RSV circulation during SARS-CoV-2 pandemic era: what happened in Italy

Background: In the northern hemisphere, Respiratory Syncytial Virus (RSV) is more frequently detected from December to February. In Italy, Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) presented a peak in incidence from the end of December 2021 to February 2022. Aim(s): To evaluate how SARS-CoV-2 pandemic has influenced RSV circulation. Method(s): We evaluated 389 children, aged 0-18 years, admitted for respiratory tract infections from September 2021 to January 2022 throughout Italy, from the north to the south. Children underwent nasal washing from 1 to 3 days after hospitalization. A (RT)-PCR was developed for detecting 15 respiratory viruses, including RSV, influenza virus A and B, human coronavirus OC43, 229E, NL-63 and HUK1, adenovirus, rhinovirus, parainfluenza virus 1-3, human bocavirus and human metapneumovirus. Result(s): We detected a virus in 338 children (86.9%): RSV was found in 267 (68.7%), other viruses in 71 (18.3%). 51 children (13.1%) resulted negative. Dividing our observational period in two-week timeframes, we found that RSV showed an early peak from October to the first half of December 2021 compared to its usual seasonality. In a previous study, we have demonstrated that RSV circulation was incredibly low from September 2020 to January 2021, in contrast with what we found in the same period in 2021-2022. Comparing RSV and SARS-CoV-2 incidences, we found that these two viruses spread in opposite ways: when SARS-CoV-2 present an incidence peak, RSV circulation reduced and viceversa. Conclusion(s): The relationship between RSV and SARS-CoV-2 showed that viral interference plays a crucial role in their epidemiology.

Covid-19 in children: disease spectrum and risk factors

Introduction: Children infected with the severe acute respiratory coronavirus 2 (SARS-CoV-2) are mostly asymptomatic or mild symptomatic. Some children experience persistent symptoms after SARS-CoV-2 infection, which may be consistent with Long COVID. Aim(s): To assess the frequency of both acute and persisting Coronavirus disease (COVID-19) symptoms in children and to search for the presence of risk factors for acute or persisting COVID-19 symptoms. Method(s): We included 697 children, aged between 0 and 18 years, who had previous SARS CoV-2 infection. Children and parents were asked questions regarding symptoms in the acute phase of COVID-19 and also persistent symptoms (extending beyond or developing 30 days and 90 days after initial diagnosis). Result(s): 79,2% of children were symptomatic in the acute phase of COVID-19;the most common acute symptoms were fever (49,6%), cough (22,1%), headache (37,9%) and asthenia (25,8%). 26,8% of children reported symptoms 30 days after initial diagnosis and 10,2% of children presented symptoms 90 days after initial diagnosis;the most common reported symptom was asthenia respectively in 12,3% (after 30 days) and in 4,9% of children (after 90 days). Persisting symptoms after 30 days were mostly present in overweigh or obese girls (35,8% vs 64,2%, p-value 0,03) and in children with asthenia (41,3% vs 20,3, p-value 0,001) in the acute phase. Children with symptoms 90 days after initial diagnosis most frequently had asthenia in the acute phase. Conclusion(s): We confirm that SARS-CoV-2 infection in children is generally mild. Also children can experience persisting symptoms that are significantly more frequent if they have a symptomatic disease and asthenia.

Lung Ultrasound: Its Findings and New Applications in Neonatology and Pediatric Diseases

Lung ultrasound has become increasingly used in both adult and pediatric populations, allowing the rapid evaluation of many lung and pleura diseases. This popularity is due to several advantages of the method such as the low cost, rapidity, lack of ionizing radiation, availability of bedside and repeatability of the method. These features are even more important after the outbreak of the SARS-CoV-2 pandemic, given the possibility of recognizing through ultrasound the signs of interstitial lung syndrome typical of pneumonia caused by the virus. The purpose of this paper is to review the available evidence of lung ultrasound (LUS) in children and its main applications in pediatric diseases.