The test is particularly useful to rule out bacterial co-infections and avoid the inappropriate prescription of antibiotics.


Subject(s)
Bacteria/isolation & purification , Bacterial Typing Techniques , COVID-19/complications , COVID-19/microbiology , Multiplex Polymerase Chain Reaction , Respiratory Tract Infections/microbiology , Adult , Bacteria/classification , Coinfection/microbiology , Humans , Intensive Care Units , Respiratory Tract Infections/etiology , Retrospective Studies , Sensitivity and Specificity
12.
Semin Respir Crit Care Med ; 42(3): 449-459, 2021 06.
Article in English | MEDLINE | ID: covidwho-1239842

ABSTRACT

Survival in lung transplant recipients (LTRs) lags behind heart, liver, and kidney transplant, in part due to the direct and indirect effects of infection. LTRs have increased susceptibility to infection due to the combination of a graft continually exposed to the outside world, multiple mechanisms for impaired mucus clearance, and immunosuppression. Community-acquired respiratory viral infections (CARVs) are common in LTRs. Picornaviruses have roughly 40% cumulative incidence followed by respiratory syncytial virus and coronaviruses. Although single-center retrospective and prospective series implicate CARV in rejection and mortality, conclusive evidence for and well-defined mechanistic links to long-term outcome are lacking. Treatment of viral infections can be challenging except for influenza. Future studies are needed to develop better treatments and clarify the links between CARV and long-term outcomes.


Subject(s)
Community-Acquired Infections , Lung Transplantation , Respiratory Tract Infections , Virus Diseases , Community-Acquired Infections/epidemiology , Community-Acquired Infections/etiology , Humans , Lung Transplantation/adverse effects , Prospective Studies , Respiratory Tract Infections/epidemiology , Respiratory Tract Infections/etiology , Retrospective Studies , Transplant Recipients , Virus Diseases/epidemiology , Viruses
13.
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
14.
J Microbiol Immunol Infect ; 54(2): 253-260, 2021 Apr.
Article in English | MEDLINE | ID: covidwho-1203183

ABSTRACT

BACKGROUND/PURPOSE: Transplant recipients are vulnerable to life-threatening community-acquired respiratory viruses (CA-RVs) infection (CA-RVI). Even if non-transplant critically ill patients in intensive care unit (ICU) have serious CA-RVI, comparison between these groups remains unclear. We aimed to evaluate clinical characteristics and mortality of CA-RVI except seasonal influenza A/B in transplant recipients and non-transplant critically ill patients in ICU. METHODS: We collected 37,777 CA-RVs multiplex real-time reverse transcription-polymerase chain reaction test results of individuals aged ≥18 years from November 2012 to November 2017. The CA-RVs tests included adenovirus, coronavirus 229E/NL63/OC43, human bocavirus, human metapneumovirus, parainfluenza virus 1/2/3, rhinovirus, and respiratory syncytial virus A/B. RESULTS: We found 286 CA-RVI cases, including 85 solid organ transplantation recipients (G1), 61 hematopoietic stem cell transplantation recipients (G2), and 140 non-transplant critically ill patients in ICU (G3), excluding those with repeated isolation within 30 days. Adenovirus positive rate and infection cases were most prominent in G2 (p < 0.001). The median time interval between transplantation and CA-RVI was 30 and 20 months in G1 and G2, respectively. All-cause in-hospital mortality was significantly higher in G3 than in G1 or G2 (51.4% vs. 28.2% or 39.3%, p = 0.002, respectively). The mechanical ventilation (MV) was the independent risk factor associated with all-cause in-hospital mortality in all three groups (hazard ratio, 3.37, 95% confidence interval, 2.04-5.56, p < 0.001). CONCLUSIONS: This study highlights the importance of CA-RVs diagnosis in transplant recipients even in long-term posttransplant period, and in non-transplant critically ill patients in ICU with MV.


Subject(s)
Community-Acquired Infections/etiology , Respiratory Tract Infections/etiology , Transplant Recipients , Adult , Aged , Cohort Studies , Community-Acquired Infections/mortality , Community-Acquired Infections/virology , Critical Illness , Disease Susceptibility , Female , Hematopoietic Stem Cell Transplantation/adverse effects , Humans , Immunocompromised Host , Male , Middle Aged , Organ Transplantation/adverse effects , Republic of Korea/epidemiology , Respiratory Tract Infections/mortality , Respiratory Tract Infections/virology , Retrospective Studies , Risk Factors
15.
Clin Chest Med ; 41(4): 739-751, 2020 12.
Article in English | MEDLINE | ID: covidwho-896783

ABSTRACT

Occupational respiratory infections can be caused by bacterial, viral, and fungal pathogens. Transmission in occupational settings can occur from other humans, animals, or the environment, and occur in various occupations and industries. In this article, we describe 4 occupationally acquired respiratory infections at the focus of NIOSH investigations over the last decade: tuberculosis (TB), influenza, psittacosis, and coccidioidomycosis. We highlight the epidemiology, clinical manifestations, occupational risk factors, and prevention measures.


Subject(s)
Occupational Diseases/etiology , Occupational Exposure/adverse effects , Respiratory Tract Infections/etiology , Humans
16.
Am J Transplant ; 21(5): 1789-1800, 2021 05.
Article in English | MEDLINE | ID: covidwho-897176

ABSTRACT

Solid organ transplant (SOT) recipients are exposed to respiratory viral infection (RVI) during seasonal epidemics; however, the associated burden of disease has not been fully characterized. We describe the epidemiology and outcomes of RVI in a cohort enrolling 3294 consecutive patients undergoing SOT from May 2008 to December 2015 in Switzerland. Patient and allograft outcomes, and RVI diagnosed during routine clinical practice were prospectively collected. Median follow-up was 3.4 years (interquartile range 1.61-5.56). Six hundred ninety-six RVIs were diagnosed in 151/334 (45%) lung and 265/2960 (9%) non-lung transplant recipients. Cumulative incidence was 60% (95% confidence interval [CI] 53%-69%) in lung and 12% (95% CI 11%-14%) in non-lung transplant recipients. RVI led to 17.9 (95% CI 15.7-20.5) hospital admissions per 1000 patient-years. Intensive care unit admission was required in 4% (27/691) of cases. Thirty-day all-cause case fatality rate was 0.9% (6/696). Using proportional hazard models we found that RVI (adjusted hazard ratio [aHR] 2.45; 95% CI 1.62-3.73), lower respiratory tract RVI (aHR 3.45; 95% CI 2.15-5.52), and influenza (aHR 3.57; 95% CI 1.75-7.26) were associated with graft failure or death. In this cohort of SOT recipients, RVI caused important morbidity and may affect long-term outcomes, underlying the need for improved preventive strategies.


Subject(s)
Influenza, Human , Organ Transplantation , Respiratory Tract Infections , Cohort Studies , Humans , Influenza, Human/epidemiology , Organ Transplantation/adverse effects , Prospective Studies , Respiratory Tract Infections/epidemiology , Respiratory Tract Infections/etiology , Seasons , Switzerland , Transplant Recipients
17.
Viruses ; 13(4)2021 03 26.
Article in English | MEDLINE | ID: covidwho-1154532

ABSTRACT

The cold season is usually accompanied by an increased incidence of respiratory infections and increased air pollution from combustion sources. As we are facing growing numbers of COVID-19 cases caused by the novel SARS-CoV-2 coronavirus, an understanding of the impact of air pollutants and meteorological variables on the incidence of respiratory infections is crucial. The incidence of influenza-like illness (ILI) can be used as a close proxy for the circulation of influenza viruses. Recently, SARS-CoV-2 has also been detected in patients with ILI. Using distributed lag nonlinear models, we analyzed the association between ILI, meteorological variables and particulate matter concentration in Bialystok, Poland, from 2013-2019. We found an exponential relationship between cumulative PM2.5 pollution and the incidence of ILI, which remained significant after adjusting for air temperatures and a long-term trend. Pollution had the greatest effect during the same week, but the risk of ILI was increased for the four following weeks. The risk of ILI was also increased by low air temperatures, low absolute humidity, and high wind speed. Altogether, our results show that all measures implemented to decrease PM2.5 concentrations would be beneficial to reduce the transmission of SARS-CoV-2 and other respiratory infections.


Subject(s)
Air Pollutants/adverse effects , Particulate Matter/adverse effects , Respiratory Tract Infections/etiology , Adolescent , Adult , Aged , Air Pollutants/analysis , Air Pollution/adverse effects , COVID-19/epidemiology , COVID-19/virology , Child , Child, Preschool , Female , Humans , Male , Meteorological Concepts , Middle Aged , Particulate Matter/analysis , Poland/epidemiology , Respiratory Tract Infections/epidemiology , SARS-CoV-2/physiology , Young Adult
18.
J Pediatric Infect Dis Soc ; 10(6): 742-744, 2021 Aug 14.
Article in English | MEDLINE | ID: covidwho-1146686

ABSTRACT

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) mitigation policies have been associated with profound decreases in diagnoses of common childhood respiratory infections. A leading theory of etiology of Kawasaki disease (KD) is that it is triggered by presently unidentified ubiquitous respiratory agent. We document that mitigation policies instituted in mid-March 2020 were associated with strikingly fewer diagnoses of KD in April-December 2020 compared with the same period in the previous 8 years (P = .01), a >67% decline. This finding supports the hypothesis that KD is caused by a respiratory-transmitted agent.


Subject(s)
COVID-19 , Mucocutaneous Lymph Node Syndrome , Respiratory Tract Infections , Child , Humans , Mucocutaneous Lymph Node Syndrome/diagnosis , Physical Distancing , Respiratory Tract Infections/diagnosis , Respiratory Tract Infections/etiology , SARS-CoV-2
19.
Monaldi Arch Chest Dis ; 90(4)2020 Dec 23.
Article in English | MEDLINE | ID: covidwho-1042105

ABSTRACT

We report the case of a man affected by cystic fibrosis who developed a severe SARS-CoV-2 related pneumonia in March 2020. In addition to lopinavir/ritonavir and hydroxychloroquine, he was treated with two doses of tocilizumab, displaying a significant clinical improvement. This is the first case described in the literature of an adult patient affected by cystic fibrosis who received tocilizumab for COVID-19, with documented total recovery, also assessed by a spirometry.


Subject(s)
Antibodies, Monoclonal, Humanized/administration & dosage , COVID-19 , Cystic Fibrosis , Hydroxychloroquine/administration & dosage , Lopinavir/administration & dosage , Pneumonia, Viral , Respiratory Tract Infections/microbiology , Ritonavir/administration & dosage , SARS-CoV-2/isolation & purification , Adult , Antiviral Agents/administration & dosage , COVID-19/complications , COVID-19/diagnosis , COVID-19/drug therapy , COVID-19/physiopathology , Cystic Fibrosis/complications , Cystic Fibrosis/immunology , Cystic Fibrosis/physiopathology , Drug Combinations , Humans , Lung/diagnostic imaging , Lung/physiopathology , Male , Oxygen Inhalation Therapy/methods , Pneumonia, Viral/diagnosis , Pneumonia, Viral/drug therapy , Pneumonia, Viral/etiology , Receptors, Interleukin-6/antagonists & inhibitors , Respiratory Function Tests/methods , Respiratory Tract Infections/drug therapy , Respiratory Tract Infections/etiology , Tomography, X-Ray Computed/methods , Treatment Outcome
20.
Nutrients ; 12(12)2020 Dec 07.
Article in English | MEDLINE | ID: covidwho-967092

ABSTRACT

There are limited proven therapies for COVID-19. Vitamin C's antioxidant, anti-inflammatory and immunomodulating effects make it a potential therapeutic candidate, both for the prevention and amelioration of COVID-19 infection, and as an adjunctive therapy in the critical care of COVID-19. This literature review focuses on vitamin C deficiency in respiratory infections, including COVID-19, and the mechanisms of action in infectious disease, including support of the stress response, its role in preventing and treating colds and pneumonia, and its role in treating sepsis and COVID-19. The evidence to date indicates that oral vitamin C (2-8 g/day) may reduce the incidence and duration of respiratory infections and intravenous vitamin C (6-24 g/day) has been shown to reduce mortality, intensive care unit (ICU) and hospital stays, and time on mechanical ventilation for severe respiratory infections. Further trials are urgently warranted. Given the favourable safety profile and low cost of vitamin C, and the frequency of vitamin C deficiency in respiratory infections, it may be worthwhile testing patients' vitamin C status and treating them accordingly with intravenous administration within ICUs and oral administration in hospitalised persons with COVID-19.


Subject(s)
Ascorbic Acid Deficiency/drug therapy , Ascorbic Acid/therapeutic use , COVID-19/drug therapy , Respiratory Tract Infections/drug therapy , Sepsis/drug therapy , Vitamins/therapeutic use , Administration, Intravenous , Administration, Oral , Anti-Inflammatory Agents/therapeutic use , Ascorbic Acid Deficiency/complications , COVID-19/complications , COVID-19/virology , Chemotherapy, Adjuvant , Critical Care , Hospitalization , Humans , Immunologic Factors/therapeutic use , Intensive Care Units , Nutritional Status , Pandemics , Respiration, Artificial , Respiratory Tract Infections/etiology , Respiratory Tract Infections/virology , SARS-CoV-2 , Sepsis/etiology , Sepsis/virology
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