Rhinovirus infection and co-infection in children with severe acute respiratory infection during the COVID-19 pandemic period.

Rhinovirus causes respiratory tract infections in children and is found in co-infections. The objective of this research was to study the clinical profile of rhinovirus infection and co-infection in children with severe acute respiratory infection (SARI) during the COVID-19 pandemic period. We included 606 children ranging in age from 0.1 to 144 months of age from March 2020 to December 2021, hospitalized in the Pediatric Intensive Care Unit (PICU). The samples were collected by secretion from the nasopharynx region. A total of 259 children were tested positive for viral infection, 153 (59.07%) of them had a single rhinovirus infection and, 56 (36.6%) were aged between 60.1 and 144 months. Nine types of co-infections were identified and were found coinfection with three or more viruses (22/104, 21.15%). Observing the seasonality, the number of cases was similar between 2020 (49.53%) and 2021 (51.47%). Patients with a single infection (86.88%) and coinfection (67.30%) were more likely to have coughed. Patients with co-infection required the use of O2 for longer than those with a single rhinovirus infection. Hemogram results obtained from individuals with a single infection had higher levels of urea when compared to patients with co-infection with and other respiratory viruses. Multiple correspondence analyses indicated different clinical symptoms and comorbidities in patients with co-infection compared to those with single infection. The results found that the rhinovirus was much prevalent virus during the pandemic period and was found in co-infection with other virus types, what is important to diagnostic for the correct treatment of patients.

Viral Coinfection of Children Hospitalized with Severe Acute Respiratory Infections during COVID-19 Pandemic.

The main pathogens of severe respiratory infection in children are respiratory viruses, and the current molecular technology allows for a rapid and simultaneous detection of a wide spectrum of these viral pathogens, facilitating the diagnosis and evaluation of viral coinfection. METHODS: This study was conducted between March 2020 and December 2021. All children admitted to the ICU with a diagnosis of SARI and who were tested by polymerase chain reaction on nasopharyngeal swabs for SARS-CoV-2 and other common respiratory viral pathogens were included in the study. RESULTS: The result of the viral panel identified 446 children, with one infected with a single virus and 160 co-infected with two or more viruses. This study employed descriptive analyses, where a total of twenty-two coinfections among SARI-causing viruses were identified. Thus, the five most frequent coinfections that were selected for the study are: hRV/SARS-CoV-2 (17.91%), hRV/RSV (14.18%), RSV/SARS-CoV-2 (12.69%), hRV/BoV (10.45%), and hRV/AdV (8.21%). The most significant age group was 38.1%, representing patients aged between 24 and 59 months (61 individuals). Patients older than 59 months represented a total of 27.5%, comprising forty-four patients. The use of oxygen therapy was statistically significant in coinfections with Bocavirus, other CoVs, Metapneumovirus, and RSV. Coinfections with SARS-CoV-2 and the other different coinfections presented a similar time of use of oxygen therapy with a value of (p > 0.05). In the year 2020, hRV/BoV was more frequent in relation to other types of coinfections, representing a total of 35.1%. The year 2021 presented a divergent profile, with hRV/SARS-CoV-2 coinfection being the most frequent (30.8%), followed by hRV/RSV (28.2%). Additionally, 25.6% and 15.4% represented coinfections between RSV/SARS-CoV-2 and hRV/AdV, respectively. We saw that two of the patients coinfected with hRV/SARS-CoV-2 died, representing 9.52% of all deaths in the study. In addition, both hRV/hBoV and hRV/RSV had death records for each case, representing 8.33% and 6.67% of all deaths, respectively. CONCLUSION: Coinfections with respiratory viruses, such as RSV and hBoV, can increase the severity of the disease in children with SARI who are admitted to the ICU, and children infected with SARS-CoV-2 have their clinical condition worsened when they have comorbidities.

Distrofia muscular de Duchenne: complicações respiratórias e seu tratamento / Duchenne muscular dystrophy: respiratory complications and treatment

A Distrofia Muscular de Duchenne é um distúrbio genético ligado ao cromossomo X, que afeta principalmente crianças do sexo masculino. Caracteriza-se pela degeneração progressiva e irreversível da musculatura esquelética, levando a uma fraqueza muscular generalizada, sendo as complicações respiratórias as principais causas de morte. Desta forma, torna-se relevante conhecer as possíveis complicações respiratórias que acometem os portadores de Distrofia Muscular de Duchenne, bem como os diversos tratamentos utilizados para diminuir a morbidade e melhorar a qualidade de vida destes pacientes. Este artigo foi construído por meio de levantamento bibliográfico, especialmente de artigos científicos pesquisados em bases de dados (MedLine, Lilacs, Capes, Pubmed, SciELO), usando como critério de busca os descritores Distrofia Muscular de Duchenne, transtorno respiratório e terapia respiratória. Verificou-se que existem controvérsias quanto à indicação de exercícios físicos e de treinamento de força e resistência muscular no tratamento das complicações respiratórias associadas à Distrofia Muscular de Duchenne. O tratamento adequado e a prevenção destas freqüentes complicações amenizam os sintomas, melhorando a qualidade de vida e diminuindo a alta morbidade e a morte precoce desses pacientes.

Duchenne Muscular Dystrophy is a genetic disturbance found on the X chromosome that affects specially boys. It is also a progressive and irreversible degeneration of the skeletal muscles that causes a general muscular debility, and the respiratory disorders are the principal cause of death. So, it is important to study the possible respiratory disorders that assail people with Duchenne Muscular Dystrophy, and the varied treatments used to reduce the morbidity and increase the patient?s quality of life. The present article was done by using a bibliographic study of scientific articles, researched in the following databases (MedLine, Lilacs, Capes, Pubmed, SciELO), through key words like Duchenne Muscular Dystrophy, respiratory disorder and respiratory therapy. We verified that there are controversies regarding the practice of physical exercises, strength training and muscle resistance in the respiratory treatment. The appropriate treatment and caution can diminish the symptoms, improve the quality of life and reduce the high morbidity and early death of these patients.