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Al-Dorzi HM, Alsafwani ZA, Alsalahi E, Aljulayfi AS, Alshaer R, Alanazi S, Aldossari MA, Alsahoo DA, Khan R. Patients with influenza admitted to a tertiary-care hospital in Riyadh between 2018 and 2022: characteristics, outcomes and factors associated with ICU admission and mortality. BMC Pulm Med 2024; 24:464. [PMID: 39300448 DOI: 10.1186/s12890-024-03281-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2024] [Accepted: 09/10/2024] [Indexed: 09/22/2024] Open
Abstract
BACKGROUND Influenza is a common cause of hospital admissions globally with regional variations in epidemiology and clinical profile. We evaluated the characteristics and outcomes of patients with influenza admitted to a tertiary-care center in Riyadh, Saudi Arabia. METHODS This was a retrospective cohort of adult patients admitted with polymerase chain reaction-confirmed influenza to King Abdulaziz Medical City-Riyadh between January 1, 2018, and May 31, 2022. We compared patients who required intensive care unit (ICU) admission to those who did not and performed multivariable logistic regression to assess the predictors of ICU admission and hospital mortality. RESULTS During the study period, 675 adult patients were hospitalized with influenza (median age 68.0 years, females 53.8%, hypertension 59.9%, diabetes 55.1%, and chronic respiratory disease 31.1%). Most admissions (83.0%) were in the colder months (October to March) in Riyadh with inter-seasonal cases even in the summertime (June to August). Influenza A was responsible for 79.0% of cases, with H3N2 and H1N1 subtypes commonly circulating in the study period. Respiratory viral coinfection occurred in 12 patients (1.8%) and bacterial coinfection in 42 patients (17.4%). 151 patients (22.4%) required ICU admission, of which 62.3% received vasopressors and 48.0% mechanical ventilation. Risk factors for ICU admission were younger age, hypertension, bilateral lung infiltrates on chest X-ray, and Pneumonia Severity Index. The overall hospital mortality was 7.4% (22.5% for ICU patients, p < 0.0001). Mortality was 45.0% in patients with bacterial coinfection, 30.9% in those requiring vasopressors, and 29.2% in those who received mechanical ventilation. Female sex (odds ratio [OR], 2.096; 95% confidence interval [CI] 1.070, 4.104), ischemic heart disease (OR, 3.053; 95% CI 1.457, 6.394), immunosuppressed state (OR, 7.102; 95% CI 1.803, 27.975), Pneumonia Severity Index (OR, 1.029; 95% CI, 1.017, 1.041), leukocyte count and serum lactate level (OR, 1.394; 95% CI, 1.163, 1.671) were independently associated with hospital mortality. CONCLUSIONS Influenza followed a seasonal pattern in Saudi Arabia, with H3N2 and H1N1 being the predominant circulating strains during the study period. ICU admission was required for > 20%. Female sex, high Pneumonia Severity Index, ischemic heart disease, and immunosuppressed state were associated with increased mortality.
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Affiliation(s)
- Hasan M Al-Dorzi
- College of Medicine, King Saud bin Abdulaziz University for Health Sciences, King Abdullah International Medical Research Center, Intensive Care Department, King Abdulaziz Medical City, Ministry of National Guard - Health Affairs, ICU2, Mail Code 1425, PO Box 22490, Riyadh, 11426, Saudi Arabia.
| | - Zahra A Alsafwani
- College of Medicine, King Saud Bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia
| | - Elham Alsalahi
- College of Medicine, King Saud Bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia
| | - Alaa S Aljulayfi
- College of Medicine, King Saud Bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia
| | - Roa Alshaer
- College of Medicine, King Saud Bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia
| | - Salam Alanazi
- College of Medicine, King Saud Bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia
| | - Munira A Aldossari
- College of Medicine, King Saud Bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia
| | - Deem A Alsahoo
- College of Medicine, King Saud Bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia
| | - Raymond Khan
- College of Medicine, King Saud bin Abdulaziz University for Health Sciences, King Abdullah International Medical Research Center, Intensive Care Department, King Abdulaziz Medical City, Ministry of National Guard - Health Affairs, ICU2, Mail Code 1425, PO Box 22490, Riyadh, 11426, Saudi Arabia
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Zhang G, Wang K, Ba L, Dong S, Gao J. Dynamic changes in the circulation of respiratory pathogens in children during and after the containment of the 2019 coronavirus disease pandemic in Kunming, China. Eur J Clin Microbiol Infect Dis 2024:10.1007/s10096-024-04945-1. [PMID: 39292354 DOI: 10.1007/s10096-024-04945-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2024] [Accepted: 09/10/2024] [Indexed: 09/19/2024]
Abstract
PURPOSE We aimed to determine the changes in the frequency of respiratory pathogens and severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) during containment of the 2019 coronavirus disease pandemic and elucidate the epidemiological interference that may have occurred after lifting pandemic measures. METHODS A total of 4,770 Nasopharyngeal swab samples were collected from children with ARTIs from the First People's Hospital of Yunnan Province between January 2022 and December 2023 and subjected to nucleic acid testing for 13 types of respiratory pathogens and severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). RESULTS The frequency of pathogens among children from 2020 to 2022 was in the following order: HRV > Mp > HADV > H3N2 > HMPV and HRV > HRSV > HPIV > H1N1 > H3N2. In weeks 1 to 3 of 2023, the frequency of pathogens significantly declined, and then H1N1 rebounded significantly in 2023. HRV, HRSV, and H3N2 showed a shift in the season of high frequency. Patterns of multi-pathogen infections were more complex in 2023 than in 2022, with HRV having a higher frequency and co-infection rate than other pathogens. These changes may have been associated with interference caused by the resurgence of SARS-CoV-2 prevalence, in addition to being influenced by changes in pandemic containment and lifting measures. CONCLUSIONS The frequency rate of common respiratory pathogens among children was not significantly different and remained high. The study findings help elucidate the aforementioned unique historical period and effectively control respiratory tract infections to reduce the harm to pediatric health caused by respiratory pathogens.
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Affiliation(s)
- Guiqian Zhang
- Department of Clinical Laboratory, The First People's Hospital of Yunnan Province, The Affiliated Hospital of Kunming University of Science and Technology, Kunming, Yunnan, China
- Institute of Basic and Clinical Medicine, Yunnan Provincial Key Laboratory of Clinical Virology, The First People's Hospital of Yunnan Province, The Affiliated Hospital of Kunming University of Science and Technology, 157 Jinbi Road, Kunming, 650100, China
| | - Kaimei Wang
- Department of Medical Technology, Yunnan University of Business Management, Kunming, Yunnan, China
| | - Limei Ba
- Department of Clinical Laboratory, The First People's Hospital of Yunnan Province, The Affiliated Hospital of Kunming University of Science and Technology, Kunming, Yunnan, China
| | - Shumei Dong
- Department of Medical Technology, Yunnan University of Business Management, Kunming, Yunnan, China
| | - Jianmei Gao
- Institute of Basic and Clinical Medicine, Yunnan Provincial Key Laboratory of Clinical Virology, The First People's Hospital of Yunnan Province, The Affiliated Hospital of Kunming University of Science and Technology, 157 Jinbi Road, Kunming, 650100, China.
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3
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Galindo-Fraga A, del Carmen Guerra-de-Blas P, Ortiz-Hernández AA, Rubenstein K, Ortega-Villa AM, Ramírez-Venegas A, Valdez-Vázquez R, Moreno-Espinosa S, Llamosas-Gallardo B, Pérez-Patrigeon S, Noyola DE, Magaña-Aquino M, Vilardell-Dávila A, Guerrero ML, Powers JH, Beigel J, Ruiz-Palacios GM. Prospective cohort study of patient demographics, viral agents, seasonality, and outcomes of influenza-like illness in Mexico in the late H1N1-pandemic and post-pandemic years (2010-2014). IJID REGIONS 2024; 12:100394. [PMID: 39045384 PMCID: PMC11265585 DOI: 10.1016/j.ijregi.2024.100394] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/09/2024] [Revised: 06/17/2024] [Accepted: 06/18/2024] [Indexed: 07/25/2024]
Abstract
Objectives Influenza-like illness (ILI) caused by respiratory viruses results in various respiratory clinical manifestations. The ILI002 prospective observational cohort study aimed to describe viral agents, seasonality, and outcomes of patients with ILI during four seasons in the influenza H1N1-pandemic and post-pandemic years (2010-2014). Methods Patients from six Mexican hospitals were enrolled from April 2010 to March 2014. Clinical data and nasopharyngeal swabs were obtained and tested for viral respiratory pathogens by real-time reverse-transcription polymerase chain reaction. Results Of the 5662 enrolled participants, 64.9% were adults and 35.1% were children. Among the 5629 participants with single-pathogen detection, rhinovirus (20.2%), influenza virus (11.2%), respiratory syncytial virus (RSV) (7.2%), and coronavirus (6.8%) were the most frequent pathogens. Co-infection occurred in 14.5% of cases; 49.3% of participants required hospitalization, particularly in RSV cases (42.9% adults, 89.6% children). The mortality rate was 2.8% higher among older adult participants and those with comorbidities. Influenza H1N1 had the highest mortality rate, yet almost half of the deceased had no pathogen. Rhinovirus persisted year-round, while influenza, coronavirus, and RSV peaked during cooler months. Conclusions Analyses showed that some viruses causing ILI may lead to severe disease and hospitalization irrespective of comorbidities. These findings may help in decision-making about public health policies on prevention measures, vaccination, treatment, and administration of health care.
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Affiliation(s)
- Arturo Galindo-Fraga
- Subdirección de Epidemiología Hospitalaria, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City, Mexico
| | | | - Ana A. Ortiz-Hernández
- División de Desarrollo y Enlace Interinstitucional, Instituto Nacional de Pediatría, Mexico City, Mexico
| | - Kevin Rubenstein
- Clinical Monitoring Research Program Directorate, Frederick National Laboratory for Cancer Research, Frederick, MD, USA
| | | | - Alejandra Ramírez-Venegas
- Departamento de Investigación en Tabaquismo y EPOC, Instituto Nacional de Enfermedades Respiratorias Ismael Cosío Villegas, Mexico City, Mexico
| | - Rafael Valdez-Vázquez
- Departamento de Infectología, Hospital General Dr. Manuel Gea González, Mexico City, Mexico
| | | | - Beatriz Llamosas-Gallardo
- División de Desarrollo y Enlace Interinstitucional, Instituto Nacional de Pediatría, Mexico City, Mexico
| | - Santiago Pérez-Patrigeon
- Division of Infectious Diseases, Queen's University, Kingston, Ontario, Canada
- Departamento de Infectología, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City, Mexico
| | - Daniel E. Noyola
- Departamento de Microbiología y Centro de Investigación en Ciencias de la Salud y Biomedicina, Facultad de Medicina, Universidad Autónoma de San Luís Potosí, San Luis Potosí, Mexico
| | | | - Ana Vilardell-Dávila
- The Mexican Emerging Infectious Diseases Clinical Research Network (LaRed), Mexico City, Mexico
| | - M. Lourdes Guerrero
- Departamento de Infectología, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City, Mexico
| | - John H. Powers
- Clinical Research Directorate, Frederick National Laboratory for Cancer Research, Frederick, MD, USA
| | - John Beigel
- National Institute of Allergy and Infectious Diseases, Bethesda, MD, USA
| | - Guillermo M. Ruiz-Palacios
- Departamento de Infectología, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City, Mexico
| | - Mexican Emerging Infectious Disease Clinical Research Network
- Subdirección de Epidemiología Hospitalaria, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City, Mexico
- The Mexican Emerging Infectious Diseases Clinical Research Network (LaRed), Mexico City, Mexico
- División de Desarrollo y Enlace Interinstitucional, Instituto Nacional de Pediatría, Mexico City, Mexico
- Clinical Monitoring Research Program Directorate, Frederick National Laboratory for Cancer Research, Frederick, MD, USA
- National Institute of Allergy and Infectious Diseases, Bethesda, MD, USA
- Departamento de Investigación en Tabaquismo y EPOC, Instituto Nacional de Enfermedades Respiratorias Ismael Cosío Villegas, Mexico City, Mexico
- Departamento de Infectología, Hospital General Dr. Manuel Gea González, Mexico City, Mexico
- Departamento de Infectología, Hospital Infantil de México Federico Gómez, Mexico City, Mexico
- Division of Infectious Diseases, Queen's University, Kingston, Ontario, Canada
- Departamento de Infectología, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City, Mexico
- Departamento de Microbiología y Centro de Investigación en Ciencias de la Salud y Biomedicina, Facultad de Medicina, Universidad Autónoma de San Luís Potosí, San Luis Potosí, Mexico
- Hospital Regional Dr. Ignacio Morones Prieto, San Luis Potosí, Mexico
- Clinical Research Directorate, Frederick National Laboratory for Cancer Research, Frederick, MD, USA
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Arimura K, Kikuchi K, Sato Y, Miura H, Sato A, Katsura H, Kondo M, Itabashi M, Tagaya E. SARS-CoV-2 co-detection with other respiratory pathogens-descriptive epidemiological study. Respir Investig 2024; 62:884-888. [PMID: 39098246 DOI: 10.1016/j.resinv.2024.07.016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2024] [Revised: 07/15/2024] [Accepted: 07/23/2024] [Indexed: 08/06/2024]
Abstract
BACKGROUND Co-detection of respiratory pathogens with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is poorly understood. This descriptive epidemiological study aimed to determine the effect of the interaction of different respiratory pathogens on clinical variables. METHODS We retrospectively reviewed the results of comprehensive multiplex polymerase chain reaction (PCR) testing from November 2020 to March 2023 to estimate respiratory pathogen co-detection rates in Shinjuku, Tokyo. We evaluated the interactions of respiratory pathogens, particularly SARS-CoV-2, between observed and expected co-detection. We estimated the trend of co-detection with SARS-CoV-2 in terms of age and sex and applied a multiple logistic regression model adjusted for age, testing period, and sex to identify influencing factors between co-detection and single detection for each pathogen. RESULTS Among 57,746 patients who underwent multiplex PCR testing, 10,516 (18.2%) had positive for at least one of the 22 pathogens. Additionally, 881 (1.5%) patients were confirmed to have a co-detection. SARS-CoV-2 exhibited negative interactions with adenovirus, coronavirus, human metapneumovirus, parainfluenza virus, respiratory syncytial virus, and rhino/enterovirus. SARS-CoV-2 co-detection with other pathogens occurred most frequently in patients of the youngest age group (0-4 years). A multiple logistic regression model indicated that younger age was the most influential factor for SARS-CoV-2 co-detection with other respiratory pathogens. CONCLUSION The study highlights the prevalence of SARS-CoV-2 co-detection with other respiratory pathogens in younger age groups, necessitating further exploration of the clinical implications and severity of SARS-CoV-2 co-detection.
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Affiliation(s)
- Ken Arimura
- Tokyo Women's Medical University, Department of Respiratory Medicine, 8-1, Kawadacho, Shinjuku, Tokyo, 1628666, Japan.
| | - Ken Kikuchi
- Tokyo Women's Medical University, Department of Infectious Diseases, 8-1, Kawadacho, Shinjuku, Tokyo, 1628666, Japan
| | - Yasuto Sato
- Shizuoka Graduate University of Public Health, Graduate School of Public Health, 4-27-2, Kita ando, Aoi, Shizuoka, Shizuoka, 4200881, Japan
| | - Hitomi Miura
- Tokyo Women's Medical University Hospital, Central Clinical Laboratory, 8-1, Kawadacho, Shinjuku, Tokyo, 1628666, Japan
| | - Asako Sato
- Tokyo Women's Medical University Hospital, Department of Clinical Laboratory, 8-1, Kawadacho, Shinjuku, Tokyo, 1628666, Japan
| | - Hideki Katsura
- Tokyo Women's Medical University, Department of Respiratory Medicine, 8-1, Kawadacho, Shinjuku, Tokyo, 1628666, Japan
| | - Mitsuko Kondo
- Tokyo Women's Medical University, Department of Respiratory Medicine, 8-1, Kawadacho, Shinjuku, Tokyo, 1628666, Japan
| | - Michio Itabashi
- Tokyo Women's Medical University, Department of Surgery, Division of Inflammatory Bowel Disease Surgery, 8-1, Kawadacho, Shinjuku, Tokyo, 1628666, Japan
| | - Etsuko Tagaya
- Tokyo Women's Medical University, Department of Respiratory Medicine, 8-1, Kawadacho, Shinjuku, Tokyo, 1628666, Japan
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Fallatah DI, Adekola HA. Digital epidemiology: harnessing big data for early detection and monitoring of viral outbreaks. Infect Prev Pract 2024; 6:100382. [PMID: 39091623 PMCID: PMC11292357 DOI: 10.1016/j.infpip.2024.100382] [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] [Received: 03/16/2024] [Accepted: 06/13/2024] [Indexed: 08/04/2024] Open
Abstract
Digital epidemiology is the process of investigating the dynamics of disease-related patterns, both social and clinical, as well as the causes of these trends in epidemiology. Digital epidemiology, utilising big data from a variety of digital sources, has emerged as a viable method for early detection and monitoring of viral outbreaks. The present review gives an overview of digital epidemiology, emphasising its importance in the timely detection of infectious disease outbreaks. Researchers may discover and track outbreaks in real time using digital data sources such as search engine queries, social media trends, and digital health records. However, data quality, concerns about privacy, and data interoperability must be addressed to maximise the effectiveness of digital epidemiology. As the global landscape of infectious diseases evolves, integrating digital epidemiology becomes critical to improving pandemic preparedness and response efforts. Integrating digital epidemiology into routine monitoring systems has the potential to improve global health outcomes and save lives in the event of viral outbreaks.
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Affiliation(s)
- Deema Ibrahim Fallatah
- Department of Clinical Laboratory Sciences, Prince Sattam bin Abdulaziz University, Saudi Arabia
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Ferrari A, Schiavetti I, Ogliastro M, Minet C, Sibilio R, Giberti I, Costa E, Massaro E, Lai PL, Mosca S, Bruzzone B, Orsi A, Panatto D, Icardi G. Co-detection of respiratory pathogens among ILI patients: characterization of samples collected during the 2018/19 and 2019/20 pre-pandemic seasons. BMC Infect Dis 2024; 24:881. [PMID: 39210273 PMCID: PMC11361097 DOI: 10.1186/s12879-024-09687-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2023] [Accepted: 07/29/2024] [Indexed: 09/04/2024] Open
Abstract
Influenza-like illness (ILI) patients co-detected with respiratory pathogens exhibit poorer health outcomes than those with single infections. To address the paucity of knowledge concerning the incidence of concurrent respiratory pathogens, their relationships, and the clinical differences between patients detected with single and multiple pathogens, we performed an in-depth characterization of the oropharyngeal samples of primary care patients collected in Genoa (Northwest Italy), during winter seasons 2018/19-2019/20.The apriori algorithm was employed to evaluate the incidence of viral, bacterial, and viral-bacterial pairs during the study period. The grade of correlation between pathogens was investigated using the Phi coefficient. Factors associated with viral, bacterial or viral-bacterial co-detection were assessed using logistic regression.The most frequently identified pathogens included influenza A, rhinovirus, Haemophilus influenzae and Streptococcus pneumoniae. The highest correlations were found between bacterial-bacterial and viral-bacterial pairs, such as Haemophilus influenzae-Streptococcus pneumoniae, adenovirus-Haemophilus influenzae, adenovirus-Streptococcus pneumoniae, RSV-A-Bordetella pertussis, and influenza B Victoria-Bordetella parapertussis. Viruses were detected together at significantly lower rates. Notably, rhinovirus, influenza, and RSV exhibited significant negative correlations with each other. Co-detection was more prevalent in children aged < 4, and cough was shown to be a reliable indicator of viral co-detection.Given the evolving epidemiological landscape following the COVID-19 pandemic, future research utilizing the methodology described here, while considering the circulation of SARS-CoV-2, could further enrich the understanding of concurrent respiratory pathogens.
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Affiliation(s)
- Allegra Ferrari
- Department of Health Sciences (DISSAL), University of Genoa, Genoa, Italy.
| | - Irene Schiavetti
- Department of Health Sciences (DISSAL), University of Genoa, Genoa, Italy
| | - Matilde Ogliastro
- Department of Health Sciences (DISSAL), University of Genoa, Genoa, Italy
| | - Carola Minet
- Department of Health Sciences (DISSAL), University of Genoa, Genoa, Italy
| | - Raffaella Sibilio
- Department of Health Sciences (DISSAL), University of Genoa, Genoa, Italy
| | - Irene Giberti
- Department of Health Sciences (DISSAL), University of Genoa, Genoa, Italy
| | - Elisabetta Costa
- Department of Health Sciences (DISSAL), University of Genoa, Genoa, Italy
| | - Elvira Massaro
- Department of Health Sciences (DISSAL), University of Genoa, Genoa, Italy
| | - Piero Luigi Lai
- Department of Health Sciences (DISSAL), University of Genoa, Genoa, Italy
- Interuniversity Research Center On Influenza and Other Transmissible Infections (CIRI-IT), Genoa, Italy
| | - Stefano Mosca
- Interuniversity Research Center On Influenza and Other Transmissible Infections (CIRI-IT), Genoa, Italy
| | | | - Andrea Orsi
- Department of Health Sciences (DISSAL), University of Genoa, Genoa, Italy
- Interuniversity Research Center On Influenza and Other Transmissible Infections (CIRI-IT), Genoa, Italy
- IRCCS Ospedale Policlinico San Martino, Genoa, Italy
| | - Donatella Panatto
- Department of Health Sciences (DISSAL), University of Genoa, Genoa, Italy
- Interuniversity Research Center On Influenza and Other Transmissible Infections (CIRI-IT), Genoa, Italy
| | - Giancarlo Icardi
- Department of Health Sciences (DISSAL), University of Genoa, Genoa, Italy
- Interuniversity Research Center On Influenza and Other Transmissible Infections (CIRI-IT), Genoa, Italy
- IRCCS Ospedale Policlinico San Martino, Genoa, Italy
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Janson A, Gracy S, Paré PE, Sandberg H, Johansson KH. Competitive networked bi-virus spread: Existence of coexistence equilibria. Math Biosci 2024; 377:109286. [PMID: 39214449 DOI: 10.1016/j.mbs.2024.109286] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2024] [Revised: 07/11/2024] [Accepted: 08/26/2024] [Indexed: 09/04/2024]
Abstract
The paper studies multi-competitive continuous-time epidemic processes. We consider the setting where two viruses are simultaneously prevalent, and the spread occurs due to individual-to-individual interaction. In such a setting, an individual is either not affected by any of the viruses, or infected by one and exactly one of the two viruses. One of the equilibrium points is the coexistence equilibrium, i.e., multiple viruses simultaneously infect separate fractions of the population. We provide a sufficient condition for the existence of a coexistence equilibrium. We identify a condition such that for certain pairs of spread matrices either every coexistence equilibrium lies on a line that is locally exponentially attractive, or there is no coexistence equilibrium. We then provide a condition that, for certain pairs of spread matrices, rules out the possibility of the existence of a coexistence equilibrium, and, as a consequence, establishes global asymptotic convergence to the endemic equilibrium of the dominant virus. Finally, we provide a mitigation strategy that employs one virus to ensure that the other virus is eradicated. The theoretical results are illustrated using simulations.
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Affiliation(s)
- Axel Janson
- Division of Decision and Control Systems, School of Electrical Engineering and Computer Science, KTH Royal Institute of Technology, and Digital Futures, Stockholm, Sweden.
| | - Sebin Gracy
- Department of Electrical Engineering and Computer Science, South Dakota School of Mines and Technology, SD, USA.
| | - Philip E Paré
- Elmore Family School of Electrical and Computer Engineering, Purdue University, IN, USA.
| | - Henrik Sandberg
- Division of Decision and Control Systems, School of Electrical Engineering and Computer Science, KTH Royal Institute of Technology, and Digital Futures, Stockholm, Sweden.
| | - Karl Henrik Johansson
- Division of Decision and Control Systems, School of Electrical Engineering and Computer Science, KTH Royal Institute of Technology, and Digital Futures, Stockholm, Sweden.
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Li K, Hamrin J, Weinberger DM, Pitzer VE. Unraveling the Role of Viral Interference in Disrupting Biennial RSV Epidemics in Northern Stockholm. MEDRXIV : THE PREPRINT SERVER FOR HEALTH SCIENCES 2024:2024.08.09.24310749. [PMID: 39148838 PMCID: PMC11326348 DOI: 10.1101/2024.08.09.24310749] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 08/17/2024]
Abstract
Respiratory syncytial virus (RSV) primarily impacts infants and older adults, with seasonal winter outbreaks in temperate countries. Biennial cycles of RSV activity have also been identified in Northern Europe and some states in the United States. Delayed RSV activity was reported worldwide during the 2009 influenza pandemic, and a disrupted biennial pattern of RSV activity was observed in northern Stockholm following the pandemic. Biennial patterns shifted to early/large outbreaks in even-numbered years and late/small outbreaks in odd-numbered years. However, the mechanisms underpinning this change in pattern remain unknown. In this work, we constructed an age-stratified mechanistic model to explicitly test three factors that could lead to the change in RSV transmission dynamics: 1) birth rates, 2) temperatures, and 3) viral interference. By fitting the model to weekly RSV admission data over a 20-year period and comparing different models, we found that viral interference from influenza was the only mechanism that explained the shifted biennial pattern. Our work demonstrates the complex interplay between different respiratory viruses, providing evidence that supports the presence of interactions between the H1N1 pandemic influenza virus and RSV at the population level, with implications for future public health interventions.
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Affiliation(s)
- Ke Li
- Department of Epidemiology of Microbial Diseases, Yale School of Public Health, New Haven, CT, USA
| | - Johan Hamrin
- Astrid Lindgren Children’s Hospital, Karolinska University Hospital, Stockholm, Sweden
| | - Daniel M. Weinberger
- Department of Epidemiology of Microbial Diseases, Yale School of Public Health, New Haven, CT, USA
| | - Virginia E. Pitzer
- Department of Epidemiology of Microbial Diseases, Yale School of Public Health, New Haven, CT, USA
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9
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Dandachi I, Alrezaihi A, Amin D, AlRagi N, Alhatlani B, Binjomah A, Aleisa K, Dong X, Hiscox JA, Aljabr W. Molecular surveillance of influenza A virus in Saudi Arabia: whole-genome sequencing and metagenomic approaches. Microbiol Spectr 2024; 12:e0066524. [PMID: 38904365 PMCID: PMC11302342 DOI: 10.1128/spectrum.00665-24] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2024] [Accepted: 05/08/2024] [Indexed: 06/22/2024] Open
Abstract
Outbreaks of influenza A viruses are generally seasonal and cause annual epidemics worldwide. Due to their frequent reassortment and evolution, annual surveillance is of paramount importance to guide vaccine strategies. The aim of this study was to explore the molecular epidemiology of influenza A virus and nasopharyngeal microbiota composition in infected patients in Saudi Arabia. A total of 103 nasopharyngeal samples from 2015 and 12 samples from 2022 were collected from patients positive for influenza A. Sequencing of influenza A as well as metatranscriptomic analysis of the nasopharyngeal microbiota was conducted using Oxford Nanopore sequencing. Phylogenetic analysis of hemagglutinin, neuraminidase segments, and concatenated influenza A genomes was performed using MEGA7. Whole-genome sequencing analysis revealed changing clades of influenza A virus: from 6B.1 in 2015 to 5a.2a in 2022. One sample containing the antiviral resistance-mediating mutation S247N toward oseltamivir and zanamivir was found. Phylogenetic analysis showed the clustering of influenza A strains with the corresponding vaccine strains in each period, thus suggesting vaccine effectiveness. Principal component analysis and alpha diversity revealed the absence of a relationship between hospital admission status, age, or gender of infected patients and the nasopharyngeal microbial composition, except for the infecting clade 5a.2a. The opportunistic pathogens Staphylococcus aureus, Streptococcus pneumoniae, Haemophilus influenzae, and Moraxella catarrhalis were the most common species detected. The molecular epidemiology appears to be changing in Saudi Arabia after the COVID-19 pandemic. Antiviral resistance should be carefully monitored in future studies. In addition, the disease severity of patients as well as the composition of the nasopharyngeal microbiota in patients infected with different clades should also be assessed.IMPORTANCEIn this work, we have found that the clade of influenza A virus circulating in Riyadh, KSA, has changed over the last few years from 6B.1 to 5a.2a. Influenza strains clustered with the corresponding vaccine strains in our population, thus emphasizing vaccine effectiveness. Metatranscriptomic analysis showed no correlation between the nasopharyngeal microbiome and the clinical and/or demographic characteristics of infected patients. This is except for the 5a.2a strains isolated post-COVID-19 pandemic. The influenza virus is among the continuously evolving viruses that can cause severe respiratory infections. Continuous surveillance of its molecular diversity and the monitoring of anti-viral-resistant strains are thus of vital importance. Furthermore, exploring potential microbial markers and/or dysbiosis of the nasopharyngeal microbiota during infection could assist in the better management of patients in severe cases.
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Affiliation(s)
- Iman Dandachi
- Research Center, King Fahad Medical City, Riyadh, Saudi Arabia
| | - Abdulrahman Alrezaihi
- Institute of Infection, Veterinary and Ecological Sciences, University of Liverpool, Liverpool, United Kingdom
| | - Dashty Amin
- Faculty of Health Sciences, Qaiwan International University, Sulaymaniyah, Kurdistan Region, Iraq
| | - Nurah AlRagi
- Pathology and Clinical Laboratory Medicine, King Fahad Medical City, Riyadh, Saudi Arabia
| | - Bader Alhatlani
- Unit of Scientific Research, Applied College, Qassim University, Buraydah, Saudi Arabia
| | | | - Kholoud Aleisa
- Riyadh Regional Laboratory, Riyadh Ministry of Health, Riyadh, Saudi Arabia
| | - Xiaofeng Dong
- Institute of Infection, Veterinary and Ecological Sciences, University of Liverpool, Liverpool, United Kingdom
| | - Julian A. Hiscox
- Institute of Infection, Veterinary and Ecological Sciences, University of Liverpool, Liverpool, United Kingdom
| | - Waleed Aljabr
- Research Center, King Fahad Medical City, Riyadh, Saudi Arabia
- Institute of Infection, Veterinary and Ecological Sciences, University of Liverpool, Liverpool, United Kingdom
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10
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Yakovlev AS, Afanasev VV, Alekseenko SI, Belyaletdinova IK, Isankina LN, Gryaznova IA, Skalny AV, Kozlovskaya LI, Ishmukhametov AA, Karganova GG. Prevalence and Clinical Impact of Viral and Bacterial Coinfections in Hospitalized Children and Adolescents Aged under 18 Years with COVID-19 during the Omicron Wave in Russia. Viruses 2024; 16:1180. [PMID: 39205154 PMCID: PMC11360790 DOI: 10.3390/v16081180] [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: 07/01/2024] [Revised: 07/20/2024] [Accepted: 07/21/2024] [Indexed: 09/04/2024] Open
Abstract
The COVID-19 pandemic has altered respiratory infection patterns in pediatric populations. The emergence of the SARS-CoV-2 Omicron variant and relaxation of public health measures have increased the likelihood of coinfections. Previous studies show conflicting results regarding the impact of viral and bacterial coinfections with SARS-CoV-2 on severity of pediatric disease. This study investigated the prevalence and clinical impact of coinfections among children hospitalized with COVID-19 during the Omicron wave. A retrospective analysis was conducted on 574 hospitalized patients aged under 18 years in Russia, from January 2022 to March 2023. Samples from patients were tested for SARS-CoV-2 and other respiratory pathogens using qRT-PCR, bacterial culture tests and mass spectrometry, and ELISA. Approximately one-third of COVID-19 cases had coinfections, with viral and bacterial coinfections occurring at similar rates. Adenovirus and Staphylococcus aureus were the most common viral and bacterial coinfections, respectively. Viral coinfections were associated with higher fevers and increased bronchitis, while bacterial coinfections correlated with longer duration of illness and higher pneumonia rates. Non-SARS-CoV-2 respiratory viruses were linked to more severe lower respiratory tract complications than SARS-CoV-2 monoinfection. These findings suggest that during the Omicron wave, seasonal respiratory viruses may have posed a greater threat to children's health than SARS-CoV-2.
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Affiliation(s)
- Alexander S. Yakovlev
- FSASI “Chumakov Federal Scientific Center for Research and Development of Immune-and-Biological Products of RAS” (Institute of Poliomyelitis), 108819 Moscow, Russia; (A.S.Y.); (L.I.K.); (A.A.I.)
| | - Vladislav V. Afanasev
- Otolaryngology Department, I.I. Mechnikov North-Western State Medical University, 191015 St. Petersburg, Russia; (V.V.A.); (S.I.A.)
| | - Svetlana I. Alekseenko
- Otolaryngology Department, I.I. Mechnikov North-Western State Medical University, 191015 St. Petersburg, Russia; (V.V.A.); (S.I.A.)
- K.A. Rauhfus Children’s City Multidisciplinary Clinical Center for High Medical Technologies, 191036 St. Petersburg, Russia; (L.N.I.); (I.A.G.)
- Saint-Petersburg Research Institute of Ear, Throat, Nose and Speech, 190013 St. Petersburg, Russia
| | | | - Ludmila N. Isankina
- K.A. Rauhfus Children’s City Multidisciplinary Clinical Center for High Medical Technologies, 191036 St. Petersburg, Russia; (L.N.I.); (I.A.G.)
| | - Irina A. Gryaznova
- K.A. Rauhfus Children’s City Multidisciplinary Clinical Center for High Medical Technologies, 191036 St. Petersburg, Russia; (L.N.I.); (I.A.G.)
| | - Anatoly V. Skalny
- Department of Medical Elementology, Peoples’ Friendship University of Russia (RUDN University), 117198 Moscow, Russia;
- Center of Bioelementology and Human Ecology, IM Sechenov Moscow State Medical University (Sechenov University), 119146 Moscow, Russia
| | - Liubov I. Kozlovskaya
- FSASI “Chumakov Federal Scientific Center for Research and Development of Immune-and-Biological Products of RAS” (Institute of Poliomyelitis), 108819 Moscow, Russia; (A.S.Y.); (L.I.K.); (A.A.I.)
- Institute of Translational Medicine and Biotechnology, IM Sechenov Moscow State Medical University (Sechenov University), 119146 Moscow, Russia
| | - Aydar A. Ishmukhametov
- FSASI “Chumakov Federal Scientific Center for Research and Development of Immune-and-Biological Products of RAS” (Institute of Poliomyelitis), 108819 Moscow, Russia; (A.S.Y.); (L.I.K.); (A.A.I.)
- Institute of Translational Medicine and Biotechnology, IM Sechenov Moscow State Medical University (Sechenov University), 119146 Moscow, Russia
| | - Galina G. Karganova
- FSASI “Chumakov Federal Scientific Center for Research and Development of Immune-and-Biological Products of RAS” (Institute of Poliomyelitis), 108819 Moscow, Russia; (A.S.Y.); (L.I.K.); (A.A.I.)
- Institute of Translational Medicine and Biotechnology, IM Sechenov Moscow State Medical University (Sechenov University), 119146 Moscow, Russia
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11
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Chin T, Foxman EF, Watkins TA, Lipsitch M. Considerations for viral co-infection studies in human populations. mBio 2024; 15:e0065824. [PMID: 38847531 PMCID: PMC11253623 DOI: 10.1128/mbio.00658-24] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/18/2024] Open
Abstract
When respiratory viruses co-circulate in a population, individuals may be infected with multiple pathogens and experience possible virus-virus interactions, where concurrent or recent prior infection with one virus affects the infection process of another virus. While experimental studies have provided convincing evidence for within-host mechanisms of virus-virus interactions, evaluating evidence for viral interference or potentiation using population-level data has proven more difficult. Recent studies have quantified the prevalence of co-detections using populations drawn from clinical settings. Here, we focus on selection bias issues associated with this study design. We provide a quantitative account of the conditions under which selection bias arises in these studies, review previous attempts to address this bias, and propose unbiased study designs with sample size estimates needed to ascertain viral interference. We show that selection bias is expected in cross-sectional co-detection prevalence studies conducted in clinical settings, except under a strict set of assumptions regarding the relative probabilities of being included in a study limited to individuals with clinical disease under different viral states. Population-wide studies that collect samples from participants irrespective of their clinical status would meanwhile require large sample sizes to be sufficiently powered to detect viral interference, suggesting that a study's timing, inclusion criteria, and the expected magnitude of interference are instrumental in determining feasibility.
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Affiliation(s)
- Taylor Chin
- Center for Communicable Disease Dynamics, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA
| | - Ellen F. Foxman
- Department of Laboratory Medicine, Yale University School of Medicine, New Haven, Connecticut, USA
- Department of Immunobiology, Yale University School of Medicine, New Haven, Connecticut, USA
| | - Timothy A. Watkins
- Department of Laboratory Medicine, Yale University School of Medicine, New Haven, Connecticut, USA
- Department of Immunobiology, Yale University School of Medicine, New Haven, Connecticut, USA
| | - Marc Lipsitch
- Center for Communicable Disease Dynamics, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA
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12
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Gilbert-Girard S, Piret J, Carbonneau J, Hénaut M, Goyette N, Boivin G. Viral interference between severe acute respiratory syndrome coronavirus 2 and influenza A viruses. PLoS Pathog 2024; 20:e1012017. [PMID: 39038029 PMCID: PMC11293641 DOI: 10.1371/journal.ppat.1012017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2024] [Revised: 08/01/2024] [Accepted: 07/06/2024] [Indexed: 07/24/2024] Open
Abstract
Some respiratory viruses can cause a viral interference through the activation of the interferon (IFN) pathway that reduces the replication of another virus. Epidemiological studies of coinfections between SARS-CoV-2 and other respiratory viruses have been hampered by non-pharmacological measures applied to mitigate the spread of SARS-CoV-2 during the COVID-19 pandemic. With the ease of these interventions, SARS-CoV-2 and influenza A viruses can now co-circulate. It is thus of prime importance to characterize their interactions. In this work, we investigated viral interference effects between an Omicron variant and a contemporary influenza A/H3N2 strain, in comparison with an ancestral SARS-CoV-2 strain and the 2009 pandemic influenza A/H1N1 virus. We infected nasal human airway epitheliums with SARS-CoV-2 and influenza, either simultaneously or 24 h apart. Viral load was measured by RT-qPCR and IFN-α/β/λ1/λ2 proteins were quantified by immunoassay. Expression of four interferon-stimulated genes (ISGs; OAS1/IFITM3/ISG15/MxA) was also measured by RT-droplet digital PCR. Additionally, susceptibility of each virus to IFN-α/β/λ2 recombinant proteins was determined. Our results showed that influenza A, and especially A/H3N2, interfered with both SARS-CoV-2 viruses, but that SARS-CoV-2 did not significantly interfere with A/H3N2 or A/H1N1. Consistently with these results, influenza, and particularly the A/H3N2 strain, caused a higher production of IFN proteins and expression of ISGs than SARS-CoV-2. SARS-CoV-2 induced a marginal IFN production and reduced the IFN response during coinfections with influenza. All viruses were susceptible to exogenous IFNs, with the ancestral SARS-CoV-2 and Omicron being less susceptible to type I and type III IFNs, respectively. Thus, influenza A causes a viral interference towards SARS-CoV-2 most likely through an IFN response. The opposite is not necessarily true, and a concurrent infection with both viruses leads to a lower IFN response. Taken together, these results help us to understand how SARS-CoV-2 interacts with another major respiratory pathogen.
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Affiliation(s)
| | - Jocelyne Piret
- Research Center of the CHU de Québec-Université Laval, Quebec City, Quebec, Canada
| | - Julie Carbonneau
- Research Center of the CHU de Québec-Université Laval, Quebec City, Quebec, Canada
| | - Mathilde Hénaut
- Research Center of the CHU de Québec-Université Laval, Quebec City, Quebec, Canada
| | - Nathalie Goyette
- Research Center of the CHU de Québec-Université Laval, Quebec City, Quebec, Canada
| | - Guy Boivin
- Research Center of the CHU de Québec-Université Laval, Quebec City, Quebec, Canada
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13
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Käding N, Waldeck F, Meier B, Boutin S, Borsche M, Balck A, Föh B, Kramer J, Klein C, Katalinic A, Rupp J. Influence of non-pharmaceutical interventions during the COVID-19 pandemic on respiratory viral infections - a prospective population-based cohort study. Front Public Health 2024; 12:1415778. [PMID: 38979040 PMCID: PMC11228307 DOI: 10.3389/fpubh.2024.1415778] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2024] [Accepted: 06/10/2024] [Indexed: 07/10/2024] Open
Abstract
Non-pharmaceutical interventions (NPI) have been proven successful in a population-based approach to protect from SARS-CoV-2 transmission during the COVID-19 pandemic. As a consequential-effect, a reduction in the spread of all respiratory viruses has been observed, but the primary factors behind this phenomenon have yet to be identified. We conducted a subgroup analysis of participants from the ELISA study, a prospective longitudinal cohort study on SARS-CoV-2 transmission, at four timepoints from November 2020 - September 2022. The aim was to provide a detailed overview of the circulation of respiratory viruses over 2 years and to identify potential personal risk factors of virus distribution. All participants were screened using qPCR for respiratory viral infections from nasopharyngeal swabs and answered a questionnaire regarding behavioral factors. Several categories of risk factors for the transmission of respiratory viruses were evaluated using a scoring system. In total, 1,124 participants were included in the study, showing high adherence to governmental-introduced NPI. The overall number of respiratory virus infections was low (0-4.9% of participants), with adenovirus (1.7%), rhino-/enterovirus (3.2%) and SARS-CoV-2 (1.2%) being the most abundant. We detected an inverse correlation between the number and intensity of NPI and the number of detected respiratory viruses. More precisely, the attendance of social events and household size was associated with rhino-/enterovirus infection while social contacts were associated with being positive for any virus. NPI introduced during the COVID-19 pandemic reduced the occurrence of seasonal respiratory viruses in our study, showing different risk-factors for enhanced transmission between viruses. Trial registration DRKS.de, German Clinical Trials Register (DRKS), Identifier: DRKS00023418, Registered on 28 October 2020.
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Affiliation(s)
- Nadja Käding
- Department of Infectious Diseases and Microbiology, University Hospital Schleswig-Holstein, Lübeck, Germany
| | - Frederike Waldeck
- Department of Infectious Diseases and Microbiology, University Hospital Schleswig-Holstein, Lübeck, Germany
| | - Bjarne Meier
- Department of Infectious Diseases and Microbiology, University Hospital Schleswig-Holstein, Lübeck, Germany
| | - Sébastien Boutin
- Department of Infectious Diseases and Microbiology, University Hospital Schleswig-Holstein, Lübeck, Germany
- Airway Research Center North (ARCN), Member of the German Center for Lung Research (DZL), Lübeck, Germany
| | - Max Borsche
- Institute of Neurogenetics, University of Lübeck, Lübeck, Germany
| | - Alexander Balck
- Institute of Neurogenetics, University of Lübeck, Lübeck, Germany
| | - Bandik Föh
- Department of Medicine I, University Hospital Schleswig-Holstein, Lübeck, Germany
| | - Jan Kramer
- LADR Laboratory Group Dr. Kramer and Colleagues, Geesthacht, Germany
| | - Christine Klein
- Institute of Neurogenetics, University of Lübeck, Lübeck, Germany
| | - Alexander Katalinic
- Institute of Social Medicine and Epidemiology, University of Lübeck, Lübeck, Germany
| | - Jan Rupp
- Department of Infectious Diseases and Microbiology, University Hospital Schleswig-Holstein, Lübeck, Germany
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14
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Cheemarla NR, Watkins TA, Mihaylova VT, Foxman EF. Viral Interference During Influenza A-SARS-CoV-2 Coinfection of the Human Airway Epithelium and Reversal by Oseltamivir. J Infect Dis 2024; 229:1430-1434. [PMID: 37722683 PMCID: PMC11095529 DOI: 10.1093/infdis/jiad402] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2023] [Revised: 09/07/2023] [Accepted: 09/15/2023] [Indexed: 09/20/2023] Open
Abstract
To gain insight into interactions among respiratory viruses, we modeled influenza A virus (IAV)-severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) coinfections using differentiated human airway epithelial cultures. Replicating IAV induced a more robust interferon response than SARS-CoV-2 and suppressed SARS-CoV-2 replication in both sequential and simultaneous infections, whereas SARS-CoV-2 did not enhance host cell defense during influenza infection or suppress IAV replication. Oseltamivir, an antiviral targeting influenza, reduced IAV replication during coinfection but also reduced the host antiviral response and restored SARS-CoV-2 replication. These results demonstrate how perturbations in one viral infection can impact its effect on a coinfecting virus.
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Affiliation(s)
- Nagarjuna R Cheemarla
- Department of Laboratory Medicine, Yale School of Medicine, New Haven, Connecticut, USA
- Department of Immunobiology, Yale School of Medicine, New Haven, Connecticut, USA
| | - Timothy A Watkins
- Department of Laboratory Medicine, Yale School of Medicine, New Haven, Connecticut, USA
- Department of Immunobiology, Yale School of Medicine, New Haven, Connecticut, USA
| | - Valia T Mihaylova
- Department of Laboratory Medicine, Yale School of Medicine, New Haven, Connecticut, USA
- Department of Immunobiology, Yale School of Medicine, New Haven, Connecticut, USA
| | - Ellen F Foxman
- Department of Laboratory Medicine, Yale School of Medicine, New Haven, Connecticut, USA
- Department of Immunobiology, Yale School of Medicine, New Haven, Connecticut, USA
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15
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Di Maio VC, Scutari R, Forqué L, Colagrossi L, Coltella L, Ranno S, Linardos G, Gentile L, Galeno E, Vittucci AC, Pisani M, Cristaldi S, Villani A, Raponi M, Bernaschi P, Russo C, Perno CF. Presence and Significance of Multiple Respiratory Viral Infections in Children Admitted to a Tertiary Pediatric Hospital in Italy. Viruses 2024; 16:750. [PMID: 38793631 PMCID: PMC11126044 DOI: 10.3390/v16050750] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2024] [Revised: 05/07/2024] [Accepted: 05/07/2024] [Indexed: 05/26/2024] Open
Abstract
Viral co-infections are frequently observed among children, but whether specific viral interactions enhance or diminish the severity of respiratory disease is still controversial. This study aimed to investigate the type of viral mono- and co-infections by also evaluating viral correlations in 3525 respiratory samples from 3525 pediatric in/outpatients screened by the Allplex Respiratory Panel Assays and with a Severe Acute Respiratory Syndrome-COronaVirus 2 (SARS-CoV-2) test available. Overall, viral co-infections were detected in 37.8% of patients and were more frequently observed in specimens from children with lower respiratory tract infections compared to those with upper respiratory tract infections (47.1% vs. 36.0%, p = 0.003). SARS-CoV-2 and influenza A were more commonly detected in mono-infections, whereas human bocavirus showed the highest co-infection rate (87.8% in co-infection). After analyzing viral pairings using Spearman's correlation test, it was noted that SARS-CoV-2 was negatively associated with all other respiratory viruses, whereas a markedly significant positive correlation (p < 0.001) was observed for five viral pairings (involving adenovirus/human bocavirus/human enterovirus/metapneumoviruses/rhinovirus). The correlation between co-infection and clinical outcome may be linked to the type of virus(es) involved in the co-infection rather than simple co-presence. Further studies dedicated to this important point are needed, since it has obvious implications from a diagnostic and clinical point of view.
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Affiliation(s)
- Velia Chiara Di Maio
- Microbiology and Diagnostic Immunology Unit, Bambino Gesù Children’s Hospital, IRCCS, 00165 Rome, Italy; (V.C.D.M.)
| | - Rossana Scutari
- Multimodal Laboratory Research Unit, Bambino Gesù Children’s Hospital, IRCCS, 00165 Rome, Italy;
| | - Lorena Forqué
- Microbiology and Diagnostic Immunology Unit, Bambino Gesù Children’s Hospital, IRCCS, 00165 Rome, Italy; (V.C.D.M.)
| | - Luna Colagrossi
- Microbiology and Diagnostic Immunology Unit, Bambino Gesù Children’s Hospital, IRCCS, 00165 Rome, Italy; (V.C.D.M.)
| | - Luana Coltella
- Microbiology and Diagnostic Immunology Unit, Bambino Gesù Children’s Hospital, IRCCS, 00165 Rome, Italy; (V.C.D.M.)
| | - Stefania Ranno
- Microbiology and Diagnostic Immunology Unit, Bambino Gesù Children’s Hospital, IRCCS, 00165 Rome, Italy; (V.C.D.M.)
| | - Giulia Linardos
- Microbiology and Diagnostic Immunology Unit, Bambino Gesù Children’s Hospital, IRCCS, 00165 Rome, Italy; (V.C.D.M.)
| | - Leonarda Gentile
- Microbiology and Diagnostic Immunology Unit, Bambino Gesù Children’s Hospital, IRCCS, 00165 Rome, Italy; (V.C.D.M.)
| | - Eugenia Galeno
- Microbiology and Diagnostic Immunology Unit, Bambino Gesù Children’s Hospital, IRCCS, 00165 Rome, Italy; (V.C.D.M.)
| | - Anna Chiara Vittucci
- Hospital University Pediatrics Clinical Area, Bambino Gesù Children’s Hospital, IRCCS, 00165 Rome, Italy (S.C.)
| | - Mara Pisani
- Hospital University Pediatrics Clinical Area, Bambino Gesù Children’s Hospital, IRCCS, 00165 Rome, Italy (S.C.)
| | - Sebastian Cristaldi
- Hospital University Pediatrics Clinical Area, Bambino Gesù Children’s Hospital, IRCCS, 00165 Rome, Italy (S.C.)
| | - Alberto Villani
- Hospital University Pediatrics Clinical Area, Bambino Gesù Children’s Hospital, IRCCS, 00165 Rome, Italy (S.C.)
| | - Massimiliano Raponi
- Medical Direction, Bambino Gesù Children’s Hospital, IRCCS, 00165 Rome, Italy
| | - Paola Bernaschi
- Microbiology and Diagnostic Immunology Unit, Bambino Gesù Children’s Hospital, IRCCS, 00165 Rome, Italy; (V.C.D.M.)
| | - Cristina Russo
- Microbiology and Diagnostic Immunology Unit, Bambino Gesù Children’s Hospital, IRCCS, 00165 Rome, Italy; (V.C.D.M.)
| | - Carlo Federico Perno
- Microbiology and Diagnostic Immunology Unit, Bambino Gesù Children’s Hospital, IRCCS, 00165 Rome, Italy; (V.C.D.M.)
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16
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Woo Y, Ma M, Okawa M, Saito T. Hepatocyte Intrinsic Innate Antiviral Immunity against Hepatitis Delta Virus Infection: The Voices of Bona Fide Human Hepatocytes. Viruses 2024; 16:740. [PMID: 38793622 PMCID: PMC11126147 DOI: 10.3390/v16050740] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2024] [Revised: 04/24/2024] [Accepted: 05/05/2024] [Indexed: 05/26/2024] Open
Abstract
The pathogenesis of viral infection is attributed to two folds: intrinsic cell death pathway activation due to the viral cytopathic effect, and immune-mediated extrinsic cellular injuries. The immune system, encompassing both innate and adaptive immunity, therefore acts as a double-edged sword in viral infection. Insufficient potency permits pathogens to establish lifelong persistent infection and its consequences, while excessive activation leads to organ damage beyond its mission to control viral pathogens. The innate immune response serves as the front line of defense against viral infection, which is triggered through the recognition of viral products, referred to as pathogen-associated molecular patterns (PAMPs), by host cell pattern recognition receptors (PRRs). The PRRs-PAMPs interaction results in the induction of interferon-stimulated genes (ISGs) in infected cells, as well as the secretion of interferons (IFNs), to establish a tissue-wide antiviral state in an autocrine and paracrine manner. Cumulative evidence suggests significant variability in the expression patterns of PRRs, the induction potency of ISGs and IFNs, and the IFN response across different cell types and species. Hence, in our understanding of viral hepatitis pathogenesis, insights gained through hepatoma cell lines or murine-based experimental systems are uncertain in precisely recapitulating the innate antiviral response of genuine human hepatocytes. Accordingly, this review article aims to extract and summarize evidence made possible with bona fide human hepatocytes-based study tools, along with their clinical relevance and implications, as well as to identify the remaining gaps in knowledge for future investigations.
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Affiliation(s)
- Yein Woo
- Division of Gastrointestinal and Liver Diseases, Department of Medicine, Keck School of Medicine, University of Southern California, Los Angeles, CA 90033, USA
| | - Muyuan Ma
- Division of Gastrointestinal and Liver Diseases, Department of Medicine, Keck School of Medicine, University of Southern California, Los Angeles, CA 90033, USA
| | - Masashi Okawa
- Division of Gastrointestinal and Liver Diseases, Department of Medicine, Keck School of Medicine, University of Southern California, Los Angeles, CA 90033, USA
- R&D Department, PhoenixBio USA Corporation, New York, NY 10006, USA
| | - Takeshi Saito
- Division of Gastrointestinal and Liver Diseases, Department of Medicine, Keck School of Medicine, University of Southern California, Los Angeles, CA 90033, USA
- USC Research Center for Liver Diseases, Los Angeles, CA 90033, USA
- Department of Molecular Microbiology and Immunology, Keck School of Medicine, University of Southern California, Los Angeles, CA 90033, USA
- Department of Pathology, Keck School of Medicine, University of Southern California, Los Angeles, CA 90033, USA
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17
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Naeem A, Alkadi HS, Manzoor MU, Yousaf I, Awadalla M, Alturaiki W, AlYami AS, Zafar A, Alosaimi B. Mutations at the conserved N-Terminal of the human Rhinovirus capsid gene VP4, and their impact on the immune response. J Immunoassay Immunochem 2024; 45:271-291. [PMID: 38551181 DOI: 10.1080/15321819.2024.2323460] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/25/2024]
Abstract
Rhinoviruses (RV) are the major cause of chronic obstructive pulmonary disease and are associated with exacerbation development as well as community-acquired pneumonia in children, leading to substantial morbidity, mortality, and hospital admission. Here we have examined how changes at the amino terminal of the conserved VP4 epitope of different RV serotypes may affect pulmonary cytokine and chemokine responses and disease severity. Samples positive for rhinovirus were used for genetic characterization, followed by profiling gene expression of pulmonary Th1 and Th2 cytokines/chemokines by RT-PCR arrays. Genetic sequencing and homology 3D modeling revealed changes at the amino terminal of the conserved viral protein 4 (VP4) epitope in the RV-A101 serotype, especially serine at several positions that are important for interactive binding with the host immune cells. We found dysregulation of pulmonary gene expression of Th1- and Th2-related cytokines and chemokines in RV-A 101 and RV-C 8 pneumonia patients. These findings might contribute to a better understanding of RV immunity and the potential mechanisms underlying the pathogenesis of severe RV infections, but further functional studies are needed to confirm the causal relationship.
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Affiliation(s)
- Asif Naeem
- Department of Research Labs, Research Center, King Fahad Medical City, Riyadh, Saudi Arabia
| | - Haitham S Alkadi
- Department of Research Labs, Research Center, King Fahad Medical City, Riyadh, Saudi Arabia
| | - Muhammad U Manzoor
- Department of Medical Imaging, Diagnostic & Interventional Neuroradiology, King Fahad Medical City, Riyadh, Saudi Arabia
| | - Imran Yousaf
- Department of Medical Imaging, Diagnostic & Interventional Neuroradiology, King Fahad Medical City, Riyadh, Saudi Arabia
| | - Maaweya Awadalla
- Department of Research Labs, Research Center, King Fahad Medical City, Riyadh, Saudi Arabia
| | - Wael Alturaiki
- Department of Medical Laboratory Sciences, College of Applied Medical Sciences, Majmaah University, Riyadh Region, Saudi Arabia
| | - Ahmad S AlYami
- Pathology and Clinical Laboratory Medicine Administration, King Fahad Medical City, Riyadh, Saudi Arabia
| | - Adnan Zafar
- Pediatric Department, John Hopkins Aramco Healthcare, Al-Ahsa, Saudi Arabia
| | - Bandar Alosaimi
- Department of Research Labs, Research Center, King Fahad Medical City, Riyadh, Saudi Arabia
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18
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Babawale PI, Guerrero-Plata A. Respiratory Viral Coinfections: Insights into Epidemiology, Immune Response, Pathology, and Clinical Outcomes. Pathogens 2024; 13:316. [PMID: 38668271 PMCID: PMC11053695 DOI: 10.3390/pathogens13040316] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2023] [Revised: 04/06/2024] [Accepted: 04/11/2024] [Indexed: 04/29/2024] Open
Abstract
Respiratory viral coinfections are a global public health threat that poses an economic burden on individuals, families, and healthcare infrastructure. Viruses may coinfect and interact synergistically or antagonistically, or their coinfection may not affect their replication rate. These interactions are specific to different virus combinations, which underlines the importance of understanding the mechanisms behind these differential viral interactions and the need for novel diagnostic methods to accurately identify multiple viruses causing a disease in a patient to avoid misdiagnosis. This review examines epidemiological patterns, pathology manifestations, and the immune response modulation of different respiratory viral combinations that occur during coinfections using different experimental models to better understand the dynamics respiratory viral coinfection takes in driving disease outcomes and severity, which is crucial to guide the development of prevention and treatment strategies.
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Affiliation(s)
| | - Antonieta Guerrero-Plata
- Department of Pathobiological Sciences, School of Veterinary Medicine, Louisiana State University, Baton Rouge, LA 70803, USA;
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19
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Cui A, Xia B, Jiang H, Li Q, Sun L, Xu J, Hu K, Xie Z, Wang Y, Zhu R, Huang C, Li Z, Xu J, Wang W, Zhang H, Gao Z, Zhang F, Xie H, Zhang Y. Prevalence and genetic diversity of human rhinovirus among patients with acute respiratory infections in China, 2012-2021. J Med Virol 2024; 96:e29582. [PMID: 38590253 DOI: 10.1002/jmv.29582] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2023] [Revised: 03/14/2024] [Accepted: 03/23/2024] [Indexed: 04/10/2024]
Abstract
To understand the prevalence of rhinovirus (RV) among acute respiratory infection (ARI) patients, 10-year ARI surveillance in multiple provinces of China were conducted during 2012-2021. Of 15 645 ARI patients, 1180 (7.54%) were confirmed to have RV infection and 820 (69.49%) were children under 5 years of age. RV typing was performed on the 527 VP1 gene sequences, and species A, B, and C accounted for 73.24%, 4.93%, and 21.82%, respectively. Although no significant difference in the proportions of age groups or disease severity was found between RV species, RV-C was more frequently detected in children under 5 years of age, RV-A was more frequently detected in elderly individuals (≥60), and the proportions of pneumonia in RV-A and RV-C patients were higher than those in RV-B patients. The epidemic peak of RV-A was earlier than that of RV-C. A total of 57 types of RV-A, 13 types of RV-B, and 35 types of RV-C were identified in RV-infected patients, and two uncertain RV types were also detected. The findings showed a few differences in epidemiological and clinical features between RV species in ARI patients, and RV-A and RV-C were more prevalent than RV-B.
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Affiliation(s)
- Aili Cui
- National Key Laboratory of Intelligent Tracking and Forecasting for Infectious Diseases (NITFID), NHC Key Laboratory of Medical Virology and Viral Diseases, National Institute for Viral Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Baicheng Xia
- National Key Laboratory of Intelligent Tracking and Forecasting for Infectious Diseases (NITFID), NHC Key Laboratory of Medical Virology and Viral Diseases, National Institute for Viral Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Haoran Jiang
- National Key Laboratory of Intelligent Tracking and Forecasting for Infectious Diseases (NITFID), NHC Key Laboratory of Medical Virology and Viral Diseases, National Institute for Viral Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Qi Li
- Institute for Viral Disease Control and Prevention, Hebei Province Center for Disease Control and Prevention, Shijiazhuang, China
| | - Liwei Sun
- Precision Medicine Research Center, Children's Hospital of Changchun, Changchun, China
| | - Jin Xu
- Henan Provincial Center for Disease Control and Prevention, Zhengzhou, China
| | - Kongxin Hu
- Institute of Health Inspection and Quarantine, Chinese Academy of Inspection and Quarantine, Beijing, China
| | - Zhibo Xie
- National Key Laboratory of Intelligent Tracking and Forecasting for Infectious Diseases (NITFID), NHC Key Laboratory of Medical Virology and Viral Diseases, National Institute for Viral Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Yage Wang
- National Key Laboratory of Intelligent Tracking and Forecasting for Infectious Diseases (NITFID), NHC Key Laboratory of Medical Virology and Viral Diseases, National Institute for Viral Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Runan Zhu
- Laboratory of Virology, Beijing Key Laboratory of Etiology of Viral Diseases in Children, Capital Institute of Pediatrics, Beijing, China
| | - Chaoyang Huang
- Department of Microbiology, Hunan Provincial Center for Disease Control and Prevention, Changsha, China
| | - Zhong Li
- Department of Viral Diseases, Institute for Communicable Disease Control and Prevention, Shandong Center for Disease Control and Prevention, Jinan, China
| | - Jing Xu
- Viral Disease Department, Shaanxi Center for Disease Control and Prevention, Xi'an, China
| | - Wenyang Wang
- Department of Medical Frontier Experimental Center, School of Medicine, Anhui University of Science and Technology, Huainan, China
| | - Hui Zhang
- Virus Laboratory, Gansu Provincial Center for Disease Control and Prevention, Lanzhou, China
| | - Zhenguo Gao
- Institute for Infectious Disease Prevention and Treatment, Xinjiang Center for Disease Control and Prevention, Wulumuqi, China
| | - Feng Zhang
- Laboratory of Viral Diseases, Qingdao Municipal Centre for Disease Control and Prevention, Qingdao Institute of Prevention Medicine, Qingdao, China
| | - Hui Xie
- Institute for Immunization and Prevention, Beijing Center for Disease Prevention and Control, Beijing Academy for Preventive Medicine, Beijing Institute of Tuberculosis Control Research and Prevention, Beijing, China
| | - Yan Zhang
- National Key Laboratory of Intelligent Tracking and Forecasting for Infectious Diseases (NITFID), NHC Key Laboratory of Medical Virology and Viral Diseases, National Institute for Viral Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China
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20
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Li K, Thindwa D, Weinberger DM, Pitzer VE. The role of viral interference in shaping RSV epidemics following the 2009 H1N1 influenza pandemic. MEDRXIV : THE PREPRINT SERVER FOR HEALTH SCIENCES 2024:2024.02.25.24303336. [PMID: 38464193 PMCID: PMC10925368 DOI: 10.1101/2024.02.25.24303336] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 03/12/2024]
Abstract
Respiratory syncytial virus (RSV) primarily affects infants, young children, and older adults, with seasonal outbreaks in the United States (US) peaking around December or January. Despite the limited implementation of non-pharmaceutical interventions, disrupted RSV activity was observed in different countries following the 2009 influenza pandemic, suggesting possible viral interference from influenza. Although interactions between the influenza A/H1N1 pandemic virus and RSV have been demonstrated at an individual level, it remains unclear whether the disruption of RSV activity at the population level can be attributed to viral interference. In this work, we first evaluated changes in the timing and intensity of RSV activity across 10 regions of the US in the years following the 2009 influenza pandemic using dynamic time warping. We observed a reduction in RSV activity following the pandemic, which was associated with intensity of influenza activity in the region. We then developed an age-stratified, two-pathogen model to examine various hypotheses regarding viral interference mechanisms. Based on our model estimates, we identified three mechanisms through which influenza infections could interfere with RSV: 1) reducing susceptibility to RSV coinfection; 2) shortening the RSV infectious period in coinfected individuals; and 3) reducing RSV infectivity in coinfection. Our study offers statistical support for the occurrence of atypical RSV seasons following the 2009 influenza pandemic. Our work also offers new insights into the mechanisms of viral interference that contribute to disruptions in RSV epidemics and provides a model-fitting framework that enables the analysis of new surveillance data for studying viral interference at the population level.
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Affiliation(s)
- Ke Li
- Department of Epidemiology of Microbial Diseases, Yale School of Public Health, New Haven, CT, USA
| | - Deus Thindwa
- Department of Epidemiology of Microbial Diseases, Yale School of Public Health, New Haven, CT, USA
| | - Daniel M Weinberger
- Department of Epidemiology of Microbial Diseases, Yale School of Public Health, New Haven, CT, USA
| | - Virginia E Pitzer
- Department of Epidemiology of Microbial Diseases, Yale School of Public Health, New Haven, CT, USA
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21
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Heimonen J, Chow EJ, Wang Y, Hughes JP, Rogers J, Emanuels A, O’Hanlon J, Han PD, Wolf CR, Logue JK, Ogokeh CE, Rolfes MA, Uyeki TM, Starita L, Englund JA, Chu HY. Risk of Subsequent Respiratory Virus Detection After Primary Virus Detection in a Community Household Study-King County, Washington, 2019-2021. J Infect Dis 2024; 229:422-431. [PMID: 37531658 PMCID: PMC10873185 DOI: 10.1093/infdis/jiad305] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2023] [Revised: 07/19/2023] [Accepted: 07/31/2023] [Indexed: 08/04/2023] Open
Abstract
BACKGROUND The epidemiology of respiratory viral infections is complex. How infection with one respiratory virus affects risk of subsequent infection with the same or another respiratory virus is not well described. METHODS From October 2019 to June 2021, enrolled households completed active surveillance for acute respiratory illness (ARI), and participants with ARI self-collected nasal swab specimens; after April 2020, participants with ARI or laboratory-confirmed severe acute respiratory syndrome coronavirus 2 and their household members self-collected nasal swab specimens. Specimens were tested using multiplex reverse-transcription polymerase chain reaction for respiratory viruses. A Cox regression model with a time-dependent covariate examined risk of subsequent detections following a specific primary viral detection. RESULTS Rhinovirus was the most frequently detected pathogen in study specimens (406 [9.5%]). Among 51 participants with multiple viral detections, rhinovirus to seasonal coronavirus (8 [14.8%]) was the most common viral detection pairing. Relative to no primary detection, there was a 1.03-2.06-fold increase in risk of subsequent virus detection in the 90 days after primary detection; risk varied by primary virus: human parainfluenza virus, rhinovirus, and respiratory syncytial virus were statistically significant. CONCLUSIONS Primary virus detection was associated with higher risk of subsequent virus detection within the first 90 days after primary detection.
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Affiliation(s)
- Jessica Heimonen
- Division of Allergy and Infectious Diseases, Department of Medicine, University of Washington, Seattle, Washington, USA
| | - Eric J Chow
- Division of Allergy and Infectious Diseases, Department of Medicine, University of Washington, Seattle, Washington, USA
- Prevention Division, Public Health—Seattle & King County, Seattle, Washington, USA
- Department of Epidemiology, University of Washington, Seattle, Washington, USA
| | - Yongzhe Wang
- Division of Allergy and Infectious Diseases, Department of Medicine, University of Washington, Seattle, Washington, USA
| | - James P Hughes
- Vaccine and Infectious Disease Division, Fred Hutchinson Cancer Research Center, Seattle, Washington, USA
- Department of Biostatistics, University of Washington, Seattle, Washington, USA
| | - Julia Rogers
- Division of Allergy and Infectious Diseases, Department of Medicine, University of Washington, Seattle, Washington, USA
| | - Anne Emanuels
- Division of Allergy and Infectious Diseases, Department of Medicine, University of Washington, Seattle, Washington, USA
| | - Jessica O’Hanlon
- Division of Allergy and Infectious Diseases, Department of Medicine, University of Washington, Seattle, Washington, USA
| | - Peter D Han
- Brotman Baty Institute for Precision Medicine, Seattle, Washington, USA
| | - Caitlin R Wolf
- Division of Allergy and Infectious Diseases, Department of Medicine, University of Washington, Seattle, Washington, USA
| | - Jennifer K Logue
- Division of Allergy and Infectious Diseases, Department of Medicine, University of Washington, Seattle, Washington, USA
| | - Constance E Ogokeh
- Influenza Division, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
- Military and Health Research Foundation, Laurel, Maryland, USA
| | - Melissa A Rolfes
- Influenza Division, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Timothy M Uyeki
- Influenza Division, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Lea Starita
- Brotman Baty Institute for Precision Medicine, Seattle, Washington, USA
- Department of Genome Sciences, University of Washington, Seattle, Washington, USA
| | - Janet A Englund
- Division of Pediatric Infectious Diseases, Seattle Children's Research Institute, Seattle, Washington, USA
- Department of Pediatrics, University of Washington, Seattle, Washington, USA
| | - Helen Y Chu
- Division of Allergy and Infectious Diseases, Department of Medicine, University of Washington, Seattle, Washington, USA
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22
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Guadalupe-Fernández V, Martínez-Solanas E, Sabrià-Sunyé A, Ferrer-Mikoly C, Martínez-Mateo A, Ciruela-Navas P, Mendioroz J, Basile L. Investigating epidemiological distribution (temporality and intensity) of respiratory pathogens following COVID-19 de-escalation process in Catalonia, September 2016-June 2021: Analysis of regional surveillance data. PLoS One 2024; 19:e0285892. [PMID: 38335176 PMCID: PMC10857536 DOI: 10.1371/journal.pone.0285892] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2022] [Accepted: 05/03/2023] [Indexed: 02/12/2024] Open
Abstract
BACKGROUND Following the low incidence rates of non-SARS-CoV-2 respiratory viruses registered during the strict lockdown enforced in the pandemic, a resurgence of several endemic viruses in Catalonia (Spain) was noted during the early summer of 2021. OBJECTIVES In this study, we investigated whether the circulation of non-SARS-CoV-2 respiratory viruses in Catalonia, assessed by Microbiological Reporting System of Catalonia (MRSC) and the Epidemiological Surveillance Network of Catalonia, was affected by the strict lockdown measures, as well as, the implication of the Coronavirus Disease 19 (COVID-19) de-escalation process in the late season outbreaks registered during the 2020-2021 season. STUDY DESIGN A retrospective comparison of epidemic patterns in the respiratory viruses' incidence, using regional public health surveillance data from MRSC, was performed between weeks 26/2016 to week 27/2021. Data were expressed as the weekly total number of test positivity for individual viruses. A segmented negative binomial regression model was conducted, with two parameters included (level and trend) for each segment of the time series (2020 pre-lockdown, 2020 post-lockdown and 2021). Results were reported as a unit changed in the strict lockdown. RESULTS A total of 51588 confirmed cases of the different respiratory viruses were included in the analysis, the majority were influenza cases (63.7%). An immediate reduction in the weekly number of cases was observed in 2020 after the COVID-19 outbreak for human adenovirus virus (HAdV) (β2 = -2.606; P <0.01), human parainfluenza virus (HPIV) (β2 = -3.023; P <0.01), influenza virus (IFV) (β2 = -1.259; P <0.01), but not for respiratory syncytial virus (RSV), where the number of cases remained unchanged. During 2020, a significant negative trend was found for RSV (β3 = -0.170, P <0.01), and a positive trend for HAdV (β3 = 0.075, P <0.01). During 2021, a significant reduction in the weekly number of cases was also observed for all respiratory viruses, and a borderline non-significant reduction for HPIV (β3 = -0.027; P = 0.086). Moreover, significant positive trends were found for each viral pathogen, except for influenza during 2020-2021 season, where cases remained close to zero. The respiratory viruses increased activity and their late season epidemic start particularly affected children under 6 years old. CONCLUSIONS Our data not only provides evidence that occurrence of different respiratory virus infections was affected by the strict lockdown taken against SARS-CoV-2 but it also shows a late resurgence of seasonal respiratory viruses' cases during the 2020-2021 season following the relaxation of COVID-19-targeted non-pharmaceutical interventions.
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Affiliation(s)
- Víctor Guadalupe-Fernández
- Sub-Directorate General of Surveillance and Response to Public Health Emergencies, Public Health Agency of Catalonia, Generalitat of Catalonia, Barcelona, Spain
- Research Support Unit of Central Catalonia, University Institute for Research in Primary Health Care Jordi Gol i Gurina, Sant Fruitós de Bages, Spain
| | - Erica Martínez-Solanas
- Sub-Directorate General of Surveillance and Response to Public Health Emergencies, Public Health Agency of Catalonia, Generalitat of Catalonia, Barcelona, Spain
| | - Aurora Sabrià-Sunyé
- Sub-Directorate General of Surveillance and Response to Public Health Emergencies, Public Health Agency of Catalonia, Generalitat of Catalonia, Barcelona, Spain
| | - Carol Ferrer-Mikoly
- Sub-Directorate General of Surveillance and Response to Public Health Emergencies, Public Health Agency of Catalonia, Generalitat of Catalonia, Barcelona, Spain
| | - Ana Martínez-Mateo
- Sub-Directorate General of Surveillance and Response to Public Health Emergencies, Public Health Agency of Catalonia, Generalitat of Catalonia, Barcelona, Spain
- CIBER Epidemiologia y Salud Pública (CIBERESP), Instituto Salud Carlos III, Madrid, Spain
| | - Pilar Ciruela-Navas
- Sub-Directorate General of Surveillance and Response to Public Health Emergencies, Public Health Agency of Catalonia, Generalitat of Catalonia, Barcelona, Spain
- CIBER Epidemiologia y Salud Pública (CIBERESP), Instituto Salud Carlos III, Madrid, Spain
| | - Jacobo Mendioroz
- Sub-Directorate General of Surveillance and Response to Public Health Emergencies, Public Health Agency of Catalonia, Generalitat of Catalonia, Barcelona, Spain
- Research Support Unit of Central Catalonia, University Institute for Research in Primary Health Care Jordi Gol i Gurina, Sant Fruitós de Bages, Spain
| | - Luca Basile
- Sub-Directorate General of Surveillance and Response to Public Health Emergencies, Public Health Agency of Catalonia, Generalitat of Catalonia, Barcelona, Spain
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23
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van Kasteren PB, Gelderloos AT, Nicolaie MA, den Hartog G, Vissers M, Luytjes W, Rots NY, van Beek J. Prevalence of human respiratory pathogens and associated mucosal cytokine levels in young children and adults: a cross-sectional observational study in the Netherlands during the winter of 2012/2013. Pathog Dis 2024; 82:ftae010. [PMID: 38714349 PMCID: PMC11132126 DOI: 10.1093/femspd/ftae010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2023] [Revised: 02/16/2024] [Accepted: 05/06/2024] [Indexed: 05/09/2024] Open
Abstract
Respiratory pathogens can cause severe disease and even death, especially in the very young and very old. Studies investigating their prevalence often focus on individuals presenting to healthcare providers with symptoms. However, the design of prevention strategies, e.g. which target groups to vaccinate, will benefit from knowledge on the prevalence of, risk factors for and host response to these pathogens in the general population. In this study, upper respiratory samples (n = 1311) were collected cross-sectionally during winter from 11- and 24-month old children, their parents, and adults ≥60 years of age that were recruited irrespective of seeking medical care. Almost all children, approximately two-thirds of parents and a quarter of older adults tested positive for at least one pathogen, often in the absence of symptoms. Viral interference was evident for the combination of rhinovirus and respiratory syncytial virus. Attending childcare facilities and having siblings associated with increased pathogen counts in children. On average, children showed increased levels of mucosal cytokines compared to parents and especially proinflammatory molecules associated with the presence of symptoms. These findings may guide further research into transmission patterns of respiratory pathogens and assist in determining the most appropriate strategies for the prediction and prevention of disease.
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Affiliation(s)
- Puck B van Kasteren
- Center for Infectious Disease Control, National Institute for Public Health and the Environment, Antonie van Leeuwenhoeklaan 9, 3721 MA, Bilthoven, The Netherlands
| | - Anne T Gelderloos
- Center for Infectious Disease Control, National Institute for Public Health and the Environment, Antonie van Leeuwenhoeklaan 9, 3721 MA, Bilthoven, The Netherlands
| | - Mioara Alina Nicolaie
- Center for Infectious Disease Control, National Institute for Public Health and the Environment, Antonie van Leeuwenhoeklaan 9, 3721 MA, Bilthoven, The Netherlands
| | - Gerco den Hartog
- Center for Infectious Disease Control, National Institute for Public Health and the Environment, Antonie van Leeuwenhoeklaan 9, 3721 MA, Bilthoven, The Netherlands
| | - Marloes Vissers
- Center for Infectious Disease Control, National Institute for Public Health and the Environment, Antonie van Leeuwenhoeklaan 9, 3721 MA, Bilthoven, The Netherlands
| | - Willem Luytjes
- Center for Infectious Disease Control, National Institute for Public Health and the Environment, Antonie van Leeuwenhoeklaan 9, 3721 MA, Bilthoven, The Netherlands
| | - Nynke Y Rots
- Center for Infectious Disease Control, National Institute for Public Health and the Environment, Antonie van Leeuwenhoeklaan 9, 3721 MA, Bilthoven, The Netherlands
| | - Josine van Beek
- Center for Infectious Disease Control, National Institute for Public Health and the Environment, Antonie van Leeuwenhoeklaan 9, 3721 MA, Bilthoven, The Netherlands
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24
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George RS, Goodey H, Russo MA, Tula R, Ghezzi P. Use of immunology in news and YouTube videos in the context of COVID-19: politicisation and information bubbles. Front Public Health 2024; 12:1327704. [PMID: 38435297 PMCID: PMC10906096 DOI: 10.3389/fpubh.2024.1327704] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2023] [Accepted: 01/18/2024] [Indexed: 03/05/2024] Open
Abstract
Background The COVID-19 pandemic propelled immunology into global news and social media, resulting in the potential for misinterpreting and misusing complex scientific concepts. Objective To study the extent to which immunology is discussed in news articles and YouTube videos in English and Italian, and if related scientific concepts are used to support specific political or ideological narratives in the context of COVID-19. Methods In English and Italian we searched the period 11/09/2019 to 11/09/2022 on YouTube, using the software Mozdeh, for videos mentioning COVID-19 and one of nine immunological concepts: antibody-dependent enhancement, anergy, cytokine storm, herd immunity, hygiene hypothesis, immunity debt, original antigenic sin, oxidative stress and viral interference. We repeated this using MediaCloud for news articles.Four samples of 200 articles/videos were obtained from the randomised data gathered and analysed for mentions of concepts, stance on vaccines, masks, lockdown, social distancing, and political signifiers. Results Vaccine-negative information was higher in videos than news (8-fold in English, 6-fold in Italian) and higher in Italian than English (4-fold in news, 3-fold in videos). We also observed the existence of information bubbles, where a negative stance towards one intervention was associated with a negative stance to other linked ideas. Some immunological concepts (immunity debt, viral interference, anergy and original antigenic sin) were associated with anti-vaccine or anti-NPI (non-pharmacological intervention) views. Videos in English mentioned politics more frequently than those in Italian and, in all media and languages, politics was more frequently mentioned in anti-guidelines and anti-vaccine media by a factor of 3 in video and of 3-5 in news. Conclusion There is evidence that some immunological concepts are used to provide credibility to specific narratives and ideological views. The existence of information bubbles supports the concept of the "rabbit hole" effect, where interest in unconventional views/media leads to ever more extreme algorithmic recommendations.
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Affiliation(s)
| | - Hannah Goodey
- Brighton and Sussex Medical School, Brighton, United Kingdom
| | | | - Rovena Tula
- Department of Biomolecular Sciences, University of Urbino, Urbino, Italy
| | - Pietro Ghezzi
- Brighton and Sussex Medical School, Brighton, United Kingdom
- Department of Biomolecular Sciences, University of Urbino, Urbino, Italy
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25
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Li Y, Wu Z, Yan Y, Shi Y, Huang J, Du H, Du Q, Li Y, Lin Y, Liu D, Lu X. Prevalence of respiratory viruses among hospitalized children with lower respiratory tract infections during the COVID-19 pandemic in Wuhan, China. Int J Infect Dis 2024; 139:6-12. [PMID: 37984762 DOI: 10.1016/j.ijid.2023.11.019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2023] [Revised: 11/14/2023] [Accepted: 11/15/2023] [Indexed: 11/22/2023] Open
Abstract
OBJECTIVES We aimed to investigate the continuous changes in respiratory virus epidemics in hospitalized children with lower respiratory tract infections (LRTIs) persisting from January 2019 to December 2022 in Wuhan, China. METHODS We retrospectively enrolled children with LRTIs admitted to the Wuhan Children's Hospital. Specimens were nasopharyngeal aspirates which had been collected and detected the following microorganisms with direct immunofluorescence: influenza virus types A and B, respiratory syncytial virus, parainfluenza virus types 1-3, and adenovirus. We also analyzed demographic data and laboratory test results. RESULTS A total of 22,660 patients were enrolled. The total virus detection rate in 2019, 2021, and 2022 significantly declined gradually (36.96% vs 29.47% vs 22.62%, P value < 0.001). All the detected viruses did not follow previously observed seasonal patterns during the COVID-19 pandemic. Children hospitalized for LRTIs were older during the COVID-19 pandemic in contrast to the pre-period, particularly notable in cases attributed to respiratory syncytial virus and parainfluenza virus type 3 infections. CONCLUSIONS This work adds to our knowledge of the epidemiology characteristics of respiratory viruses spanning the COVID-19 pandemic among children with LRTIs. The circulation of respiratory viruses changed consistently, and active LRTI surveillance in children remains critical for defining the healthcare burden of respiratory viruses.
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Affiliation(s)
- Ying Li
- Department of Respiratory Medicine, Wuhan Children's Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China; Pediatric Respiratory Disease Laboratory, Institute of Maternal and Child Health, Wuhan Children's Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China; CAS Key Laboratory of Special Pathogens and Biosafety, Wuhan Institute of Virology, Center for Biosafety Mega-Science, Chinese Academy of Sciences, Wuhan China; Computational Virology Group, Center for Bacteria and Viruses Resources and Bioinformation, Wuhan Institute of Virology, Chinese Academy of Sciences, Wuhan China; University of Chinese Academy of Sciences, Beijing, 101409, China
| | - Zhiyong Wu
- CAS Key Laboratory of Special Pathogens and Biosafety, Wuhan Institute of Virology, Center for Biosafety Mega-Science, Chinese Academy of Sciences, Wuhan China; Computational Virology Group, Center for Bacteria and Viruses Resources and Bioinformation, Wuhan Institute of Virology, Chinese Academy of Sciences, Wuhan China; University of Chinese Academy of Sciences, Beijing, 101409, China
| | - Yi Yan
- CAS Key Laboratory of Special Pathogens and Biosafety, Wuhan Institute of Virology, Center for Biosafety Mega-Science, Chinese Academy of Sciences, Wuhan China; Computational Virology Group, Center for Bacteria and Viruses Resources and Bioinformation, Wuhan Institute of Virology, Chinese Academy of Sciences, Wuhan China
| | - Yue Shi
- CAS Key Laboratory of Special Pathogens and Biosafety, Wuhan Institute of Virology, Center for Biosafety Mega-Science, Chinese Academy of Sciences, Wuhan China; Computational Virology Group, Center for Bacteria and Viruses Resources and Bioinformation, Wuhan Institute of Virology, Chinese Academy of Sciences, Wuhan China
| | - Jiaming Huang
- CAS Key Laboratory of Special Pathogens and Biosafety, Wuhan Institute of Virology, Center for Biosafety Mega-Science, Chinese Academy of Sciences, Wuhan China; Computational Virology Group, Center for Bacteria and Viruses Resources and Bioinformation, Wuhan Institute of Virology, Chinese Academy of Sciences, Wuhan China; University of Chinese Academy of Sciences, Beijing, 101409, China
| | - Hui Du
- Department of Respiratory Medicine, Wuhan Children's Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China; Pediatric Respiratory Disease Laboratory, Institute of Maternal and Child Health, Wuhan Children's Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Qing Du
- Department of Respiratory Medicine, Wuhan Children's Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China; Pediatric Respiratory Disease Laboratory, Institute of Maternal and Child Health, Wuhan Children's Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Yang Li
- Department of Respiratory Medicine, Wuhan Children's Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China; Pediatric Respiratory Disease Laboratory, Institute of Maternal and Child Health, Wuhan Children's Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Yaxin Lin
- Department of Respiratory Medicine, Wuhan Children's Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China; Pediatric Respiratory Disease Laboratory, Institute of Maternal and Child Health, Wuhan Children's Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Di Liu
- CAS Key Laboratory of Special Pathogens and Biosafety, Wuhan Institute of Virology, Center for Biosafety Mega-Science, Chinese Academy of Sciences, Wuhan China; Computational Virology Group, Center for Bacteria and Viruses Resources and Bioinformation, Wuhan Institute of Virology, Chinese Academy of Sciences, Wuhan China; University of Chinese Academy of Sciences, Beijing, 101409, China
| | - Xiaoxia Lu
- Department of Respiratory Medicine, Wuhan Children's Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China; Pediatric Respiratory Disease Laboratory, Institute of Maternal and Child Health, Wuhan Children's Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
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Vink E, Banda L, Amoah AS, Kasenda S, Read JM, Jewell C, Denis B, Mwale AC, Crampin A, Anscombe C, Menyere M, Ho A. Prevalence of Endemic Respiratory Viruses During the COVID-19 Pandemic in Urban and Rural Malawi. Open Forum Infect Dis 2024; 11:ofad643. [PMID: 38312213 PMCID: PMC10836885 DOI: 10.1093/ofid/ofad643] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2023] [Accepted: 12/19/2023] [Indexed: 02/06/2024] Open
Abstract
Background We investigated endemic respiratory virus circulation patterns in Malawi, where no lockdown was imposed, during the COVID-19 pandemic. Methods Within a prospective household cohort in urban and rural Malawi, adult participants provided upper respiratory tract (URT) samples at 4 time points between February 2021 and April 2022. Polymerase chain reaction (PCR) was performed for SARS-CoV-2, influenza, and other endemic respiratory viruses. Results 1626 URT samples from 945 participants in 542 households were included. Overall, 7.6% (n = 123) samples were PCR- positive for >1 respiratory virus; SARS-CoV-2 (4.4%) and rhinovirus (2.0%) were most common. No influenza A virus was detected. Influenza B and respiratory syncytial virus (RSV) were rare. Higher virus positivity were detected in the rural setting and at earlier time points. Coinfections were infrequent. Conclusions Endemic respiratory viruses circulated in the community in Malawi during the pandemic, though influenza and RSV were rarely detected. Distinct differences in virus positivity and demographics were observed between urban and rural cohorts.
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Affiliation(s)
- Elen Vink
- MRC-University of Glasgow Centre for Virus Research, Glasgow, UK
| | - Louis Banda
- Malawi Epidemiology and Intervention Research Unit, Lilongwe and Chilumba, Malawi
| | - Abena S Amoah
- Malawi Epidemiology and Intervention Research Unit, Lilongwe and Chilumba, Malawi
- Department of Population Health, Faculty of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, London, UK
- Leiden University Medical Center, Leiden, the Netherlands
| | - Stephen Kasenda
- Malawi Epidemiology and Intervention Research Unit, Lilongwe and Chilumba, Malawi
| | - Jonathan M Read
- Centre for Health Information Computation and Statistics, Lancaster Medical School, Lancaster University, Lancaster, UK
| | - Chris Jewell
- Department of Mathematics and Statistics, Lancaster University, Lancaster, UK
| | - Brigitte Denis
- Malawi-Liverpool-Wellcome Trust Clinical Research Programme, Blantyre, Malawi
| | | | - Amelia Crampin
- Malawi Epidemiology and Intervention Research Unit, Lilongwe and Chilumba, Malawi
- Department of Population Health, Faculty of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, London, UK
- School of Health and Wellbeing, University of Glasgow, Glasgow, UK
| | - Catherine Anscombe
- Department of Mathematics and Statistics, Lancaster University, Lancaster, UK
- Liverpool School of Tropical Medicine, University of Liverpool, Liverpool, UK
| | - Mavis Menyere
- Malawi-Liverpool-Wellcome Trust Clinical Research Programme, Blantyre, Malawi
| | - Antonia Ho
- MRC-University of Glasgow Centre for Virus Research, Glasgow, UK
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Chan CM, Wahab AA, Ali A. Assessing the impact of COVID-19 on epidemiological changes of severe pediatric respiratory syncytial virus infections in Malaysia. Front Public Health 2024; 12:1246921. [PMID: 38356949 PMCID: PMC10866006 DOI: 10.3389/fpubh.2024.1246921] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2023] [Accepted: 01/19/2024] [Indexed: 02/16/2024] Open
Abstract
Introduction Respiratory syncytial virus (RSV) is one of the leading causes of hospitalization and mortality among children with respiratory tract infections. The non-pharmaceutical preventive measures against severe acute respiratory syndrome coronavirus (COVID-19) may have reduced the transmission of RSV, altering its tropical epidemiological seasonality. Thus, this study represents the first attempt to evaluate changes in RSV epidemiology in the context of COVID-19 pandemic in Malaysia. Methods Conducted at a tertiary hospital in Kuala Lumpur, Malaysia, this retrospective study analyzed collated data of children aged <12 years who were admitted for severe respiratory infections from 2017 to 2022. Time series models were used to predict the differences between actual and forecasted RSV cases, while logistic regression assessed the statistical association between RSV and COVID-19. Results Among the 4,084 children analyzed, we reported a significant inverse relationship between RSV and COVID-19 infections during the pandemic (2020-2021) (p < 0.05). In 2020, the RSV positivity rate sharply declined to 8.3 and 5.9%, respectively, in the two prominent seasons. Time series analysis showed a tremendous decrease in cases compared to the expected values, with reductions of 98.3% in the first season and 95.7% in the second season. However, following the lifting of the restriction order in 2022, RSV infections rose sharply with a positivity rate of 36.3%, higher than pre-COVID-19 pandemic levels. Conclusion This study provides evidence of increasing RSV cases post-COVID-19 pandemic, due to immunity debt. Hence, the healthcare system must be prepared to address future RSV outbreaks with the appropriate implementation of prophylaxis and public health measures.
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Affiliation(s)
- Chee Mun Chan
- Department of Pediatrics, Faculty of Medicine, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
- Research Center, Hospital Tunku Ampuan Besar Tuanku Aishah Rohani, UKM Specialist Children’s Hospital, Kuala Lumpur, Malaysia
| | - Asrul Abdul Wahab
- Department of Microbiology, Faculty of Medicine, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
| | - Adli Ali
- Department of Pediatrics, Faculty of Medicine, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
- Research Center, Hospital Tunku Ampuan Besar Tuanku Aishah Rohani, UKM Specialist Children’s Hospital, Kuala Lumpur, Malaysia
- Institute of IR4.0, Universiti Kebangsaan Malaysia, Bangi, Malaysia
- Infection and Immunology Health and Advanced Medicine Cluster, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
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Kawase M, Suwa R, Sugimoto S, Kakizaki M, Kume Y, Chishiki M, Ono T, Okabe H, Norito S, Ujike M, Hosoya M, Hashimoto K, Shirato K. Evidence of the simultaneous replications of active viruses in specimens positive for multiple respiratory viruses. Microbiol Spectr 2024; 12:e0192023. [PMID: 38051050 PMCID: PMC10783086 DOI: 10.1128/spectrum.01920-23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2023] [Accepted: 11/04/2023] [Indexed: 12/07/2023] Open
Abstract
IMPORTANCE Since the pandemic of coronavirus diseases 2019, the use of real-time PCR assay has become widespread among people who were not familiar with it in virus detection. As a result, whether a high real-time PCR value in one time test indicates virus transmissibly became a complicated social problem, regardless of the difference in assays and/or amplification conditions, the time and number of diagnostic test during the time course of infection. In addition, the multiple positives in the test of respiratory viruses further add to the confusion in the interpretation of the infection. To address this issue, we performed virus isolation using pediatric SARI (severe acute respiratory infections) specimens on air-liquid interface culture of human bronchial/tracheal epithelial cell culture. The result of this study can be a strong evidence that the specimens showing positivity for multiple agents in real-time PCR tests possibly contain infectious viruses.
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Affiliation(s)
- Miyuki Kawase
- Department of Virology III, National Institute of Infectious Disease, Gakuen, Musashimurayama, Tokyo, Japan
| | - Reiko Suwa
- Department of Virology III, National Institute of Infectious Disease, Gakuen, Musashimurayama, Tokyo, Japan
| | - Satoko Sugimoto
- Department of Virology III, National Institute of Infectious Disease, Gakuen, Musashimurayama, Tokyo, Japan
| | - Masatoshi Kakizaki
- Department of Virology III, National Institute of Infectious Disease, Gakuen, Musashimurayama, Tokyo, Japan
| | - Yohei Kume
- Department of Pediatrics, School of Medicine, Fukushima Medical University, Hikarigaoka, Fukushima, Japan
| | - Mina Chishiki
- Department of Pediatrics, School of Medicine, Fukushima Medical University, Hikarigaoka, Fukushima, Japan
| | - Takashi Ono
- Department of Pediatrics, School of Medicine, Fukushima Medical University, Hikarigaoka, Fukushima, Japan
| | - Hisao Okabe
- Department of Pediatrics, School of Medicine, Fukushima Medical University, Hikarigaoka, Fukushima, Japan
| | - Sakurako Norito
- Department of Pediatrics, School of Medicine, Fukushima Medical University, Hikarigaoka, Fukushima, Japan
| | - Makoto Ujike
- Faculty of Veterinary Medicine, Nippon Veterinary and Life Science University, Musashino, Tokyo, Japan
| | - Mitsuaki Hosoya
- Department of Pediatrics, School of Medicine, Fukushima Medical University, Hikarigaoka, Fukushima, Japan
| | - Koichi Hashimoto
- Department of Pediatrics, School of Medicine, Fukushima Medical University, Hikarigaoka, Fukushima, Japan
| | - Kazuya Shirato
- Department of Virology III, National Institute of Infectious Disease, Gakuen, Musashimurayama, Tokyo, Japan
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29
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Demirhan S, Goldman DL, Herold BC. Differences in the Clinical Manifestations and Host Immune Responses to SARS-CoV-2 Variants in Children Compared to Adults. J Clin Med 2023; 13:128. [PMID: 38202135 PMCID: PMC10780117 DOI: 10.3390/jcm13010128] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2023] [Revised: 12/20/2023] [Accepted: 12/22/2023] [Indexed: 01/12/2024] Open
Abstract
The COVID-19 pandemic challenged the medical field to rapidly identify and implement new approaches to the diagnosis, treatment and prevention of SARS-CoV-2 infections. The scientific community also needed to rapidly initiate basic, translational, clinical and epidemiological studies to understand the pathophysiology of this new family of viruses, which continues to evolve with the emergence of new genetic variants. One of the earliest clinical observations that provided a framework for the research was the finding that, in contrast to most other respiratory viruses, children developed less severe acute and post-acute disease compared to adults. Although the clinical manifestations of SARS-CoV-2 infection changed with each new wave of the pandemic, which was dominated by evolving viral variants, the differences in severity between children and adults persisted. Comparative immunologic studies have shown that children mount a more vigorous local innate response characterized by the activation of interferon pathways and recruitment of innate cells to the mucosa, which may mitigate against the hyperinflammatory adaptive response and systemic cytokine release that likely contributed to more severe outcomes including acute respiratory distress syndrome in adults. In this review, the clinical manifestations and immunologic responses in children during the different waves of COVID-19 are discussed.
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Affiliation(s)
| | | | - Betsy C. Herold
- Department of Pediatrics, Division of Infectious Diseases, Albert Einstein College of Medicine, The Children’s Hospital at Montefiore, 1225 Morris Park Avenue, Bronx, NY 10461, USA; (S.D.); (D.L.G.)
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Matera L, Manti S, Petrarca L, Pierangeli A, Conti MG, Mancino E, Leonardi S, Midulla F, Nenna R. An overview on viral interference during SARS-CoV-2 pandemic. Front Pediatr 2023; 11:1308105. [PMID: 38178911 PMCID: PMC10764478 DOI: 10.3389/fped.2023.1308105] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/05/2023] [Accepted: 12/07/2023] [Indexed: 01/06/2024] Open
Abstract
Respiratory viruses represent the most frequent cause of mortality, morbidity and high healthcare costs for emergency visits and hospitalization in the pediatric age. Respiratory viruses can circulate simultaneously and can potentially infect the same host, determining different types of interactions, the so-called viral interference. The role of viral interference has assumed great importance since December 2019, when the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) came on the scene. The aim of this narrative review is to present our perspective regarding research in respiratory virus interference and discuss recent advances on the topic because, following SARS-CoV-2 restrictions mitigation, we are experimenting the co-circulation of respiratory viruses along with SARS-CoV-2. This scenario is raising many concerns about possible virus-virus interactions, both positive and negative, and the clinical, diagnostic and therapeutic management of these coinfections. Moreover, we cannot rule out that also climatic conditions and social behaviours are involved. Thus, this situation can lead to different population epidemic dynamics, including changes in the age of the targeted population, disease course and severity, highlighting the need for prospective epidemiologic studies and mathematical modelling able to predict the timing and magnitude of epidemics caused by SARS-CoV-2/seasonal respiratory virus interactions in order to adjust better public health interventions.
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Affiliation(s)
- Luigi Matera
- Department of Maternal Infantile and Urological Sciences, Sapienza University of Rome, Rome, Italy
| | - Sara Manti
- Department of Human and Pediatric Pathology, Pediatric Unit, G. Martino Hospital, University of Messina, Messina, Italy
| | - Laura Petrarca
- Department of Maternal Infantile and Urological Sciences, Sapienza University of Rome, Rome, Italy
| | - Alessandra Pierangeli
- Laboratory of Virology, Department of Molecular Medicine, Affiliated to Istituto Pasteur Italia, Sapienza University of Rome, Rome, Italy
| | - Maria Giulia Conti
- Department of Maternal Infantile and Urological Sciences, Sapienza University of Rome, Rome, Italy
| | - Enrica Mancino
- Department of Maternal Infantile and Urological Sciences, Sapienza University of Rome, Rome, Italy
| | - Salvatore Leonardi
- Pediatric Respiratory Unit, Department of Clinical and Experimental Medicine, University of Catania, Catania, Italy
| | - Fabio Midulla
- Department of Maternal Infantile and Urological Sciences, Sapienza University of Rome, Rome, Italy
| | - Raffaella Nenna
- Department of Maternal Infantile and Urological Sciences, Sapienza University of Rome, Rome, Italy
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Chishtie J, Sapiro N, Wiebe N, Rabatach L, Lorenzetti D, Leung AA, Rabi D, Quan H, Eastwood CA. Use of Epic Electronic Health Record System for Health Care Research: Scoping Review. J Med Internet Res 2023; 25:e51003. [PMID: 38100185 PMCID: PMC10757236 DOI: 10.2196/51003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2023] [Revised: 10/29/2023] [Accepted: 11/05/2023] [Indexed: 12/18/2023] Open
Abstract
BACKGROUND Electronic health records (EHRs) enable health data exchange across interconnected systems from varied settings. Epic is among the 5 leading EHR providers and is the most adopted EHR system across the globe. Despite its global reach, there is a gap in the literature detailing how EHR systems such as Epic have been used for health care research. OBJECTIVE The objective of this scoping review is to synthesize the available literature on use cases of the Epic EHR for research in various areas of clinical and health sciences. METHODS We used established scoping review methods and searched 9 major information repositories, including databases and gray literature sources. To categorize the research data, we developed detailed criteria for 5 major research domains to present the results. RESULTS We present a comprehensive picture of the method types in 5 research domains. A total of 4669 articles were screened by 2 independent reviewers at each stage, while 206 articles were abstracted. Most studies were from the United States, with a sharp increase in volume from the year 2015 onwards. Most articles focused on clinical care, health services research and clinical decision support. Among research designs, most studies used longitudinal designs, followed by interventional studies implemented at single sites in adult populations. Important facilitators and barriers to the use of Epic and EHRs in general were identified. Important lessons to the use of Epic and other EHRs for research purposes were also synthesized. CONCLUSIONS The Epic EHR provides a wide variety of functions that are helpful toward research in several domains, including clinical and population health, quality improvement, and the development of clinical decision support tools. As Epic is reported to be the most globally adopted EHR, researchers can take advantage of its various system features, including pooled data, integration of modules and developing decision support tools. Such research opportunities afforded by the system can contribute to improving quality of care, building health system efficiencies, and conducting population-level studies. Although this review is limited to the Epic EHR system, the larger lessons are generalizable to other EHRs.
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Affiliation(s)
- Jawad Chishtie
- Center for Health Informatics, University of Calgary, Calgary, AB, Canada
- Alberta Health Services, Calgary, AB, Canada
| | - Natalie Sapiro
- Center for Health Informatics, University of Calgary, Calgary, AB, Canada
| | - Natalie Wiebe
- Center for Health Informatics, University of Calgary, Calgary, AB, Canada
- Alberta Health Services, Calgary, AB, Canada
| | | | - Diane Lorenzetti
- Community Health Sciences, University of Calgary, Calgary, AB, Canada
- Health Sciences Library, University of Calgary, Calgary, AB, Canada
| | - Alexander A Leung
- Community Health Sciences, University of Calgary, Calgary, AB, Canada
- Department of Medicine, University of Calgary, Calgary, AB, Canada
| | - Doreen Rabi
- Community Health Sciences, University of Calgary, Calgary, AB, Canada
- Department of Medicine, University of Calgary, Calgary, AB, Canada
| | - Hude Quan
- Center for Health Informatics, University of Calgary, Calgary, AB, Canada
- Community Health Sciences, University of Calgary, Calgary, AB, Canada
| | - Cathy A Eastwood
- Center for Health Informatics, University of Calgary, Calgary, AB, Canada
- Community Health Sciences, University of Calgary, Calgary, AB, Canada
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32
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Ju DU, Park D, Kim IH, Kim S, Yoo HM. Development of Human Rhinovirus RNA Reference Material Using Digital PCR. Genes (Basel) 2023; 14:2210. [PMID: 38137032 PMCID: PMC10742479 DOI: 10.3390/genes14122210] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2023] [Revised: 12/08/2023] [Accepted: 12/11/2023] [Indexed: 12/24/2023] Open
Abstract
The human rhinovirus (RV) is a positive-stranded RNA virus that causes respiratory tract diseases affecting both the upper and lower halves of the respiratory system. RV enhances its replication by concentrating RNA synthesis within a modified host membrane in an intracellular compartment. RV infections often occur alongside infections caused by other respiratory viruses, and the RV virus may remain asymptomatic for extended periods. Alongside qualitative detection, it is essential to accurately quantify RV RNA from clinical samples to explore the relationships between RV viral load, infections caused by the virus, and the resulting symptoms observed in patients. A reference material (RM) is required for quality evaluation, the performance evaluation of molecular diagnostic products, and evaluation of antiviral agents in the laboratory. The preparation process for the RM involves creating an RV RNA mixture by combining RV viral RNA with RNA storage solution and matrix. The resulting RV RNA mixture is scaled up to a volume of 25 mL, then dispensed at 100 µL per vial and stored at -80 °C. The process of measuring the stability and homogeneity of RV RMs was conducted by employing reverse transcription droplet digital polymerase chain reaction (RT-ddPCR). Digital PCR is useful for the analysis of standards and can help to improve measurement compatibility: it represents the equivalence of a series of outcomes for reference materials and samples being analyzed when a few measurement procedures are employed, enabling objective comparisons between quantitative findings obtained through various experiments. The number of copies value represents a measured result of approximately 1.6 × 105 copies/μL. The RM has about an 11% bottle-to-bottle homogeneity and shows stable results for 1 week at temperatures of 4 °C and -20 °C and for 12 months at a temperature of -80 °C. The developed RM can enhance the dependability of RV molecular tests by providing a precise reference value for the absolute copy number of a viral target gene. Additionally, it can serve as a reference for diverse studies.
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Affiliation(s)
- Dong U Ju
- Biometrology Group, Korea Research Institute of Standards and Science (KRISS), Daejeon 34113, Republic of Korea
- School of Biomedical Engineering, Korea University, Seoul 02841, Republic of Korea
| | - Dongju Park
- Biometrology Group, Korea Research Institute of Standards and Science (KRISS), Daejeon 34113, Republic of Korea
| | - Il-Hwan Kim
- Biometrology Group, Korea Research Institute of Standards and Science (KRISS), Daejeon 34113, Republic of Korea
| | - Seil Kim
- Biometrology Group, Korea Research Institute of Standards and Science (KRISS), Daejeon 34113, Republic of Korea
- Department of Precision Measurement, University of Science & Technology (UST), Daejeon 34113, Republic of Korea
| | - Hee Min Yoo
- Biometrology Group, Korea Research Institute of Standards and Science (KRISS), Daejeon 34113, Republic of Korea
- Department of Precision Measurement, University of Science & Technology (UST), Daejeon 34113, Republic of Korea
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Mochan E, Sego TJ. Mathematical Modeling of the Lethal Synergism of Coinfecting Pathogens in Respiratory Viral Infections: A Review. Microorganisms 2023; 11:2974. [PMID: 38138118 PMCID: PMC10745501 DOI: 10.3390/microorganisms11122974] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2023] [Revised: 12/05/2023] [Accepted: 12/08/2023] [Indexed: 12/24/2023] Open
Abstract
Influenza A virus (IAV) infections represent a substantial global health challenge and are often accompanied by coinfections involving secondary viruses or bacteria, resulting in increased morbidity and mortality. The clinical impact of coinfections remains poorly understood, with conflicting findings regarding fatality. Isolating the impact of each pathogen and mechanisms of pathogen synergy during coinfections is challenging and further complicated by host and pathogen variability and experimental conditions. Factors such as cytokine dysregulation, immune cell function alterations, mucociliary dysfunction, and changes to the respiratory tract epithelium have been identified as contributors to increased lethality. The relative significance of these factors depends on variables such as pathogen types, infection timing, sequence, and inoculum size. Mathematical biological modeling can play a pivotal role in shedding light on the mechanisms of coinfections. Mathematical modeling enables the quantification of aspects of the intra-host immune response that are difficult to assess experimentally. In this narrative review, we highlight important mechanisms of IAV coinfection with bacterial and viral pathogens and survey mathematical models of coinfection and the insights gained from them. We discuss current challenges and limitations facing coinfection modeling, as well as current trends and future directions toward a complete understanding of coinfection using mathematical modeling and computer simulation.
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Affiliation(s)
- Ericka Mochan
- Department of Computational and Chemical Sciences, Carlow University, Pittsburgh, PA 15213, USA
| | - T. J. Sego
- Department of Medicine, University of Florida, Gainesville, FL 32611, USA;
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Petat H, Schuers M, Marguet C, Humbert X, Le Bas F, Rabiaza A, Corbet S, Leterrier B, Vabret A, Ar Gouilh M. Positive and negative viral associations in patients with acute respiratory tract infections in primary care: the ECOVIR study. Front Public Health 2023; 11:1269805. [PMID: 38074759 PMCID: PMC10706622 DOI: 10.3389/fpubh.2023.1269805] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2023] [Accepted: 10/30/2023] [Indexed: 12/18/2023] Open
Abstract
Introduction Acute respiratory infections (ARIs) are the most common viral infections encountered in primary care settings. The identification of causal viruses is still not available in routine practice. Although new strategies of prevention are being identified, knowledge of the relationships between respiratory viruses remains limited. Materials and methods ECOVIR was a multicentric prospective study in primary care, which took place during two pre-pandemic seasons (2018-2019 and 2019-2020). Patients presenting to their General practitioner (GP) with ARIs were included, without selecting for age or clinical conditions. Viruses were detected on nasal swab samples using a multiplex Polymerase Chain Reaction test focused on 17 viruses [Respiratory Syncytial Virus-A (RSV-A), RSV-B, Rhinovirus/Enterovirus (HRV), human Metapneumovirus (hMPV), Adenovirus (ADV), Coronaviruses (CoV) HKU1, NL63, 229E, OC43, Influenza virus (H1 and H3 subtypes), Influenza virus B, Para-Influenza viruses (PIVs) 1-4, and Bocavirus (BoV)]. Results Among the 668 analyzed samples, 66% were positive for at least one virus, of which 7.9% were viral codetections. The viral detection was negatively associated with the age of patients. BoV, ADV, and HRV occurred more significantly in younger patients than the other viruses (p < 0.05). Codetections were significantly associated with RSV, HRV, BoV, hMPV, and ADV and not associated with influenza viruses, CoV, and PIVs. HRV and influenza viruses were negatively associated with all the viruses. Conversely, a positive association was found between ADV and BoV and between PIVs and BoV. Conclusion Our study provides additional information on the relationships between respiratory viruses, which remains limited in primary care.
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Affiliation(s)
- Hortense Petat
- Department of Paediatrics and Adolescent Medicine Rouen, Univ Rouen Normandie, Dynamicure INSERM UMR 1311, CHU Rouen, Rouen, France
| | - Matthieu Schuers
- Department of General Practice, Univ Rouen Normandie, INSERM U1142, CHU Rouen, Rouen, France
| | - Christophe Marguet
- Department of Paediatrics and Adolescent Medicine Rouen, Univ Rouen Normandie, Dynamicure INSERM UMR 1311, CHU Rouen, Rouen, France
| | - Xavier Humbert
- Department of General Practice, Univ Caen Normandie santé, Caen, France
| | - François Le Bas
- Department of General Practice, Univ Caen Normandie santé, Caen, France
| | - Andry Rabiaza
- Department of General Practice, Univ Caen Normandie santé, Caen, France
| | - Sandrine Corbet
- Department of Virology, Univ Caen Normandie, INSERM Dynamicure UMR 1311, CHU Caen, Caen, France
| | - Bryce Leterrier
- Department of Virology, Univ Caen Normandie, INSERM Dynamicure UMR 1311, CHU Caen, Caen, France
| | - Astrid Vabret
- Department of Virology, Univ Caen Normandie, INSERM Dynamicure UMR 1311, CHU Caen, Caen, France
| | - Meriadeg Ar Gouilh
- Department of Virology, Univ Caen Normandie, INSERM Dynamicure UMR 1311, CHU Caen, Caen, France
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LeJeune L, Browne C. Effect of cross-immunity in a two-strain cholera model with aquatic component. Math Biosci 2023; 365:109086. [PMID: 37821025 DOI: 10.1016/j.mbs.2023.109086] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2023] [Revised: 10/03/2023] [Accepted: 10/05/2023] [Indexed: 10/13/2023]
Abstract
The bacteria Vibrio cholerae relies heavily upon an aquatic reservoir as a transmission route with two distinct serotypes observed in many recent outbreaks. In this paper, we extend previously studied ordinary differential equation epidemiological models to create a two-strain SIRP (susceptible-infectious-recovered-pathogen) system which incorporates both partial cross-immunity between disease strains and environmental pathogen transmission. Of particular interest are undamped anti-phase periodic solutions, as these display a type of coexistence where strains routinely switch dominance, and understanding what drives this switch can optimize the efficiency of the host population's control measures against the disease. We derive the basic reproduction number R0 and use stability analysis to examine the disease free and single-strain equilibria. We formulate a unique coexistence equilibrium and prove uniform persistence of both strains when R0>1. In addition, we simulate solutions to this system, along with seasonally forced versions of the model with and without host coinfection. Cross-immunity and transmission pathways influence damped or sustained oscillatory dynamics, where the presence of seasonality can modify, amplify or synchronize the period and phase of serotypes, driving epidemic waves. Cycling of serotypes over large time intervals, similar to observed data, is found for a range of cross-immunity levels, and the inclusion of coinfection in the model contributes to sustained anti-phase periodic solutions.
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Affiliation(s)
- Leah LeJeune
- Department of Mathematics, University of Louisiana at Lafayette, Lafayette, LA, USA
| | - Cameron Browne
- Department of Mathematics, University of Louisiana at Lafayette, Lafayette, LA, USA.
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Lönnrot M, Lynch KF, Rewers M, Lernmark Å, Vehik K, Akolkar B, Hagopian W, Krischer J, McIndoe RA, Toppari J, Ziegler AG, Petrosino JF, Lloyd R, Hyöty H. Gastrointestinal Infections Modulate the Risk for Insulin Autoantibodies as the First-Appearing Autoantibody in the TEDDY Study. Diabetes Care 2023; 46:1908-1915. [PMID: 37607456 PMCID: PMC10620548 DOI: 10.2337/dc23-0518] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/23/2023] [Accepted: 07/31/2023] [Indexed: 08/24/2023]
Abstract
OBJECTIVE To investigate gastrointestinal infection episodes (GIEs) in relation to the appearance of islet autoantibodies in The Environmental Determinants of Diabetes in the Young (TEDDY) cohort. RESEARCH DESIGN AND METHODS GIEs on risk of autoantibodies against either insulin (IAA) or GAD (GADA) as the first-appearing autoantibody were assessed in a 10-year follow-up of 7,867 children. Stool virome was characterized in a nested case-control study. RESULTS GIE reports (odds ratio [OR] 2.17 [95% CI 1.39-3.39]) as well as Norwalk viruses found in stool (OR 5.69 [1.36-23.7]) at <1 year of age were associated with an increased IAA risk at 2-4 years of age. GIEs reported at age 1 to <2 years correlated with a lower risk of IAA up to 10 years of age (OR 0.48 [0.35-0.68]). GIE reports at any other age were associated with an increase in IAA risk (OR 2.04 for IAA when GIE was observed 12-23 months prior [1.41-2.96]). Impacts on GADA risk were limited to GIEs <6 months prior to autoantibody development in children <4 years of age (OR 2.16 [1.54-3.02]). CONCLUSIONS Bidirectional associations were observed. GIEs were associated with increased IAA risk when reported before 1 year of age or 12-23 months prior to IAA. Norwalk virus was identified as one possible candidate factor. GIEs reported during the 2nd year of life were associated with a decreased IAA risk.
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Affiliation(s)
- Maria Lönnrot
- Department of Virology, Faculty of Medicine and Health Technology, Tampere University, and Department of Dermatology, Tampere University Hospital, Wellbeing Services County of Pirkanmaa, Tampere, Finland
| | - Kristian F. Lynch
- Health Informatics Institute, Morsani College of Medicine, University of South Florida, Tampa, FL
| | - Marian Rewers
- Barbara Davis Center for Childhood Diabetes, University of Colorado, Aurora, CO
| | - Åke Lernmark
- Department of Clinical Sciences, Lund University Clinical Research Center, Skåne University Hospital, Malmo, Sweden
| | - Kendra Vehik
- Health Informatics Institute, Morsani College of Medicine, University of South Florida, Tampa, FL
| | - Beena Akolkar
- National Institute of Diabetes and Digestive and Kidney Diseases, Bethesda, MD
| | | | - Jeffrey Krischer
- Health Informatics Institute, Morsani College of Medicine, University of South Florida, Tampa, FL
| | - Rickhard A. McIndoe
- Center for Biotechnology and Genomic Medicine, Medical College of Georgia, Augusta University, Augusta, GA
| | - Jorma Toppari
- Department of Pediatrics, Turku University Hospital, and Institute of Biomedicine, Research Centre for Integrative Physiology and Pharmacology, University of Turku, Turku, Finland
| | - Anette-G. Ziegler
- Institute of Diabetes Research, Helmholtz Zentrum München, Neuherberg, Germany
- Klinikum rechts der Isar, Technische Universität München, Neuherberg, Germany
- Forschergruppe Diabetes e.V., Neuherberg, Germany
| | - Joseph F. Petrosino
- Baylor Alkek Center for Metagenomics and Microbiome Research, Department of Molecular Virology and Microbiology, Baylor College of Medicine, Houston, TX
| | - Richard Lloyd
- Baylor Alkek Center for Metagenomics and Microbiome Research, Department of Molecular Virology and Microbiology, Baylor College of Medicine, Houston, TX
| | - Heikki Hyöty
- Department of Virology, Faculty of Medicine and Health Technology, Tampere University, and Fimlab Laboratories, Wellbeing Services County of Pirkanmaa, Tampere, Finland
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Samuels RJ, Sumah I, Alhasan F, McHenry R, Short L, Chappell JD, Haddadin Z, Halasa NB, Valério ID, Amorim G, Grant DS, Schieffelin JS, Moon TD. Respiratory virus surveillance in hospitalized children less than two-years of age in Kenema, Sierra Leone during the COVID-19 pandemic (October 2020- October 2021). PLoS One 2023; 18:e0292652. [PMID: 37816008 PMCID: PMC10564235 DOI: 10.1371/journal.pone.0292652] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2023] [Accepted: 09/25/2023] [Indexed: 10/12/2023] Open
Abstract
Globally, viral pathogens are the leading cause of acute respiratory infection in children under-five years. We aim to describe the epidemiology of viral respiratory pathogens in hospitalized children under-two years of age in Eastern Province of Sierra Leone, during the second year of the SARS-CoV-2 pandemic. We conducted a prospective study of children hospitalized with respiratory symptoms between October 2020 and October 2021. We collected demographic and clinical characteristics and calculated each participant´s respiratory symptom severity. Nose and throat swabs were collected at enrollment. Total nucleic acid was purified and tested for multiple respiratory viruses. Statistical analysis was performed using R version 4.2.0 software. 502 children less than two-years of age were enrolled. 376 (74.9%) had at least one respiratory virus detected. The most common viruses isolated were HRV/EV (28.2%), RSV (19.5%) and PIV (13.1%). Influenza and SARS-CoV-2 were identified in only 9.2% and 3.9% of children, respectively. Viral co-detection was common. Human metapneumovirus and RSV had more than two-fold higher odds of requiring O2 therapy while hospitalized. Viral pathogen prevalence was high (74.9%) in our study population. Despite this, 100% of children received antibiotics, underscoring a need to expand laboratory diagnostic capacity and to revisit clinical guidelines implementation in these children. Continuous surveillance and serologic studies among more diverse age groups, with greater geographic breadth, are needed in Sierra Leone to better characterize the long-term impact of COVID-19 on respiratory virus prevalence and to better characterize the seasonality of respiratory viruses in Sierra Leone.
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Affiliation(s)
- Robert J. Samuels
- Kenema Government Hospital, Ministry of Health and Sanitation, Kenema, Sierra Leone
| | - Ibrahim Sumah
- Kenema Government Hospital, Ministry of Health and Sanitation, Kenema, Sierra Leone
| | - Foday Alhasan
- Kenema Government Hospital, Ministry of Health and Sanitation, Kenema, Sierra Leone
| | - Rendie McHenry
- Department of Pediatrics, Division of Pediatric Infectious Diseases, Vanderbilt University Medical Center, Nashville, Tennessee, United States of America
| | - Laura Short
- Department of Pediatrics, Division of Pediatric Infectious Diseases, Vanderbilt University Medical Center, Nashville, Tennessee, United States of America
| | - James D. Chappell
- Department of Pediatrics, Division of Pediatric Infectious Diseases, Vanderbilt University Medical Center, Nashville, Tennessee, United States of America
| | - Zaid Haddadin
- Department of Pediatrics, Division of Pediatric Infectious Diseases, Vanderbilt University Medical Center, Nashville, Tennessee, United States of America
| | - Natasha B. Halasa
- Department of Pediatrics, Division of Pediatric Infectious Diseases, Vanderbilt University Medical Center, Nashville, Tennessee, United States of America
| | - Inaê D. Valério
- Vanderbilt Institute for Global Health, Vanderbilt University Medical Center, Nashville, Tennessee, United States of America
| | - Gustavo Amorim
- Department of Biostatistics, Vanderbilt University Medical Center, Nashville, Tennessee, United States of America
| | - Donald S. Grant
- Kenema Government Hospital, Ministry of Health and Sanitation, Kenema, Sierra Leone
- College of Medicine and Allied Health Sciences, University of Sierra Leone, Freetown, Sierra Leone
| | - John S. Schieffelin
- Department of Pediatrics, Division of Pediatric Infectious Diseases, Tulane University, New Orleans, Louisiana, United States of America
| | - Troy D. Moon
- Department of Pediatrics, Division of Pediatric Infectious Diseases, Vanderbilt University Medical Center, Nashville, Tennessee, United States of America
- Vanderbilt Institute for Global Health, Vanderbilt University Medical Center, Nashville, Tennessee, United States of America
- Department of Pediatrics, Division of Pediatric Infectious Diseases, Tulane University, New Orleans, Louisiana, United States of America
- Department of Tropical Medicine, Tulane University School of Public Health and Tropical Medicine, New Orleans, Louisiana, United States of America
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Lampros A, Talla C, Diarra M, Tall B, Sagne S, Diallo MK, Diop B, Oumar I, Dia N, Sall AA, Barry MA, Loucoubar C. Shifting Patterns of Influenza Circulation during the COVID-19 Pandemic, Senegal. Emerg Infect Dis 2023; 29:1808-1817. [PMID: 37610149 PMCID: PMC10461650 DOI: 10.3201/eid2909.230307] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/24/2023] Open
Abstract
Historically low levels of seasonal influenza circulation were reported during the first years of the COVID-19 pandemic and were mainly attributed to implementation of nonpharmaceutical interventions. In tropical regions, influenza's seasonality differs largely, and data on this topic are scarce. We analyzed data from Senegal's sentinel syndromic surveillance network before and after the start of the COVID-19 pandemic to assess changes in influenza circulation. We found that influenza shows year-round circulation in Senegal and has 2 distinct epidemic peaks: during January-March and during the rainy season in August-October. During 2021-2022, the expected January-March influenza peak completely disappeared, corresponding to periods of active SARS-CoV-2 circulation. We noted an unexpected influenza epidemic peak during May-July 2022. The observed reciprocal circulation of SARS-CoV-2 and influenza suggests that factors such as viral interference might be at play and should be further investigated in tropical settings.
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Affiliation(s)
- Alexandre Lampros
- Hôpital Européen Georges Pompidou, Paris, France (A. Lampros)
- Institut Pasteur de Dakar, Dakar, Senegal (A. Lampros, C. Talla, M. Diarra, B. Tall, S. Sagne, M. Korka Diallo, N. Dia, A.A. Sall, M.A. Barry, C. Loucoubar)
- Government of Senegal Ministry of Health and Social Action, Dakar (A. Lampros, B. Diop)
- World Health Organization, Dakar (A. Lampros, I. Oumar)
| | - Cheikh Talla
- Hôpital Européen Georges Pompidou, Paris, France (A. Lampros)
- Institut Pasteur de Dakar, Dakar, Senegal (A. Lampros, C. Talla, M. Diarra, B. Tall, S. Sagne, M. Korka Diallo, N. Dia, A.A. Sall, M.A. Barry, C. Loucoubar)
- Government of Senegal Ministry of Health and Social Action, Dakar (A. Lampros, B. Diop)
- World Health Organization, Dakar (A. Lampros, I. Oumar)
| | - Maryam Diarra
- Hôpital Européen Georges Pompidou, Paris, France (A. Lampros)
- Institut Pasteur de Dakar, Dakar, Senegal (A. Lampros, C. Talla, M. Diarra, B. Tall, S. Sagne, M. Korka Diallo, N. Dia, A.A. Sall, M.A. Barry, C. Loucoubar)
- Government of Senegal Ministry of Health and Social Action, Dakar (A. Lampros, B. Diop)
- World Health Organization, Dakar (A. Lampros, I. Oumar)
| | - Billo Tall
- Hôpital Européen Georges Pompidou, Paris, France (A. Lampros)
- Institut Pasteur de Dakar, Dakar, Senegal (A. Lampros, C. Talla, M. Diarra, B. Tall, S. Sagne, M. Korka Diallo, N. Dia, A.A. Sall, M.A. Barry, C. Loucoubar)
- Government of Senegal Ministry of Health and Social Action, Dakar (A. Lampros, B. Diop)
- World Health Organization, Dakar (A. Lampros, I. Oumar)
| | - Samba Sagne
- Hôpital Européen Georges Pompidou, Paris, France (A. Lampros)
- Institut Pasteur de Dakar, Dakar, Senegal (A. Lampros, C. Talla, M. Diarra, B. Tall, S. Sagne, M. Korka Diallo, N. Dia, A.A. Sall, M.A. Barry, C. Loucoubar)
- Government of Senegal Ministry of Health and Social Action, Dakar (A. Lampros, B. Diop)
- World Health Organization, Dakar (A. Lampros, I. Oumar)
| | - Mamadou Korka Diallo
- Hôpital Européen Georges Pompidou, Paris, France (A. Lampros)
- Institut Pasteur de Dakar, Dakar, Senegal (A. Lampros, C. Talla, M. Diarra, B. Tall, S. Sagne, M. Korka Diallo, N. Dia, A.A. Sall, M.A. Barry, C. Loucoubar)
- Government of Senegal Ministry of Health and Social Action, Dakar (A. Lampros, B. Diop)
- World Health Organization, Dakar (A. Lampros, I. Oumar)
| | - Boly Diop
- Hôpital Européen Georges Pompidou, Paris, France (A. Lampros)
- Institut Pasteur de Dakar, Dakar, Senegal (A. Lampros, C. Talla, M. Diarra, B. Tall, S. Sagne, M. Korka Diallo, N. Dia, A.A. Sall, M.A. Barry, C. Loucoubar)
- Government of Senegal Ministry of Health and Social Action, Dakar (A. Lampros, B. Diop)
- World Health Organization, Dakar (A. Lampros, I. Oumar)
| | - Ibrahim Oumar
- Hôpital Européen Georges Pompidou, Paris, France (A. Lampros)
- Institut Pasteur de Dakar, Dakar, Senegal (A. Lampros, C. Talla, M. Diarra, B. Tall, S. Sagne, M. Korka Diallo, N. Dia, A.A. Sall, M.A. Barry, C. Loucoubar)
- Government of Senegal Ministry of Health and Social Action, Dakar (A. Lampros, B. Diop)
- World Health Organization, Dakar (A. Lampros, I. Oumar)
| | - Ndongo Dia
- Hôpital Européen Georges Pompidou, Paris, France (A. Lampros)
- Institut Pasteur de Dakar, Dakar, Senegal (A. Lampros, C. Talla, M. Diarra, B. Tall, S. Sagne, M. Korka Diallo, N. Dia, A.A. Sall, M.A. Barry, C. Loucoubar)
- Government of Senegal Ministry of Health and Social Action, Dakar (A. Lampros, B. Diop)
- World Health Organization, Dakar (A. Lampros, I. Oumar)
| | - Amadou Alpha Sall
- Hôpital Européen Georges Pompidou, Paris, France (A. Lampros)
- Institut Pasteur de Dakar, Dakar, Senegal (A. Lampros, C. Talla, M. Diarra, B. Tall, S. Sagne, M. Korka Diallo, N. Dia, A.A. Sall, M.A. Barry, C. Loucoubar)
- Government of Senegal Ministry of Health and Social Action, Dakar (A. Lampros, B. Diop)
- World Health Organization, Dakar (A. Lampros, I. Oumar)
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Zhang L, Xiao Y, Xiang Z, Chen L, Wang Y, Wang X, Dong X, Ren L, Wang J. Statistical Analysis of Common Respiratory Viruses Reveals the Binary of Virus-Virus Interaction. Microbiol Spectr 2023; 11:e0001923. [PMID: 37378522 PMCID: PMC10433823 DOI: 10.1128/spectrum.00019-23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2023] [Accepted: 06/09/2023] [Indexed: 06/29/2023] Open
Abstract
Respiratory viruses may interfere with each other and affect the epidemic trend of the virus. However, the understanding of the interactions between respiratory viruses at the population level is still very limited. We here conducted a prospective laboratory-based etiological study by enrolling 14,426 patients suffered from acute respiratory infection (ARI) in Beijing, China during 2005 to 2015. All 18 respiratory viruses were simultaneously tested for each nasal and throat swabs collected from enrolled patients using molecular tests. The virus correlations were quantitatively evaluated, and the respiratory viruses could be divided into two panels according to the positive and negative correlations. One included influenza viruses (IFVs) A, B, and respiratory syncytial virus (RSV), while the other included human parainfluenza viruses (HPIVs) 1/3, 2/4, adenovirus (Adv), human metapneumovirus (hMPV), and enterovirus (including rhinovirus, named picoRNA), α and β human coronaviruses (HCoVs). The viruses were positive-correlated in each panel, while negative-correlated between panels. After adjusting the confounding factors by vector autoregressive model, positive interaction between IFV-A and RSV and negative interaction between IFV-A and picoRNA are still be observed. The asynchronous interference of IFV-A significantly delayed the peak of β human coronaviruses epidemic. The binary property of the respiratory virus interactions provides new insights into the viral epidemic dynamics in human population, facilitating the development of infectious disease control and prevention strategies. IMPORTANCE Systematic quantitative assessment of the interactions between different respiratory viruses is pivotal for the prevention of infectious diseases and the development of vaccine strategies. Our data showed stable interactions among respiratory viruses at human population level, which are season irrelevant. Respiratory viruses could be divided into two panels according to their positive and negative correlations. One included influenza virus and respiratory syncytial virus, while the other included other common respiratory viruses. It showed negative correlations between the two panels. The asynchronous interference between influenza virus and β human coronaviruses significantly delayed the peak of β human coronaviruses epidemic. The binary property of the viruses indicated transient immunity induced by one kind of virus would play role on subsequent infection, which provides important data for the development of epidemic surveillance strategies.
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Affiliation(s)
- Lulu Zhang
- Institute of Pathogen Biology, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, People’s Republic of China
| | - Yan Xiao
- Institute of Pathogen Biology, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, People’s Republic of China
- Key Laboratory of Respiratory Disease Pathogenomics, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, People’s Republic of China
| | - Zichun Xiang
- Institute of Pathogen Biology, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, People’s Republic of China
| | - Lan Chen
- Institute of Pathogen Biology, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, People’s Republic of China
| | - Ying Wang
- Institute of Pathogen Biology, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, People’s Republic of China
| | - Xinming Wang
- Institute of Pathogen Biology, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, People’s Republic of China
| | - Xiaojing Dong
- Santa Clara University, Santa Clara, California, USA
| | - Lili Ren
- Institute of Pathogen Biology, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, People’s Republic of China
- Key Laboratory of Respiratory Disease Pathogenomics, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, People’s Republic of China
| | - Jianwei Wang
- Institute of Pathogen Biology, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, People’s Republic of China
- Key Laboratory of Respiratory Disease Pathogenomics, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, People’s Republic of China
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Cao R, Du Y, Tong J, Xia D, Song Q, Xia Z, Liu M, Du H, Han J, Gao C. Influence of COVID-19 pandemic on the virus spectrum in children with respiratory infection in Xuzhou, China: a long-term active surveillance study from 2015 to 2021. BMC Infect Dis 2023; 23:467. [PMID: 37442963 DOI: 10.1186/s12879-023-08247-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2023] [Accepted: 04/12/2023] [Indexed: 07/15/2023] Open
Abstract
BACKGROUND To investigate the impact of the coronavirus disease 2019 (COVID-19) outbreak on the prevalence of respiratory viruses among pediatric patients with acute respiratory infections in Xuzhou from 2015-2021. METHODS Severe acute respiratory infection (SARI) cases in hospitalized children were collected from 2015-2021 in Xuzhou, China. Influenza virus(IFV), respiratory syncytial virus (RSV), human parainfluenza virus type 3(hPIV-3), human rhinovirus (hRV), human adenovirus(hAdV), human coronavirus(hCoV) were detected by real-time fluorescence polymerase chain reaction(RT-qPCR), and the results were statistically analyzed by SPSS 23.0 software. RESULTS A total of 1663 samples with SARI were collected from 2015-2021, with a male-to-female ratio of 1.67:1 and a total virus detection rate of 38.5% (641/1663). The total detection rate of respiratory viruses decreased from 46.2% (2015-2019) to 36% (2020-2021) under the control measures for COVID-19 (P < 0.01). The three viruses with the highest detection rates changed from hRV, RSV, and hPIV-3 to hRV, RSV, and hCoV. The epidemic trend of hPIV-3 and hAdV was upside down before and after control measures(P < 0.01); however, the epidemic trend of RV and RSV had not changed from 2015 to 2021(P > 0.05). After the control measures, the detection rate of hPIV-3 decreased in all age groups, and the detection rate of hCoV increased in all except the 1 ~ 3 years old group. CONCLUSIONS Implementing control measures for COVID-19 outbreak curbed the spread of respiratory viruses among children as a whole. However, the epidemic of RV and RSV was not affected by the COVID-19 control policy.
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Affiliation(s)
- Rundong Cao
- Center for Viral Resource, Chinese Center for Disease Control and Prevention, National Institute for Viral Disease Control and Prevention, Beijing, 102206, China
| | - Yangguang Du
- Xuzhou Center for Disease Control and Prevention, Xuzhou, 221002, China
| | - Jing Tong
- Xuzhou Center for Disease Control and Prevention, Xuzhou, 221002, China
| | - Dong Xia
- Center for Viral Resource, Chinese Center for Disease Control and Prevention, National Institute for Viral Disease Control and Prevention, Beijing, 102206, China
| | - Qinqin Song
- Center for Viral Resource, Chinese Center for Disease Control and Prevention, National Institute for Viral Disease Control and Prevention, Beijing, 102206, China
| | - Zhiqiang Xia
- Center for Viral Resource, Chinese Center for Disease Control and Prevention, National Institute for Viral Disease Control and Prevention, Beijing, 102206, China
| | - Mi Liu
- Center for Viral Resource, Chinese Center for Disease Control and Prevention, National Institute for Viral Disease Control and Prevention, Beijing, 102206, China
| | - Haijun Du
- Center for Viral Resource, Chinese Center for Disease Control and Prevention, National Institute for Viral Disease Control and Prevention, Beijing, 102206, China
| | - Jun Han
- Center for Viral Resource, Chinese Center for Disease Control and Prevention, National Institute for Viral Disease Control and Prevention, Beijing, 102206, China.
| | - Chen Gao
- Center for Viral Resource, Chinese Center for Disease Control and Prevention, National Institute for Viral Disease Control and Prevention, Beijing, 102206, China.
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Yingchoncharoen P, Thongpiya J, Saowapa S, Abdelnabi M, Vinan-Vega M, Nugent K. Severe Acute Respiratory Distress Syndrome Secondary to Concomitant Influenza A and Rhinovirus Infection Complicated by Methicillin-resistant Staphylococcus aureus Pneumonia in an Early Pregnancy Patient With Vaping-induced Lung Injury. J Community Hosp Intern Med Perspect 2023; 13:91-96. [PMID: 37868245 PMCID: PMC10589014 DOI: 10.55729/2000-9666.1213] [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] [Received: 01/08/2023] [Revised: 04/20/2023] [Accepted: 04/26/2023] [Indexed: 10/24/2023] Open
Abstract
Acute respiratory distress syndrome (ARDS) is a life-threatening lung injury characterized by rapid onset of widespread inflammation in the lungs. Multiple risk factors, including pneumonia, non-pulmonary sepsis, aspiration of gastric contents or inhalation injury, have been reported, to cause ARDS. We present a case of a healthy young woman in her first trimester with vaping-induced lung injury who presented with spontaneous pneumothorax and acute respiratory distress syndrome with concomitant influenza A and rhinovirus infection followed by methicillin-resistant Staphylococcus aureus pneumonia.
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Affiliation(s)
| | - Jerapas Thongpiya
- Department of Internal Medicine, Texas Tech University Health Sciences Center, Lubbock, TX,
USA
| | - Sakditad Saowapa
- Department of Internal Medicine, Texas Tech University Health Sciences Center, Lubbock, TX,
USA
| | - Mahmoud Abdelnabi
- Department of Internal Medicine, Texas Tech University Health Sciences Center, Lubbock, TX,
USA
| | - Myrian Vinan-Vega
- Department of Internal Medicine, Texas Tech University Health Sciences Center, Lubbock, TX,
USA
| | - Kenneth Nugent
- Department of Internal Medicine, Texas Tech University Health Sciences Center, Lubbock, TX,
USA
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42
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Edderdouri K, Kabbaj H, Laamara L, Lahmouddi N, Lamdarsi O, Zouaki A, El Amin G, Zirar J, Seffar M. Contribution of the FilmArray BioFire® Technology in the Diagnosis of Viral Respiratory Infections during the COVID-19 Pandemic at Ibn Sina University Hospital Center in Rabat: Epidemiological Study about 503 Cases. Adv Virol 2023; 2023:2679770. [PMID: 37384256 PMCID: PMC10299880 DOI: 10.1155/2023/2679770] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2023] [Revised: 05/09/2023] [Accepted: 06/08/2023] [Indexed: 06/30/2023] Open
Abstract
Respiratory viruses are the most involved pathogens in acute respiratory infections. During the COVID-19 pandemic, new elements have been brought to this topic, especially at the diagnostic and therapeutic level. The objective of this work is to describe the epidemiology of respiratory viruses in patients admitted to the Ibn Sina University Hospital of Rabat during a period characterized by the emergence and spread of SARS-CoV-2. We conducted a retrospective study from January 1 to December 31. We included all patients treated for acute respiratory infection and for whom a multiplex respiratory panel PCR was requested. Virus detection was performed using a FilmArray RP 2.1 plus BioFire multiplex respiratory panel. The study population was relatively adults with a mean age of 39 years. The sex ratio M/F was 1.20. The survey revealed a high prevalence of 42.3% of patients hospitalized in the adult intensive care unit whose respiratory distress was the most common reason for hospitalization (58%). The positivity rate was 48.1%. This rate was higher in the pediatric population 83.13% compared to adults 29.7%. Monoinfection was found in 36.4% of cases, and codetection in 11.7% of cases. This survey revealed that a total of 322 viruses were detected, HRV being the most incriminated virus (48.7%), followed by RSV in 13.8% of patients. Considering the five most detected viruses in our study (HRV, RSV, PIV3, ADV, and hMPV), we found that the incidence was significantly higher in the pediatric population. SARS-CoV-2 was detected only in adult's population. In our study, we found that influenza A and B viruses, PIV2, MERS, and all bacteria were not detected by this kit during the study period. Regarding the seasonal distribution, RSV and hMPV showed a significantly high incidence during autumn and summer and SARS-CoV-2 and CoV OC43 showed a high peak during winter. In this study, we found a lack of detection of influenza virus and a shift in the usual winter peak of RSV to the summer, while the detection of ADV and HRV was less affected. This difference in detection could be due on the one hand to the difference in stability between enveloped and nonenveloped viruses and on the other hand to the escape of certain viruses to the different sanitary measures introduced after the declaration of the COVID-19 pandemic. These same measures were effective against enveloped viruses such as RSV and influenza viruses. The emergence of SARS-CoV-2 has modified the epidemiology of other respiratory viruses, either directly by viral interference or indirectly by the preventive measures taken.
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Affiliation(s)
- Khalid Edderdouri
- Mohamed V University, Faculty of Medicine and Pharmacy, Rabat, Morocco
- Ibn Sina University Hospital Center, Central Laboratory of Virology, Rabat, Morocco
| | - Hakima Kabbaj
- Mohamed V University, Faculty of Medicine and Pharmacy, Rabat, Morocco
- Ibn Sina University Hospital Center, Central Laboratory of Virology, Rabat, Morocco
| | - Leila Laamara
- Mohamed V University, Faculty of Medicine and Pharmacy, Rabat, Morocco
- Ibn Sina University Hospital Center, Central Laboratory of Virology, Rabat, Morocco
| | - Noureddine Lahmouddi
- Mohamed V University, Faculty of Medicine and Pharmacy, Rabat, Morocco
- Ibn Sina University Hospital Center, Central Laboratory of Virology, Rabat, Morocco
| | - Oumayma Lamdarsi
- Mohamed V University, Faculty of Medicine and Pharmacy, Rabat, Morocco
- Ibn Sina University Hospital Center, Central Laboratory of Virology, Rabat, Morocco
| | - Amal Zouaki
- Mohamed V University, Faculty of Medicine and Pharmacy, Rabat, Morocco
- Ibn Sina University Hospital Center, Central Laboratory of Virology, Rabat, Morocco
| | - Ghizlane El Amin
- Mohamed V University, Faculty of Medicine and Pharmacy, Rabat, Morocco
- Ibn Sina University Hospital Center, Central Laboratory of Virology, Rabat, Morocco
| | - Jalila Zirar
- Mohamed V University, Faculty of Medicine and Pharmacy, Rabat, Morocco
- Ibn Sina University Hospital Center, Central Laboratory of Virology, Rabat, Morocco
| | - Myriam Seffar
- Mohamed V University, Faculty of Medicine and Pharmacy, Rabat, Morocco
- Ibn Sina University Hospital Center, Central Laboratory of Virology, Rabat, Morocco
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Camporesi A, Morello R, Pierucci UM, Proli F, Lazzareschi I, Bersani G, Valentini P, Roland D, Buonsenso D. 2021/22 and 2022/23 Post-Pandemic Bronchiolitis Seasons in Two Major Italian Cities: A Prospective Study. CHILDREN (BASEL, SWITZERLAND) 2023; 10:1081. [PMID: 37371312 DOI: 10.3390/children10061081] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/04/2023] [Revised: 06/14/2023] [Accepted: 06/16/2023] [Indexed: 06/29/2023]
Abstract
Objectives: Bronchiolitis remains a major cause of morbidity and mortality in children under 24 months. During the first year of the pandemic, non-pharmacological interventions resulted in a significant reduction of bronchiolitis cases. Early in 2021, a rebound of bronchiolitis was reported with a description of out-of-season outbreaks. In this study, we prospectively evaluated the impact of bronchiolitis in two Italian University centers located in different geographical areas, aiming to compare two post-pandemic bronchiolitis seasons (2021/22 and 2022/23) in terms of severity, outcomes, microbiology and temporal distribution. Methods: This was a bicentric prospective observational cohort study. All consecutive children under 24 months of age assessed in the participating institutions during the specified seasons and receiving a clinical diagnosis of bronchiolitis were included. Results: A total of 900 patients were enrolled. Patients in the second season were globally younger and had comorbidities less often. Temporal distribution changed between the two seasons. Of the patients, 56% were tested for RSV; 60% of these was positive. Patients with RSV were globally younger (3.5 months vs. 4.9, p < 0.001), more often had a need for any kind of respiratory and fluid support and more often needed ward or PICU admission. At the end of the ED visit, 430 patients were discharged home, 372 (41.3%) were admitted to an inpatient ward and 46 (5.1%) to a pediatric intensive care unit. Conclusions: The 2022/23 post-COVID bronchiolitis was mostly similar to that of 2021/22, and was in line with pre-pandemic expectations.
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Affiliation(s)
- Anna Camporesi
- Department of Pediatric Anesthesia and Intensive Care, Children's Hospital "Vittore Buzzi", Via Ludovico Castelvetro 32, 20154 Milano, Italy
| | - Rosa Morello
- Department of Woman and Child Health and Public Health, Fondazione Policlinico Universitario A. Gemelli IRCCS, 00168 Rome, Italy
| | - Ugo Maria Pierucci
- Department of Pediatric Surgery, Children's Hospital "Vittore Buzzi", 20154 Milano, Italy
| | - Francesco Proli
- Department of Woman and Child Health and Public Health, Fondazione Policlinico Universitario A. Gemelli IRCCS, 00168 Rome, Italy
| | - Ilaria Lazzareschi
- Department of Woman and Child Health and Public Health, Fondazione Policlinico Universitario A. Gemelli IRCCS, 00168 Rome, Italy
| | - Giulia Bersani
- Department of Woman and Child Health and Public Health, Fondazione Policlinico Universitario A. Gemelli IRCCS, 00168 Rome, Italy
| | - Piero Valentini
- Department of Woman and Child Health and Public Health, Fondazione Policlinico Universitario A. Gemelli IRCCS, 00168 Rome, Italy
| | - Damian Roland
- Paediatric Emergency Medicine Leicester Academic (PEMLA) Group, Leicester Hospital, Leicester LE1 5WW, UK
- Social Science APPlied to Healthcare Improvement Research, SAPPHIRE Group, Health Sciences, Leicester University, Leicester LE1 7RH, UK
| | - Danilo Buonsenso
- Department of Woman and Child Health and Public Health, Fondazione Policlinico Universitario A. Gemelli IRCCS, 00168 Rome, Italy
- Center for Global Health Research Studies, Università Cattolica del Sacro Cuore, 00168 Rome, Italy
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Fahim M, Abu ElSood H, AbdElGawad B, Deghedy O, Naguib A, Roshdy WH, Showky S, Kamel R, Elguindy N, Abdel Fattah M, Afifi S, Kandeel A, Abdelghaffar K. Adapting an integrated acute respiratory infections sentinel surveillance to the COVID-19 pandemic requirements, Egypt, 2020-2022. PUBLIC HEALTH IN PRACTICE 2023; 5:100358. [PMID: 36686982 PMCID: PMC9846875 DOI: 10.1016/j.puhip.2023.100358] [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] [Received: 08/06/2022] [Revised: 12/14/2022] [Accepted: 01/12/2023] [Indexed: 01/19/2023] Open
Abstract
Objectives In Egypt, an integrated surveillance for acute respiratory infections (ARIs) was established in 2016 to identify the causes of ARIs. The surveillance system includes 19 governmental hospitals. In response to the coronavirus disease 2019 (COVID-19) pandemic, the World Health Organisation (WHO) requested surveillance adaptation to address the emerging challenges. This study aims to describe the experience in Egypt of adapting ARI surveillance to the COVID-19 pandemic. Methods WHO case definitions were used to identify patients with ARIs. Nasopharyngeal/oropharyngeal swabs were collected for SARS-CoV-2 and influenza testing. Demographic and clinical information were obtained by interviewing patients at the hospitals. During the COVID-19 pandemic, the first two outpatients daily and every fifth admitted patient were enrolled in the study. To determine the status of ARIs in Egypt during the pandemic, patient demographic, clinical and laboratory data from 2020 to 2022 were obtained and descriptive analyses were performed. Results Overall, 18,160 patients were enrolled in the study, including 7923 (43.6%) seen at outpatient clinics and 10,237 (56.4%) inpatients. Of the study participants, 6453 (35.5%) tested positive for ARIs, including 5620 (87.1%) for SARS-CoV-2, 781 (12.1%) for influenza and 52 (0.8%) for SARS-CoV-2/influenza coinfection. SARS-CoV-2 was the cause for 95.3% of admitted patients and 65.4% of outpatients. Influenza subtypes included A/H3 (55.7%), Influenza-B (29.1%) and H1/pdm09 (14.2%). Compared with influenza, SARS-CoV-2 tended to infect the elderly, in warm weather and in urban governorates, and resulted in more hospitalisations, longer hospital stays and higher case fatalities (16.3% vs 6.6%, p < 0.001). Conclusions ARI surveillance in Egypt was successfully adapted to the COVID-19 pandemic and effectively described the clinical characteristics and severity of circulating viruses. Surveillance reported the re-emergence of influenza with a severe course and high fatality. Surveillance is essential for monitoring the activity of respiratory viruses with the aim of guiding clinical management, including preventative and control measures.
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Affiliation(s)
- Manal Fahim
- Department of Epidemiology and Surveillance, Preventive Sector, Ministry of Health and Population, 3 Magles ElShaab Street, Kasr Alainy, Cairo, Egypt
| | - Hanaa Abu ElSood
- Department of Epidemiology and Surveillance, Preventive Sector, Ministry of Health and Population, 3 Magles ElShaab Street, Kasr Alainy, Cairo, Egypt
| | - Basma AbdElGawad
- Department of Epidemiology and Surveillance, Preventive Sector, Ministry of Health and Population, 3 Magles ElShaab Street, Kasr Alainy, Cairo, Egypt
| | - Ola Deghedy
- Department of Epidemiology and Surveillance, Preventive Sector, Ministry of Health and Population, 3 Magles ElShaab Street, Kasr Alainy, Cairo, Egypt
| | - Amel Naguib
- Central Public Health Laboratory, Ministry of Health and Population, Elsheikh Rehan Street, Cairo, Egypt
| | - Wael H. Roshdy
- Central Public Health Laboratory, Ministry of Health and Population, Elsheikh Rehan Street, Cairo, Egypt
| | - Shymaa Showky
- Central Public Health Laboratory, Ministry of Health and Population, Elsheikh Rehan Street, Cairo, Egypt
| | - Reham Kamel
- Department of Epidemiology and Surveillance, Preventive Sector, Ministry of Health and Population, 3 Magles ElShaab Street, Kasr Alainy, Cairo, Egypt
| | - Nancy Elguindy
- Central Public Health Laboratory, Ministry of Health and Population, Elsheikh Rehan Street, Cairo, Egypt
| | - Mohammad Abdel Fattah
- Preventive Sector, Ministry of Health and Population, 3 Magles ElShaab Street, Kasr Alainy, Cairo, Egypt
| | - Salma Afifi
- Ministry of Health and Population Consultant, 3 Magles ElShaab Street, Kasr Alainy, Cairo, Egypt
| | - Amr Kandeel
- Preventive Sector, Ministry of Health and Population, 3 Magles ElShaab Street, Kasr Alainy, Cairo, Egypt
| | - Khaled Abdelghaffar
- Ministry of Health and Population, 3 Magles ElShaab Street, Kasr Alainy, Cairo, Egypt
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Pinky L, DeAguero JR, Remien CH, Smith AM. How Interactions during Viral-Viral Coinfection Can Shape Infection Kinetics. Viruses 2023; 15:1303. [PMID: 37376603 PMCID: PMC10301061 DOI: 10.3390/v15061303] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2023] [Revised: 05/29/2023] [Accepted: 05/30/2023] [Indexed: 06/29/2023] Open
Abstract
Respiratory viral infections are a leading global cause of disease with multiple viruses detected in 20-30% of cases, and several viruses simultaneously circulating. Some infections with unique viral copathogens result in reduced pathogenicity, while other viral pairings can worsen disease. The mechanisms driving these dichotomous outcomes are likely variable and have only begun to be examined in the laboratory and clinic. To better understand viral-viral coinfections and predict potential mechanisms that result in distinct disease outcomes, we first systematically fit mathematical models to viral load data from ferrets infected with respiratory syncytial virus (RSV), followed by influenza A virus (IAV) after 3 days. The results suggest that IAV reduced the rate of RSV production, while RSV reduced the rate of IAV infected cell clearance. We then explored the realm of possible dynamics for scenarios that had not been examined experimentally, including a different infection order, coinfection timing, interaction mechanisms, and viral pairings. IAV coinfection with rhinovirus (RV) or SARS-CoV-2 (CoV2) was examined by using human viral load data from single infections together with murine weight-loss data from IAV-RV, RV-IAV, and IAV-CoV2 coinfections to guide the interpretation of the model results. Similar to the results with RSV-IAV coinfection, this analysis shows that the increased disease severity observed during murine IAV-RV or IAV-CoV2 coinfection was likely due to the slower clearance of IAV-infected cells by the other viruses. The improved outcome when IAV followed RV, on the other hand, could be replicated when the rate of RV infected cell clearance was reduced by IAV. Simulating viral-viral coinfections in this way provides new insights about how viral-viral interactions can regulate disease severity during coinfection and yields testable hypotheses ripe for experimental evaluation.
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Affiliation(s)
- Lubna Pinky
- Department of Pediatrics, University of Tennessee Health Science Center, Memphis, TN 38163, USA
| | - Joseph R. DeAguero
- Bioinformatics and Computational Biology Program, University of Idaho, Moscow, ID 83844, USA
| | - Christopher H. Remien
- Department of Mathematics and Statistical Science, University of Idaho, Moscow, ID 83844, USA
| | - Amber M. Smith
- Department of Pediatrics, University of Tennessee Health Science Center, Memphis, TN 38163, USA
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Ong HH, Liu J, Oo Y, Thong M, Wang DY, Chow VT. Prolonged Primary Rhinovirus Infection of Human Nasal Epithelial Cells Diminishes the Viral Load of Secondary Influenza H3N2 Infection via the Antiviral State Mediated by RIG-I and Interferon-Stimulated Genes. Cells 2023; 12:cells12081152. [PMID: 37190061 DOI: 10.3390/cells12081152] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2022] [Revised: 03/23/2023] [Accepted: 03/30/2023] [Indexed: 05/17/2023] Open
Abstract
Our previous study revealed that prolonged human rhinovirus (HRV) infection rapidly induces antiviral interferons (IFNs) and chemokines during the acute stage of infection. It also showed that expression levels of RIG-I and interferon-stimulated genes (ISGs) were sustained in tandem with the persistent expression of HRV RNA and HRV proteins at the late stage of the 14-day infection period. Some studies have explored the protective effects of initial acute HRV infection on secondary influenza A virus (IAV) infection. However, the susceptibility of human nasal epithelial cells (hNECs) to re-infection by the same HRV serotype, and to secondary IAV infection following prolonged primary HRV infection, has not been studied in detail. Therefore, the aim of this study was to investigate the effects and underlying mechanisms of HRV persistence on the susceptibility of hNECs against HRV re-infection and secondary IAV infection. We analyzed the viral replication and innate immune responses of hNECs infected with the same HRV serotype A16 and IAV H3N2 at 14 days after initial HRV-A16 infection. Prolonged primary HRV infection significantly diminished the IAV load of secondary H3N2 infection, but not the HRV load of HRV-A16 re-infection. The reduced IAV load of secondary H3N2 infection may be explained by increased baseline expression levels of RIG-I and ISGs, specifically MX1 and IFITM1, which are induced by prolonged primary HRV infection. As is congruent with this finding, in those cells that received early and multi-dose pre-treatment with Rupintrivir (HRV 3C protease inhibitor) prior to secondary IAV infection, the reduction in IAV load was abolished compared to the group without pre-treatment with Rupintrivir. In conclusion, the antiviral state induced from prolonged primary HRV infection mediated by RIG-I and ISGs (including MX1 and IFITM1) can confer a protective innate immune defense mechanism against secondary influenza infection.
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Affiliation(s)
- Hsiao Hui Ong
- Department of Otolaryngology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore 117545, Singapore
- Infectious Diseases Translational Research Program, Yong Loo Lin School of Medicine, National University of Singapore, Singapore 117545, Singapore
| | - Jing Liu
- Department of Otolaryngology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore 117545, Singapore
- Infectious Diseases Translational Research Program, Yong Loo Lin School of Medicine, National University of Singapore, Singapore 117545, Singapore
| | - Yukei Oo
- Infectious Diseases Translational Research Program, Yong Loo Lin School of Medicine, National University of Singapore, Singapore 117545, Singapore
| | - Mark Thong
- Department of Otolaryngology-Head & Neck Surgery, National University Health System, Singapore 119228, Singapore
| | - De Yun Wang
- Department of Otolaryngology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore 117545, Singapore
- Infectious Diseases Translational Research Program, Yong Loo Lin School of Medicine, National University of Singapore, Singapore 117545, Singapore
| | - Vincent T Chow
- Infectious Diseases Translational Research Program, Yong Loo Lin School of Medicine, National University of Singapore, Singapore 117545, Singapore
- Department of Microbiology and Immunology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore 117545, Singapore
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Pinky L, DeAguero JR, Remien CH, Smith AM. How Interactions During Viral-Viral Coinfection Can Shape Infection Kinetics. BIORXIV : THE PREPRINT SERVER FOR BIOLOGY 2023:2023.04.05.535744. [PMID: 37066297 PMCID: PMC10104040 DOI: 10.1101/2023.04.05.535744] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 04/18/2023]
Abstract
Respiratory virus infections are a leading cause of disease worldwide with multiple viruses detected in 20-30% of cases and several viruses simultaneously circulating. Some infections with viral copathogens have been shown to result in reduced pathogenicity while other virus pairings can worsen disease. The mechanisms driving these dichotomous outcomes are likely variable and have only begun to be examined in the laboratory and clinic. To better understand viral-viral coinfections and predict potential mechanisms that result in distinct disease outcomes, we first systematically fit mathematical models to viral load data from ferrets infected with respiratory syncytial virus (RSV) followed by influenza A virus (IAV) after 3 days. The results suggested that IAV reduced the rate of RSV production while RSV reduced the rate of IAV infected cell clearance. We then explored the realm of possible dynamics for scenarios not examined experimentally, including different infection order, coinfection timing, interaction mechanisms, and viral pairings. IAV coinfection with rhinovirus (RV) or SARS-CoV-2 (CoV2) was examined by using human viral load data from single infections together with murine weight loss data from IAV-RV, RV-IAV, and IAV-CoV2 coinfections to guide the interpretation of the model results. Similar to the results with RSV-IAV coinfection, this analysis showed that the increased disease severity observed during murine IAV-RV or IAV-CoV2 coinfection was likely due to slower clearance of IAV infected cells by the other viruses. On the contrary, the improved outcome when IAV followed RV could be replicated when the rate of RV infected cell clearance was reduced by IAV. Simulating viral-viral coinfections in this way provides new insights about how viral-viral interactions can regulate disease severity during coinfection and yields testable hypotheses ripe for experimental evaluation.
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48
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Jarju S, Senghore E, Brotherton H, Affleck L, Saidykhan A, Jallow S, Krubally E, Sinjanka E, Ndene MN, Bajo F, Sanyang MM, Saidy B, Bah A, Mohammed NI, Forrest K, Clarke E, Dalessandro U, Sesay AK, Usuf E, Cerami C, Roca A, Kampmann B, de Silva TI. Circulation of respiratory viruses during the COVID-19 pandemic in The Gambia. Gates Open Res 2023; 6:148. [PMID: 36726685 PMCID: PMC9883272 DOI: 10.12688/gatesopenres.14155.3] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/23/2023] [Indexed: 03/29/2023] Open
Abstract
Background: In many countries, non-pharmaceutical interventions to limit severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) transmission resulted in significant reductions in other respiratory viruses. However, similar data from Africa are limited. We explored the extent to which viruses such as influenza and rhinovirus co-circulated with SARS-CoV-2 in The Gambia during the COVID-19 pandemic. Methods: Between April 2020 and March 2022, respiratory viruses were detected using RT-PCR in nasopharyngeal swabs from 1397 participants with influenza-like illness. An assay to detect SARS-CoV-2 and a viral multiplex RT-PCR assay was used as previously described to detect influenza A and B, respiratory syncytial virus (RSV) A and B, parainfluenza viruses 1-4, human metapneumovirus (HMPV), adenovirus, seasonal coronaviruses (229E, OC43, NL63) and human rhinovirus. Results: Overall virus positivity was 44.2%, with prevalence higher in children <5 years (80%) compared to children aged 5-17 years (53.1%), adults aged 18-50 (39.5%) and >50 years (39.9%), p<0.0001. After SARS-CoV-2 (18.3%), rhinoviruses (10.5%) and influenza viruses (5.5%) were the most prevalent. SARS-CoV-2 positivity was lower in children <5 (4.3%) and 5-17 years (12.7%) than in adults aged 18-50 (19.3%) and >50 years (24.3%), p<0.0001. In contrast, rhinoviruses were most prevalent in children <5 years (28.7%), followed by children aged 5-17 (15.8%), adults aged 18-50 (8.3%) and >50 years (6.3%), p<0.0001. Four SARS-CoV-2 waves occurred, with 36.1%-52.4% SARS-CoV-2 positivity during peak months. Influenza infections were observed in both 2020 and 2021 during the rainy season as expected (peak positivity 16.4%-23.5%). Peaks of rhinovirus were asynchronous to the months when SARS-CoV-2 and influenza peaked. Conclusion: Our data show that many respiratory viruses continued to circulate during the COVID-19 pandemic in The Gambia, including human rhinoviruses, despite the presence of NPIs during the early stages of the pandemic, and influenza peaks during expected months.
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Affiliation(s)
- Sheikh Jarju
- Medical Research Council Unit The Gambia at the London School of Hygiene and Tropical Medicine, Fajara, P.O.BOX 273, The Gambia
| | - Elina Senghore
- Medical Research Council Unit The Gambia at the London School of Hygiene and Tropical Medicine, Fajara, P.O.BOX 273, The Gambia
| | - Helen Brotherton
- Medical Research Council Unit The Gambia at the London School of Hygiene and Tropical Medicine, Fajara, P.O.BOX 273, The Gambia
| | - Lucy Affleck
- Medical Research Council Unit The Gambia at the London School of Hygiene and Tropical Medicine, Fajara, P.O.BOX 273, The Gambia
| | - Alasana Saidykhan
- Medical Research Council Unit The Gambia at the London School of Hygiene and Tropical Medicine, Fajara, P.O.BOX 273, The Gambia
| | - Samba Jallow
- Medical Research Council Unit The Gambia at the London School of Hygiene and Tropical Medicine, Fajara, P.O.BOX 273, The Gambia
| | - Ebrima Krubally
- Medical Research Council Unit The Gambia at the London School of Hygiene and Tropical Medicine, Fajara, P.O.BOX 273, The Gambia
| | - Edrisa Sinjanka
- Medical Research Council Unit The Gambia at the London School of Hygiene and Tropical Medicine, Fajara, P.O.BOX 273, The Gambia
| | - Morris Ngor Ndene
- Medical Research Council Unit The Gambia at the London School of Hygiene and Tropical Medicine, Fajara, P.O.BOX 273, The Gambia
| | - Fabakary Bajo
- Medical Research Council Unit The Gambia at the London School of Hygiene and Tropical Medicine, Fajara, P.O.BOX 273, The Gambia
| | - Musa M Sanyang
- Medical Research Council Unit The Gambia at the London School of Hygiene and Tropical Medicine, Fajara, P.O.BOX 273, The Gambia
| | - Binta Saidy
- Medical Research Council Unit The Gambia at the London School of Hygiene and Tropical Medicine, Fajara, P.O.BOX 273, The Gambia
| | - Alasana Bah
- Medical Research Council Unit The Gambia at the London School of Hygiene and Tropical Medicine, Fajara, P.O.BOX 273, The Gambia
| | - Nuredin I Mohammed
- Medical Research Council Unit The Gambia at the London School of Hygiene and Tropical Medicine, Fajara, P.O.BOX 273, The Gambia
| | - Karen Forrest
- Medical Research Council Unit The Gambia at the London School of Hygiene and Tropical Medicine, Fajara, P.O.BOX 273, The Gambia
| | - Ed Clarke
- Medical Research Council Unit The Gambia at the London School of Hygiene and Tropical Medicine, Fajara, P.O.BOX 273, The Gambia
| | - Umberto Dalessandro
- Medical Research Council Unit The Gambia at the London School of Hygiene and Tropical Medicine, Fajara, P.O.BOX 273, The Gambia
| | - Abdul K Sesay
- Medical Research Council Unit The Gambia at the London School of Hygiene and Tropical Medicine, Fajara, P.O.BOX 273, The Gambia
| | - Effua Usuf
- Medical Research Council Unit The Gambia at the London School of Hygiene and Tropical Medicine, Fajara, P.O.BOX 273, The Gambia
| | - Carla Cerami
- Medical Research Council Unit The Gambia at the London School of Hygiene and Tropical Medicine, Fajara, P.O.BOX 273, The Gambia
| | - Anna Roca
- Medical Research Council Unit The Gambia at the London School of Hygiene and Tropical Medicine, Fajara, P.O.BOX 273, The Gambia
- Department of Infectious Disease Epidemiology, Faculty of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, London, WC1E 7HT, UK
| | - Beate Kampmann
- Medical Research Council Unit The Gambia at the London School of Hygiene and Tropical Medicine, Fajara, P.O.BOX 273, The Gambia
- The Vaccine Centre, Faculty of Infectious and Tropical Diseases, London School of Hygiene and Tropical Medicine, London, WC1E 7HT, UK
| | - Thushan I de Silva
- Medical Research Council Unit The Gambia at the London School of Hygiene and Tropical Medicine, Fajara, P.O.BOX 273, The Gambia
- The Vaccine Centre, Faculty of Infectious and Tropical Diseases, London School of Hygiene and Tropical Medicine, London, WC1E 7HT, UK
- 4. Department of Infection, Immunity and Cardiovascular Disease, The Medical School, The University of Sheffield, Beech Hill Road, Sheffield, S10 2RX, UK
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Chow EJ, Uyeki TM, Chu HY. The effects of the COVID-19 pandemic on community respiratory virus activity. Nat Rev Microbiol 2023; 21:195-210. [PMID: 36253478 PMCID: PMC9574826 DOI: 10.1038/s41579-022-00807-9] [Citation(s) in RCA: 106] [Impact Index Per Article: 106.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/13/2022] [Indexed: 01/14/2023]
Abstract
The emergence of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) caused substantial global morbidity and deaths, leading governments to turn to non-pharmaceutical interventions to slow down the spread of infection and lessen the burden on health care systems. These policies have evolved over the course of the COVID-19 pandemic, including after the availability of COVID-19 vaccines, with regional and country-level differences in their ongoing use. The COVID-19 pandemic has been associated with changes in respiratory virus infections worldwide, which have differed between virus types. Reductions in respiratory virus infections, including by influenza virus and respiratory syncytial virus, were most notable at the onset of the COVID-19 pandemic and continued in varying degrees through subsequent waves of SARS-CoV-2 infections. The decreases in community infection burden have resulted in reduced hospitalizations and deaths associated with non-SARS-CoV-2 respiratory infections. Respiratory virus evolution relies on the maintaining of a diverse genetic pool, but evidence of genetic bottlenecking brought on by case reduction during the COVID-19 pandemic has resulted in reduced genetic diversity of some respiratory viruses, including influenza virus. By describing the differences in these changes between viral species across different geographies over the course of the COVID-19 pandemic, we may better understand the complex factors involved in community co-circulation of respiratory viruses.
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Affiliation(s)
- Eric J Chow
- Division of Allergy and Infectious Diseases, Department of Medicine, University of Washington, Seattle, WA, USA
| | - Timothy M Uyeki
- Influenza Division, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Helen Y Chu
- Division of Allergy and Infectious Diseases, Department of Medicine, University of Washington, Seattle, WA, USA.
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Faraguna MC, Lepri I, Clavenna A, Bonati M, Vimercati C, Sala D, Cattoni A, Melzi ML, Biondi A. The bronchiolitis epidemic in 2021-2022 during the SARS-CoV-2 pandemic: experience of a third level centre in Northern Italy. Ital J Pediatr 2023; 49:26. [PMID: 36803828 PMCID: PMC9942300 DOI: 10.1186/s13052-023-01425-8] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/12/2022] [Accepted: 02/07/2023] [Indexed: 02/22/2023] Open
Abstract
BACKGROUND The aim of this study is to compare the 2021-2022 bronchiolitis season to the four previous years (2017-2018, 2018-2019, 2019-2020, 2020-2021) to see if there was an anticipation of the peak, an overall increase of cases, and an increased need of intensive care. METHODS A retrospective single-centre study in the San Gerardo Hospital Fondazione MBBM, Monza, Italy was performed. Emergency Departments (ED) visits of patients aged < 18 years and ≤ 12 months were analyzed: the incidence of bronchiolitis on total assessments, the urgency level at triage and the hospitalization rate were compared. Data of children admitted to the Pediatric Department due to bronchiolitis were analyzed in terms of need of intensive care, respiratory support (type and duration), length of hospital stay, main etiological agent, patient characteristics. RESULTS During 2020-2021 (first pandemic period) an important reduction in the ED attendance for bronchiolitis was observed, while in 2021-2022 there was an increase in incidence of bronchiolitis (13% of visits in infants < 1 year) and in the rate of urgent accesses (p = 0.0002), but hospitalization rates did not differ compared to previous years. Furthermore, an anticipated peak in November 2021 was observed. In the 2021-2022 cohort of admitted children to the Pediatric Department, a statistically significative increased need of intensive care unit was detected (Odds Ratio 3.1, 95% CI 1.4-6.8 after adjustment for severity and clinical characteristics). Instead, respiratory support (type and duration) and length of hospital stay did not differ. RSV was the main etiological agent and RSV-bronchiolitis determined a more severe infection (type and duration of breathing support, intensive care need and length of hospital stay). CONCLUSIONS During Sars-CoV-2 lockdowns (2020-2021), there was a dramatic decrease of bronchiolitis and others respiratory infections. In the following season, 2021-2022, an overall increase of cases with an anticipated peak was observed and data analysis confirmed that patients in 2021-2022 required more intensive care than children in the four previous seasons.
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Affiliation(s)
| | - Irene Lepri
- Residency in Pediatrics, University of Milano Bicocca, Monza, Italy.
| | - Antonio Clavenna
- grid.4527.40000000106678902Laboratory for Mother and Child Health, Department of Public Health, Istituto Di Ricerche Farmacologiche Mario Negri IRCCS, Milan, Italy
| | - Maurizio Bonati
- grid.4527.40000000106678902Laboratory for Mother and Child Health, Department of Public Health, Istituto Di Ricerche Farmacologiche Mario Negri IRCCS, Milan, Italy
| | - Chiara Vimercati
- grid.415025.70000 0004 1756 8604Department of Pediatrics, Fondazione IRCCS San Gerardo Dei Tintori, Monza, Italy
| | - Debora Sala
- grid.415025.70000 0004 1756 8604Department of Pediatrics, Fondazione IRCCS San Gerardo Dei Tintori, Monza, Italy
| | - Alessandro Cattoni
- grid.415025.70000 0004 1756 8604Department of Pediatrics, Fondazione IRCCS San Gerardo Dei Tintori, Monza, Italy
| | - Maria Luisa Melzi
- grid.415025.70000 0004 1756 8604Department of Pediatrics, Fondazione IRCCS San Gerardo Dei Tintori, Monza, Italy
| | - Andrea Biondi
- grid.415025.70000 0004 1756 8604Department of Pediatrics, Fondazione IRCCS San Gerardo Dei Tintori, Monza, Italy ,grid.7563.70000 0001 2174 1754Department of Medicine and Surgery, University of Milano Bicocca, Monza, Italy
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