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Osei-Yeboah R, Amankwah S, Begier E, Adedze M, Nyanzu F, Appiah P, Ansah JOB, Campbell H, Sato R, Jodar L, Gessner BD, Nair H. Burden of Respiratory Syncytial Virus (RSV) Infection Among Adults in Nursing and Care Homes: A Systematic Review. Influenza Other Respir Viruses 2024; 18:e70008. [PMID: 39284784 PMCID: PMC11405123 DOI: 10.1111/irv.70008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2024] [Revised: 08/20/2024] [Accepted: 08/29/2024] [Indexed: 09/22/2024] Open
Abstract
BACKGROUND Older adults in nursing and care homes (NCHs) are vulnerable to severe respiratory syncytial virus (RSV) infection, hospitalization, and death. This study aimed to gather data on RSV disease among older adults in NCHs and identify reported risk factors for RSV hospitalization and case fatality. METHODS The study protocol was registered in PROSPERO (CRD42022371908). We searched MEDLINE, EMBASE, and Global Health databases to identify articles published between 2000 and 2023. Observational and experimental studies conducted among older adults in NCHs requiring assistive care and reporting RSV illness were included and relevant data were extracted. RESULTS Of 18,690 studies screened, 32 were selected for full-text review, and 20 were included. Overall, the number of NCH residents ranged from 42 to 1459 with a mean age between 67.6 and 85 years. Attack rates ranged from 6.7% to 47.6% and annual incidence ranged from 0.5% to 14%. Case fatality rates ranged from 7.7% to 23.1%. We found similar annual incidence rates of RSV-positive acute respiratory infection (ARI) of 4582 (95% CI: 3259-6264) and 4785 (95% CI: 2258-10,141) per 100,000 reported in two studies. Annual incidence rate of RSV-positive lower respiratory tract infection was 3040 (95% CI: 1986-4454) cases per 100,000 adults. Annual RSV-ARI hospital admission rates were between 600 (95% CI: 190-10,000) and 1104 (95% CI: 350-1930) per 100,000 person-years. Among all RSV disease cases, commonly reported chronic medical conditions included chronic obstructive pulmonary disease (COPD), heart failure, ischemic heart disease, coronary artery disease, hypertension, diabetes, kidney dysfunction, cerebrovascular accident, malignancies, dementia, and those with a Charlson comorbidity score > 6.5. CONCLUSION Data on RSV infection among NCH residents are limited and largely heterogeneous but document a high risk of illness, frequent hospitalization, and high mortality. Preventive interventions, such as vaccination, should be considered for this high-risk population. Nationally representative epidemiologic studies and NCH-based viral pathogen surveillance could more precisely assess the burden on NCH residents.
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Affiliation(s)
- Richard Osei-Yeboah
- Centre for Global Health, Usher Institute, University of Edinburgh, Edinburgh, UK
| | - Stephen Amankwah
- Institute of Biochemistry and Biophysics, Polish Academy of Sciences, Warsaw, Poland
| | - Elizabeth Begier
- Global Medical Development Scientific and Clinical Affairs, Pfizer Vaccines, Dublin, Ireland
| | - Miranda Adedze
- Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Franklin Nyanzu
- Department of Epidemiology and Disease Control, School of Public Health, University of Ghana, Accra, Ghana
| | - Pious Appiah
- Department of Medical Microbiology, Medical School, College of Health Sciences, University of Ghana, Accra, Ghana
| | | | - Harry Campbell
- Centre for Global Health, Usher Institute, University of Edinburgh, Edinburgh, UK
| | - Reiko Sato
- Value & Evidence, Pfizer Inc, Collegeville, Pennsylvania, USA
| | - Luis Jodar
- Vaccines Medical Development, Scientific and Clinical Affairs, Pfizer Inc, Collegeville, Pennsylvania, USA
| | - Bradford D Gessner
- Vaccines Medical Development, Scientific and Clinical Affairs, Pfizer Inc, Collegeville, Pennsylvania, USA
| | - Harish Nair
- Centre for Global Health, Usher Institute, University of Edinburgh, Edinburgh, UK
- MRC/Wits Rural Public Health and Health Transitions Research Unit (Agincourt), School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
- School of Public Health, Nanjing Medical University, Nanjing, People's Republic of China
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2
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Nguyen-Van-Tam JS, O'Leary M, Martin ET, Heijnen E, Callendret B, Fleischhackl R, Comeaux C, Tran TMP, Weber K. Burden of respiratory syncytial virus infection in older and high-risk adults: a systematic review and meta-analysis of the evidence from developed countries. Eur Respir Rev 2022; 31:31/166/220105. [DOI: 10.1183/16000617.0105-2022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2022] [Accepted: 07/28/2022] [Indexed: 11/17/2022] Open
Abstract
BackgroundRespiratory syncytial virus (RSV) significantly impacts the health of older and high-risk adults (those with comorbidities). We aimed to synthesise the evidence on RSV disease burden and RSV-related healthcare utilisation in both populations.MethodsWe searched Embase and MEDLINE for papers published between 2000 and 2019 reporting the burden and clinical presentation of symptomatic RSV infection and the associated healthcare utilisation in developed countries in adults aged ≥60 years or at high risk. We calculated pooled estimates using random-effects inverse variance-weighted meta-analysis.Results103 out of 3429 articles met the inclusion criteria. Among older adults, RSV caused 4.66% (95% CI 3.34–6.48%) of symptomatic respiratory infections in annual studies and 7.80% (95% CI 5.77–10.45%) in seasonal studies; RSV-related case fatality proportion (CFP) was 8.18% (95% CI 5.54–11.94%). Among high-risk adults, RSV caused 7.03% (95% CI 5.18–9.48%) of symptomatic respiratory infections in annual studies, and 7.69% (95% CI 6.23–9.46%) in seasonal studies; CFP was 9.88% (95% CI 6.66–14.43%). Data paucity impaired the calculation of estimates on population incidence, clinical presentation, severe outcomes and healthcare-related utilisation.ConclusionsOlder and high-risk adults frequently experience symptomatic RSV infection, with appreciable mortality; however, detailed data are lacking. Increased surveillance and research are needed to quantify population-based disease burden and facilitate RSV treatments and vaccine development.
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3
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Abdel-Aziz HR, Atia NS. Respiratory Infections Prevention in Rural Older Adults: An Interventional Study. Clin Nurs Res 2022; 31:1445-1453. [PMID: 35285282 DOI: 10.1177/10547738221081981] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
Abstract
Respiratory tract infections are one of the major causes of morbidity and mortality in older adults. This quasi-experimental study aimed to evaluate the effect of an educational intervention on respiratory infections prevention (RIP) in rural older adults. The study sample composed of 80 older adults from a rural area, randomly assigned into two groups. The intervention group (n = 40) received ten 1-hour twice-weekly sessions and the control group (n = 40) received no intervention. Pre- and post-intervention assessments were done using measures of knowledge, attitudes, and practices regarding RIP. Chi-square test, Fisher's exact test, independent samples t-test, and paired t-test were used for data analysis. The study findings showed that the study intervention resulted in statistically significant improvements in the intervention group's knowledge, attitudes, and practices regarding RIP compared with the control group (p < .01). The educational intervention was effective and could be used to help rural older adults prevent respiratory infections.
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Affiliation(s)
| | - Nashwa Saber Atia
- Faculty of Nursing, Community Health Nursing Department, Zagazig University, Egypt
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4
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Negrey JD, Mitani JC, Wrangham RW, Otali E, Reddy RB, Pappas TE, Grindle KA, Gern JE, Machanda ZP, Muller MN, Langergraber KE, Thompson ME, Goldberg TL. Viruses associated with ill health in wild chimpanzees. Am J Primatol 2022; 84:e23358. [PMID: 35015311 PMCID: PMC8853648 DOI: 10.1002/ajp.23358] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2021] [Revised: 12/20/2021] [Accepted: 12/28/2021] [Indexed: 02/03/2023]
Abstract
Viral infection is a major cause of ill health in wild chimpanzees (Pan troglodytes), but most evidence to date has come from conspicuous disease outbreaks with high morbidity and mortality. To examine the relationship between viral infection and ill health during periods not associated with disease outbreaks, we conducted a longitudinal study of wild eastern chimpanzees (P. t. schweinfurthii) in the Kanyawara and Ngogo communities of Kibale National Park, Uganda. We collected standardized, observational health data for 4 years and then used metagenomics to characterize gastrointestinal viromes (i.e., all viruses recovered from fecal samples) in individual chimpanzees before and during episodes of clinical disease. We restricted our analyses to viruses thought to infect mammals or primarily associated with mammals, discarding viruses associated with nonmammalian hosts. We found 18 viruses (nine of which were previously identified in this population) from at least five viral families. Viral richness (number of viruses per sample) did not vary by health status. By contrast, total viral load (normalized proportion of sequences mapping to viruses) was significantly higher in ill individuals compared with healthy individuals. Furthermore, when ill, Kanyawara chimpanzees exhibited higher viral loads than Ngogo chimpanzees, and males, but not females, exhibited higher infection rates with certain viruses and higher total viral loads as they aged. Post-hoc analyses, including the use of a machine-learning classification method, indicated that one virus, salivirus (Picornaviridae), was the main contributor to health-related and community-level variation in viral loads. Another virus, chimpanzee stool-associated virus (chisavirus; unclassified Picornavirales), was associated with ill health at Ngogo but not at Kanyawara. Chisavirus, chimpanzee adenovirus (Adenoviridae), and bufavirus (Parvoviridae) were also associated with increased age in males. Associations with sex and age are consistent with the hypothesis that nonlethal viral infections cumulatively reflect or contribute to senescence in long-lived species such as chimpanzees.
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Affiliation(s)
- Jacob D. Negrey
- Department of Pathobiological Sciences, University of Wisconsin-Madison, Madison, WI, 53706, USA
- Section on Comparative Medicine, Wake Forest School of Medicine, Winston-Salem, NC, 27101, USA
| | - John C. Mitani
- Department of Anthropology, University of Michigan, Ann Arbor, MI, 48109, USA
| | - Richard W. Wrangham
- Department of Human Evolutionary Biology, Harvard University, Cambridge, MA, 02138, USA
| | | | - Rachna B. Reddy
- Department of Human Evolutionary Biology, Harvard University, Cambridge, MA, 02138, USA
| | - Tressa E. Pappas
- Department of Pediatrics, University of Wisconsin-Madison, Madison, WI, 53792, USA
| | - Kristine A. Grindle
- Department of Pediatrics, University of Wisconsin-Madison, Madison, WI, 53792, USA
| | - James E. Gern
- Department of Pediatrics, University of Wisconsin-Madison, Madison, WI, 53792, USA
| | - Zarin P. Machanda
- Department of Anthropology, Tufts University, Medford, MA, 02155, USA
| | - Martin N. Muller
- Department of Anthropology, University of New Mexico, Albuquerque, NM, 87131, USA
| | - Kevin E. Langergraber
- School of Human Evolution and Social Change, Arizona State University, Tempe, AZ, 85287, USA
- Institute of Human Origins, Arizona State University, Tempe, AZ, 85287, USA
| | | | - Tony L. Goldberg
- Department of Pathobiological Sciences, University of Wisconsin-Madison, Madison, WI, 53706, USA
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Brouwer L, Moreni G, Wolthers KC, Pajkrt D. World-Wide Prevalence and Genotype Distribution of Enteroviruses. Viruses 2021; 13:v13030434. [PMID: 33800518 PMCID: PMC7999254 DOI: 10.3390/v13030434] [Citation(s) in RCA: 53] [Impact Index Per Article: 17.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2021] [Revised: 03/02/2021] [Accepted: 03/03/2021] [Indexed: 12/18/2022] Open
Abstract
Enteroviruses (EVs) are highly prevalent viruses world-wide, causing a wide range of diseases in both children and adults. Insight in the global prevalence of EVs is important to define their clinical significance and total disease burden, and assists in making therapeutic decisions. While many studies have been conducted to describe epidemiology of EVs in specific (sub)populations and patient cohorts, little effort has been made to aggregate the available evidence. In the current study, we conducted a search in the PubMed and Embase (Ovid) databases to identify articles reporting EV prevalence and type distribution. We summarized the findings of 153 included studies. We found that EVs are highly prevalent viruses in all continents. Enterovirus B was the most detected species worldwide, while the other species showed continent-specific differences, with Enterovirus C more detected in Africa and Enterovirus A more detected in Asia. Echovirus 30 was by far the most detected type, especially in studies conducted in Europe. EV types in species Enterovirus B-including echovirus 30-were often detected in patient groups with neurological infections and in cerebrospinal fluid, while Enterovirus C types were often found in stool samples.
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Affiliation(s)
- Lieke Brouwer
- Department of Medical Microbiology, Amsterdam UMC, Meibergdreef 9, 1105 AZ Amsterdam, The Netherlands; (G.M.); (K.C.W.)
- Department of Pediatric Infectious Diseases, Amsterdam UMC, Meibergdreef 9, 1105 AZ Amsterdam, The Netherlands;
- Correspondence:
| | - Giulia Moreni
- Department of Medical Microbiology, Amsterdam UMC, Meibergdreef 9, 1105 AZ Amsterdam, The Netherlands; (G.M.); (K.C.W.)
- Department of Pediatric Infectious Diseases, Amsterdam UMC, Meibergdreef 9, 1105 AZ Amsterdam, The Netherlands;
| | - Katja C. Wolthers
- Department of Medical Microbiology, Amsterdam UMC, Meibergdreef 9, 1105 AZ Amsterdam, The Netherlands; (G.M.); (K.C.W.)
| | - Dasja Pajkrt
- Department of Pediatric Infectious Diseases, Amsterdam UMC, Meibergdreef 9, 1105 AZ Amsterdam, The Netherlands;
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Han L, Ran J, Chan KH, Mak YW, Suen L, Cowling BJ, Yang L. Indoor Environmental Factors and Acute Respiratory Illness in a Prospective Cohort of Community-Dwelling Older Adults. J Infect Dis 2021; 222:967-978. [PMID: 32297941 DOI: 10.1093/infdis/jiaa188] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/24/2019] [Accepted: 04/15/2020] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND Ambient environmental factors have been associated with respiratory infections in ecological studies, but few studies have explored the impact of indoor environmental factors in detail. The current study aimed to investigate the impact of indoor environment on the risk of acute respiratory illness (ARI) in a subtropical city. METHOD A prospective cohort study was conducted in 285 community-dwelling older adults from December 2016 through May 2019. Individual household indoor environment data and ARI incidence were continuously collected. A time-stratified case-crossover analysis was conducted to estimate the excess risk of ARI associated with per-unit increase of daily mean indoor temperature, relative humidity, and absolute humidity (AH). RESULT In total, 168 episodes of ARI were reported with an average risk of 36.8% per year. We observed a negative association of ARI with indoor AH up to 5 lag days in cool seasons, with a 6-day cumulative excess risk estimate of -9.0% (95% confidence interval, -15.9% to -1.5%). Negative associations between household temperature or relative humidity and ARI were less consistent across warm and cool seasons. CONCLUSIONS Lower indoor AH in household was associated with a higher risk of ARI in the community-dwelling older adults in Hong Kong during cold seasons.
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Affiliation(s)
- Lefei Han
- School of Nursing, the Hong Kong Polytechnic University, Hong Kong Special Administrative Region, People's Republic of China
| | - Jinjun Ran
- School of Public Health, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong Special Administrative Region, People's Republic of China
| | - Kwok-Hung Chan
- Department of Microbiology, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong Special Administrative Region, People's Republic of China
| | - Yim-Wah Mak
- School of Nursing, the Hong Kong Polytechnic University, Hong Kong Special Administrative Region, People's Republic of China
| | - Lorna Suen
- School of Nursing, the Hong Kong Polytechnic University, Hong Kong Special Administrative Region, People's Republic of China
| | - Benjamin John Cowling
- School of Public Health, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong Special Administrative Region, People's Republic of China
| | - Lin Yang
- School of Nursing, the Hong Kong Polytechnic University, Hong Kong Special Administrative Region, People's Republic of China
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7
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Rachow T, Lamik T, Kalkreuth J, Kurze S, Wagner K, Stier P, Hammersen FJ, Rüthrich MM, Winkelmann N, Klink A, Hilgendorf I, Hermann B, Lang S, Hochhaus A, von Lilienfeld-Toal M. Detection of community-acquired respiratory viruses in allogeneic stem-cell transplant recipients and controls-A prospective cohort study. Transpl Infect Dis 2020; 22:e13415. [PMID: 32779843 PMCID: PMC7404629 DOI: 10.1111/tid.13415] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2019] [Revised: 06/28/2020] [Accepted: 07/07/2020] [Indexed: 02/06/2023]
Abstract
Background Community‐acquired respiratory viruses (CARV) cause upper and lower respiratory tract infections (URTI/LRTI) and may be life‐threatening for recipients of an allogeneic stem cell transplantation (allo‐SCT). Methods In a prospective study encompassing 4 winter‐seasons, we collected throat gargles (TG) at random time points from allo‐SCT recipients (patients) and controls and followed them up for at least 3 weeks including repetitive sampling and documentation of symptoms. A Multiplex‐PCR system to identify 20 CARV and Mycoplasma pneumoniae was used to detect CARV. Results One hundred ninety‐four patients with 426 TG and 273 controls with 549 TG were included. There were more patients with a positive test result (25% vs 11% in the controls), and the patients had a higher number of positive TG (70 = 16%) compared to controls (32 = 6%) (P < .001). Altogether, 115 viruses were detected. Multiple viruses in one TG (11/48, 34%) and prolonged shedding were only observed in patients (13/48, 27%). Patients had more RSV (18/83, 26%) and adenovirus (15/83, 21%) than controls (both viruses 2/32, 6%). Independent risk factors for the detection of CARV included age >40 years (OR 3.38, 95% CI 1.8‐6.4, P < .001) and presence of URTI‐symptoms (OR 3.22, 95% CI 1.9‐5.5, P < .001). No controls developed a LRTI or died whereas 4/48 (8%) patients developed a LRTI (coronavirus in 2, RSV in 1 and influenza A H1N1 in 1 patient). One patient died of CARV (influenza A H1N1). Conclusion Allo‐SCT‐recipients have more CARV‐infections, exhibit a different epidemiology, have more cases of co‐infection or prolonged shedding and have a higher rate of LRTI and mortality.
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Affiliation(s)
- Tobias Rachow
- Klinik für Innere Medizin II-Hämatologie und internistische Onkologie, Universitätsklinikum Jena, Jena, Germany
| | - Toni Lamik
- Klinik für Innere Medizin II-Hämatologie und internistische Onkologie, Universitätsklinikum Jena, Jena, Germany
| | - Jana Kalkreuth
- Klinik für Innere Medizin II-Hämatologie und internistische Onkologie, Universitätsklinikum Jena, Jena, Germany
| | - Stephanie Kurze
- Klinik für Innere Medizin II-Hämatologie und internistische Onkologie, Universitätsklinikum Jena, Jena, Germany
| | - Kathleen Wagner
- Klinik für Innere Medizin II-Hämatologie und internistische Onkologie, Universitätsklinikum Jena, Jena, Germany.,Leibniz-Institut für Naturstoff-Forschung und Infektionsbiologie, Hans-Knöll-Institut, Jena, Germany
| | - Pia Stier
- Klinik für Innere Medizin II-Hämatologie und internistische Onkologie, Universitätsklinikum Jena, Jena, Germany.,Leibniz-Institut für Naturstoff-Forschung und Infektionsbiologie, Hans-Knöll-Institut, Jena, Germany
| | - Friedrich J Hammersen
- Klinik für Innere Medizin II-Hämatologie und internistische Onkologie, Universitätsklinikum Jena, Jena, Germany
| | - Maria Madeleine Rüthrich
- Klinik für Innere Medizin II-Hämatologie und internistische Onkologie, Universitätsklinikum Jena, Jena, Germany
| | - Nils Winkelmann
- Klinik für Innere Medizin II-Hämatologie und internistische Onkologie, Universitätsklinikum Jena, Jena, Germany
| | - Anne Klink
- Klinik für Innere Medizin II-Hämatologie und internistische Onkologie, Universitätsklinikum Jena, Jena, Germany
| | - Inken Hilgendorf
- Klinik für Innere Medizin II-Hämatologie und internistische Onkologie, Universitätsklinikum Jena, Jena, Germany
| | - Beate Hermann
- Dianovis GmbH, Greiz, Germany.,Institut für Medizinische Mikrobiologie, Universitätsklinikum Jena, Jena, Germany
| | - Susanne Lang
- Klinik für Innere Medizin II-Hämatologie und internistische Onkologie, Universitätsklinikum Jena, Jena, Germany
| | - Andreas Hochhaus
- Klinik für Innere Medizin II-Hämatologie und internistische Onkologie, Universitätsklinikum Jena, Jena, Germany
| | - Marie von Lilienfeld-Toal
- Klinik für Innere Medizin II-Hämatologie und internistische Onkologie, Universitätsklinikum Jena, Jena, Germany.,Leibniz-Institut für Naturstoff-Forschung und Infektionsbiologie, Hans-Knöll-Institut, Jena, Germany
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8
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Nouvenne A, Ticinesi A, Parise A, Prati B, Esposito M, Cocchi V, Crisafulli E, Volpi A, Rossi S, Bignami EG, Baciarello M, Brianti E, Fabi M, Meschi T. Point-of-Care Chest Ultrasonography as a Diagnostic Resource for COVID-19 Outbreak in Nursing Homes. J Am Med Dir Assoc 2020; 21:919-923. [PMID: 32571651 PMCID: PMC7247494 DOI: 10.1016/j.jamda.2020.05.050] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2020] [Revised: 05/13/2020] [Accepted: 05/20/2020] [Indexed: 01/08/2023]
Abstract
Objective Bedside chest ultrasonography, when integrated with clinical data, is an accurate tool for improving the diagnostic process of many respiratory diseases. This study aims to evaluate the feasibility of a chest ultrasonographic screening program in nursing homes for detecting coronavirus disease-19 (COVID-19)–related pneumonia and improving the appropriateness of hospital referral of residents. Design Pragmatic, descriptive, feasibility study from April 2 to April 9, 2020. Setting and Participants A total of 83 older residents (age 85 ± 8) presenting mild to moderate respiratory symptoms and not previously tested for COVID-19, residing in 5 nursing homes in Northern Italy. Methods Chest ultrasonography was performed at the bedside by a team of hospital specialists with certified expertise in thoracic ultrasonography, following a systematic approach exploring 4 different areas for each hemithorax, from the anterior and posterior side. Presence of ultrasonographic signs of interstitial pneumonia, including comet-tail artifacts (B-lines) with focal or diffuse distribution, subpleural consolidations, and pleural line indentation, was detected. The specialist team integrated ultrasonography data with clinical and anamnestic information, and gave personalized therapeutic advice for each patient, including hospital referral when needed. Results The most frequent reasons for ultrasonographic evaluation were fever (63% of participants) and mild dyspnea (40%). Fifty-six patients (67%) had abnormal ultrasonographic findings. The most common patterns were presence of multiple subpleural consolidations (32 patients) and diffuse B-lines (24 patients), with bilateral involvement. A diagnosis of suspect COVID-19 pneumonia was made in 44 patients, and 6 of them required hospitalization. Twelve patients had ultrasonographic patterns suggesting other respiratory diseases, and 2 patients with normal ultrasonographic findings were diagnosed with COPD exacerbation. Conclusions and Implications In nursing home residents, screening of COVID-19 pneumonia with bedside chest ultrasonography is feasible and may represent a valid diagnostic aid for an early detection of COVID-19 outbreaks and adequate patient management.
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Affiliation(s)
- Antonio Nouvenne
- Geriatric-Rehabilitation Department, Azienda Ospedaliero-Universitaria di Parma, Parma, Italy
| | - Andrea Ticinesi
- Geriatric-Rehabilitation Department, Azienda Ospedaliero-Universitaria di Parma, Parma, Italy.
| | - Alberto Parise
- Geriatric-Rehabilitation Department, Azienda Ospedaliero-Universitaria di Parma, Parma, Italy
| | - Beatrice Prati
- Geriatric-Rehabilitation Department, Azienda Ospedaliero-Universitaria di Parma, Parma, Italy
| | - Marcello Esposito
- Post-Graduate Specialization Course in Emergency-Urgency Medicine, Department of Medicine and Surgery, University of Parma, Parma, Italy
| | - Valentina Cocchi
- Post-Graduate Specialization Course in Emergency-Urgency Medicine, Department of Medicine and Surgery, University of Parma, Parma, Italy
| | - Emanuele Crisafulli
- Post-Graduate Specialization Course in Emergency-Urgency Medicine, Department of Medicine and Surgery, University of Parma, Parma, Italy
| | - Annalisa Volpi
- Emergency-Urgency Department, Azienda Ospedaliero-Universitaria di Parma and Azienda Unità Sanitaria Locale di Parma, Parma, Italy
| | - Sandra Rossi
- Emergency-Urgency Department, Azienda Ospedaliero-Universitaria di Parma and Azienda Unità Sanitaria Locale di Parma, Parma, Italy
| | - Elena Giovanna Bignami
- Department of Medicine and Surgey, University of Parma, Parma, Italy; General Surgical and Specialistic Department, Azienda Ospedaliero-Universitaria di Parma, Parma, Italy
| | - Marco Baciarello
- Department of Medicine and Surgey, University of Parma, Parma, Italy; General Surgical and Specialistic Department, Azienda Ospedaliero-Universitaria di Parma, Parma, Italy
| | - Ettore Brianti
- General Management, Azienda Ospedaliero-Universitaria di Parma, Parma, Italy
| | - Massimo Fabi
- General Management, Azienda Ospedaliero-Universitaria di Parma, Parma, Italy
| | - Tiziana Meschi
- Geriatric-Rehabilitation Department, Azienda Ospedaliero-Universitaria di Parma, Parma, Italy; Department of Medicine and Surgey, University of Parma, Parma, Italy
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9
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Nazareth R, Chasqueira MJ, Rodrigues ML, Paulino C, Conceição C, Lêdo L, Segura Ú, Santos M, Messias A, Póvoa P, Paixão P. Respiratory viruses in mechanically ventilated patients: a pilot study. BMC Pulm Med 2020; 20:39. [PMID: 32054471 PMCID: PMC7020345 DOI: 10.1186/s12890-020-1082-5] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2019] [Accepted: 02/07/2020] [Indexed: 12/17/2022] Open
Abstract
BACKGROUND Respiratory virome is an integral part of the human microbiome and its characterization may contribute to a better understanding of the changes that arise in the disease and, consequently, influence the approach and treatment of patients with acute lower respiratory infections. The aim of this study was to evaluate the presence of respiratory viruses in the lower airways of individuals undergoing invasive mechanical ventilation, with and without acute lower respiratory infection (respectively WRI and WORI groups). METHODS We studied 44 mini-bronchoalveolar lavage samples (collected with a double catheter, Combicath® kit) from patients with mean age in the seventh decade, 20 from WORI group and 24 from WRI group, who were hospitalized for acute respiratory failure in Intensive Care Units of two hospitals in the Lisbon area. Real-time PCR was applied to verify analyse the presence of 15 common respiratory viruses (adenovirus, human bocavirus, influenza virus A and B, repiratory syncytial virus, human parainfluenza virus types 1, 2, 3 and 4, human enterovirus, human rhinovirus, human metapneumovirus, human coronavirus group 1 (229E, NL63) and 2 (OC43, HKU1). RESULTS Respiratory viruses were detected in six of the 20 patients in the WORI group: influenza AH3 (n = 2), parainfluenza virus 1/3 (n = 2), human rhinovirus (n = 2), respiratory syncytial virus (n = 1) and human metapneumovirus (n = 1). In the WRI group, respiratory viruses were detected in 12 of the 24 patients: influenza AH3 (n = 3), human rhinovirus (n = 3), respiratory syncytial virus (n = 3), human metapneumovirus (n = 3), human bocavirus (n = 2) and human enterovirus (n = 1). Simultaneous detection of two viruses was recorded in two samples in both groups. CONCLUSIONS The results of this study suggest the presence of common respiratory viruses in the lower respiratory tract without causing symptomatic infection, even in carefully collected lower samples. This may have important implications on the interpretation of the results on the diagnostic setting.
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Affiliation(s)
- Raquel Nazareth
- Hospital Beatriz Ângelo, Avenida Carlos Teixeira, 3, 2674-514, Loures, Portugal. .,Centro de Estudos de Doenças Crónicas, CEDOC, Faculdade de Ciências Médicas
- NOVA Medical School, Campo Mártires da Pátria, 130, 1169-056, Lisbon, Portugal.
| | - Maria-Jesus Chasqueira
- Centro de Estudos de Doenças Crónicas, CEDOC, Faculdade de Ciências Médicas
- NOVA Medical School, Campo Mártires da Pátria, 130, 1169-056, Lisbon, Portugal
| | - Maria-Lúcia Rodrigues
- Centro de Estudos de Doenças Crónicas, CEDOC, Faculdade de Ciências Médicas
- NOVA Medical School, Campo Mártires da Pátria, 130, 1169-056, Lisbon, Portugal
| | - Carolina Paulino
- Hospital São Francisco de Xavier, Estrada Forte do Alto Duque, 1449-005, Lisbon, Portugal
| | - Catarina Conceição
- Hospital São Francisco de Xavier, Estrada Forte do Alto Duque, 1449-005, Lisbon, Portugal
| | - Lia Lêdo
- Hospital São Francisco de Xavier, Estrada Forte do Alto Duque, 1449-005, Lisbon, Portugal
| | - Úrsula Segura
- Hospital Beatriz Ângelo, Avenida Carlos Teixeira, 3, 2674-514, Loures, Portugal
| | - Madalena Santos
- Hospital Curry Cabral, Centro Hospitalar de Lisboa Central, Rua da Beneficiência n° 8, 1069-166, Lisbon, Portugal
| | - António Messias
- Hospital Beatriz Ângelo, Avenida Carlos Teixeira, 3, 2674-514, Loures, Portugal
| | - Pedro Póvoa
- Centro de Estudos de Doenças Crónicas, CEDOC, Faculdade de Ciências Médicas
- NOVA Medical School, Campo Mártires da Pátria, 130, 1169-056, Lisbon, Portugal.,Hospital São Francisco de Xavier, Estrada Forte do Alto Duque, 1449-005, Lisbon, Portugal.,Center for Clinical Epidemiology and Research Unit of Clinical Epidemiology, OUH Odense University Hospital, Odense, Denmark
| | - Paulo Paixão
- Centro de Estudos de Doenças Crónicas, CEDOC, Faculdade de Ciências Médicas
- NOVA Medical School, Campo Mártires da Pátria, 130, 1169-056, Lisbon, Portugal.,Clinical Pathology Laboratory (Synlab), Hospital da Luz, Av Lusíada, 100, 1500-650, Lisbon, Portugal
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10
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Checovich MM, Barlow S, Shult P, Reisdorf E, Temte JL. Evaluation of Viruses Associated With Acute Respiratory Infections in Long-Term Care Facilities Using a Novel Method: Wisconsin, 2016‒2019. J Am Med Dir Assoc 2019; 21:29-33. [PMID: 31636034 PMCID: PMC7106273 DOI: 10.1016/j.jamda.2019.09.003] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2019] [Revised: 08/28/2019] [Accepted: 09/02/2019] [Indexed: 01/06/2023]
Abstract
Residents of long-term care facilities (LCTFs) have high morbidity and mortality associated with acute respiratory infections (ARIs). Limited information exists on the virology of ARI in LTCFs, where virological testing is reactive. We report on findings of a surveillance feasibility substudy from a larger prospective trial of introducing rapid influenza diagnostic testing (RIDT) at 10 Wisconsin LTCFs. Any resident with symptoms consistent with ARI had a nasal swab specimen collected for RIDT by staff. Following RIDT, the residual swab was placed into viral transport medium and tested for influenza using Reverse transcription polymerase chain reaction, and for 20 pathogens using a multiplex polymerase chain reaction respiratory pathogen panel. Numbers of viruses in each of 7 categories (influenza A, influenza B, coronaviruses, human metapneumovirus, parainfluenza, respiratory syncytial virus, and rhinovirus/enterovirus) across the 3 years were compared using χ2. Totals of 160, 215, and 122 specimens were collected during 2016‒2017, 2017‒2018, and 2018‒2019, respectively. Respiratory pathogen panel identified viruses in 54.8% of tested specimens. Influenza A (19.2%), influenza B (12.6%), respiratory syncytial virus (15.9%), and human metapneumovirus (20.9%) accounted for 69% of all detections, whereas coronaviruses (17.2%), rhinovirus/enterovirus (10.5%) and parainfluenza (3.8%) were less common. The distribution of viruses varied significantly across the 3 years (χ2 = 71.663; df = 12; P < .001). Surveillance in LTCFs using nasal swabs collected for RIDT is highly feasible and yields high virus identification rates. Significant differences in virus composition occurred across the 3 study years. Simple approaches to surveillance may provide a more comprehensive assessment of respiratory viruses in LTCF settings.
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Affiliation(s)
- Mary M Checovich
- Department of Family Medicine and Community Health, University of Wisconsin School of Medicine and Public Health, Madison, WI.
| | - Shari Barlow
- Department of Family Medicine and Community Health, University of Wisconsin School of Medicine and Public Health, Madison, WI
| | - Peter Shult
- Wisconsin State Laboratory of Hygiene, Madison, WI
| | | | - Jonathan L Temte
- Department of Family Medicine and Community Health, University of Wisconsin School of Medicine and Public Health, Madison, WI
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11
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Belo J, Carreiro-Martins P, Papoila AL, Palmeiro T, Caires I, Alves M, Nogueira S, Aguiar F, Mendes A, Cano M, Botelho MA, Neuparth N. The impact of indoor air quality on respiratory health of older people living in nursing homes: spirometric and exhaled breath condensate assessments. JOURNAL OF ENVIRONMENTAL SCIENCE AND HEALTH. PART A, TOXIC/HAZARDOUS SUBSTANCES & ENVIRONMENTAL ENGINEERING 2019; 54:1153-1158. [PMID: 31274053 DOI: 10.1080/10934529.2019.1637206] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/27/2018] [Revised: 06/16/2019] [Accepted: 06/23/2019] [Indexed: 06/09/2023]
Abstract
In the Portuguese Geriatric Study of the Health Effects of Indoor Air Quality in Senior Nursing Homes, we aimed to evaluate the impact of indoor air contaminants on the respiratory symptoms and biomarkers in a sample of elderly living in nursing homes. A total of 269 elderly answered a health questionnaire, performed a spirometry and 150 out of these collected an exhaled breath condensate sample for pH and nitrites analysis. The study included the evaluation of indoor chemical and microbiological contaminants. The median age of the participants was 84 (78-87) years and 70.6% were women. The spirometric data indicated the presence of airway obstruction in 14.5% of the sample. Median concentrations of air pollutants did not exceed the existing standards, although increased peak values were observed. In the multivariable analysis, each increment of 100 µg/m3 of total volatile organic compounds was associated with the odds of respiratory infection in the previous three months ( OR̂ =1.05; 95% CI: 1.00-1.09). PM2.5 concentrations were inversely associated with pH values ( β̂ = -0.04, 95%: -0.06 to -0.01, for each increment of 10 µg/m3). Additionally, a direct and an inverse association were found between total bacteria and FEV1/FVC and FVC, respectively.
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Affiliation(s)
- Joana Belo
- H&TRC- Health & Technology Research Center, ESTeSL- Escola Superior de Tecnologia da Saúde, Instituto Politécnico de Lisboa , Lisbon , Portugal
- Integrated Pathophysiological Mechanisms Research Group, Nova Medical School, CEDOC , Lisbon , Portugal
| | - Pedro Carreiro-Martins
- Integrated Pathophysiological Mechanisms Research Group, Nova Medical School, CEDOC , Lisbon , Portugal
- Serviço de Imunoalergologia, Hospital de Dona Estefânia, Centro Hospitalar de Lisboa Central, EPE , Lisbon , Portugal
| | - Ana L Papoila
- Epidemiology and Statistics Analysis Unit, Research Centre, Centro Hospitalar de Lisboa Central, EPE, CEAUL , Lisbon , Portugal
- NOVA Medical School/Faculdade de Ciências Médicas, Universidade Nova de Lisboa , Lisbon , Portugal
| | - Teresa Palmeiro
- CEDOC, Integrated Pathophysiological Mechanisms Research Group, Nova Medical School , Lisbon , Portugal
| | - Iolanda Caires
- Integrated Pathophysiological Mechanisms Research Group, Nova Medical School, CEDOC , Lisbon , Portugal
| | - Marta Alves
- Epidemiology and Statistics Analysis Unit, Research Centre, Centro Hospitalar de Lisboa Central, EPE, CEAUL , Lisbon , Portugal
| | - Susana Nogueira
- DINAMIÁCET - Centre for Socioeconomic and Territorial Studies, ISCTE, Lisbon University Institute , Lisbon , Portugal
| | - Fátima Aguiar
- Environmental Health Department, National Institute of Health Doutor Ricardo Jorge , Lisbon , Portugal
| | - Ana Mendes
- Environmental Health Department, National Institute of Health , Porto , Portugal
- Institute of Public Health (ISPUP), Porto University , Porto , Portugal
| | - Manuela Cano
- Environmental Health Department, National Institute of Health Doutor Ricardo Jorge , Lisbon , Portugal
| | - Maria A Botelho
- CEDOC, Integrated Pathophysiological Mechanisms Research Group, Nova Medical School , Lisbon , Portugal
| | - Nuno Neuparth
- Serviço de Imunoalergologia, Hospital de Dona Estefânia, Centro Hospitalar de Lisboa Central, EPE , Lisbon , Portugal
- CEDOC, Integrated Pathophysiological Mechanisms Research Group, Nova Medical School , Lisbon , Portugal
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12
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Bogner J. [Flu-like disease in summer - what do we know about it?]. MMW Fortschr Med 2019; 161:39-43. [PMID: 31230309 PMCID: PMC7100306 DOI: 10.1007/s15006-019-0657-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
Durchsucht man die deutschsprachige medizinische Literatur nach dem Begriff „Sommergrippe“, scheitert man kläglich. Jeder glaubt zu wissen, was damit gemeint ist, doch keiner schreibt darüber. Ist das überhaupt ein seriöses Thema?
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Affiliation(s)
- Johannes Bogner
- Sektion Klinische Infektiologie, Med. Klinik und Poliklinik IV, Klinikum der Univ. München, Pettenkoferstr. 8a, D-80336, München, Deutschland.
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