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Gan YZ, Yang P, Liu R, Wang YH, Hu YW, Yang Y. Changes in Spectrum of Respiratory Pathogen Infections and Disease Severity Among Children in Hohhot, China: Impact of COVID-19 Prevention Measures. Med Sci Monit 2024; 30:e942845. [PMID: 38451880 DOI: 10.12659/msm.942845] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/09/2024] Open
Abstract
BACKGROUND This retrospective study evaluated the effects of specific COVID-19 preventive measures, including the use of medical masks, nucleic acid testing, and patient isolation, on respiratory infections, disease severity, and seasonal patterns among children in Hohhot, located in northern China. Understanding these alterations is pivotal in developing effective strategies to handle pediatric respiratory infections within the context of continuous public health initiatives. MATERIAL AND METHODS At the First Hospital of Hohhot, throat swabs were collected from 605 children with community-acquired respiratory between January 2022 and March 2023 for pathogen infection spectrum detection using microarray testing. RESULTS Among the patients, 56.03% were male, and their average age was 3.45 years. SARS-CoV-2 infections were highest between October 2022 and January 2023. Influenza A peaked in March 2023, and other pathogens such as respiratory syncytial virus and influenza B virus disappeared after December 2022. The proportion of mixed infections was 41.94% among SARS-CoV-2 patients, while other pathogens had mixed infection rates exceeding 57.14%. Before December 2022, the mean WBC count for Streptococcus pneumoniae and Haemophilus influenzae was 8.83×10⁹/L, CRP was 18.36 mg/L, and PCT was 1.11 ng/ml. After December 2022, these values decreased significantly. Coughing, difficulty breathing, running nose, and lower respiratory tract infection diagnoses decreased in December 2022, except for SARS-CoV-2 infections. CONCLUSIONS SARS-CoV-2 peaked around November 2022, influenza A peaked in March 2023, and other pathogens like respiratory syncytial virus and influenza B virus were greatly reduced after December 2022. Inflammatory markers and respiratory symptoms decreased after December 2022, except for SARS-CoV-2.
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Affiliation(s)
- Yan-Zi Gan
- Child Health Department, The First Hospital of Hohhot, Hohhot, Inner Mongolia, China (mainland)
| | - Peng Yang
- Neurophysiology Department, The Second Affiliated Hospital of Inner Mongolia Medical University, Hohhot, Inner Mongolia, China (mainland)
| | - Rui Liu
- The State Key Laboratory of Reproductive Regulation and Breeding of Grassland Livestock, School of Life Sciences, Inner Mongolia University, Hohhot, Inner Mongolia, China (mainland)
| | - Yan-Hai Wang
- Child Health Department, The First Hospital of Hohhot, Hohhot, Inner Mongolia, China (mainland)
| | - Yu-Wei Hu
- Child Health Department, The First Hospital of Hohhot, Hohhot, Inner Mongolia, China (mainland)
| | - Yang Yang
- The State Key Laboratory of Reproductive Regulation and Breeding of Grassland Livestock, School of Life Sciences, Inner Mongolia University, Hohhot, Inner Mongolia, China (mainland)
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Rhoden J, Hoffmann AT, Stein JF, Rocha BSD, Barros VMD, Silva EVD, Fleck JD, Rigotto C. Viral coinfection in hospitalized patients during the COVID-19 pandemic in Southern Brazil: a retrospective cohort study. Respir Res 2024; 25:71. [PMID: 38317218 PMCID: PMC10840208 DOI: 10.1186/s12931-024-02708-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2023] [Accepted: 01/25/2024] [Indexed: 02/07/2024] Open
Abstract
PURPOSE Since the worldwide spread of SARS-CoV-2, different strategies have been followed to combat the pandemic and limit virus transmission. In the meantime, other respiratory viruses continued to circulate, though at decreased rates. METHODS This study was conducted between June and July 2022, in a hospital in the metropolitan region of Rio Grande do Sul state, in the southernmost state of Brazil. The 337 hospitalized patients included those with respiratory symptoms without delimitation of age. Reverse transcription-quantitative real-time polymerase chain reaction detected 15 different respiratory viruses and confirmed coinfections in the samples. Different statistical tests were applied to evaluate the association between associations of clinical characteristics and coinfection. RESULTS Sampling corresponds to 337 selected and 330 patients analyzed. The principal clinical outcome found was hospital discharge in 309 (94%) cases, while 21 (6%) resulted in death. The principal viral agents related to coinfections were Human rhinovirus, Human enterovirus, and Respiratory syncytial virus. The most frequent viral agent detected was SARS-CoV-2, with 60 (18%) infections, followed by 51 (15%) cases of Respiratory syncytial virus B (15%) and 44 (13%) cases of Human rhinovirus 1. Coinfection was mainly observed in children, while adults and the elderly were more affected by a single infection. Analyzing COVID-19 vaccination, 175 (53%) were unvaccinated while the remainder had at least one dose of the vaccine. CONCLUSIONS This study presents information to update the understanding of viral circulation in the region. Furthermore, the findings clarify the behavior of viral infections and possible coinfections in hospitalized patients, considering different ages and clinical profiles. In addition, this knowledge can help to monitor the population's clinical manifestations and prevent future outbreaks of respiratory viruses.
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Affiliation(s)
- Jaqueline Rhoden
- Laboratório de Microbiologia Molecular, Universidade Feevale, Rodovia ERS-239, N◦ 2755, Prédio Vermelho, Piso 1, Sala 103, Vila Nova, Novo Hamburgo, Rio Grande Do Sul, CEP 93525-075, Brazil.
- Santa Casa de Misericórdia de Porto Alegre, Hospital Dom Vicente Scherer, Centro Histórico, Av. Independência, Nº 155, Porto Alegre, Rio Grande Do Sul, CEP 90035- 074, Brazil.
| | - Andressa Taíz Hoffmann
- Santa Casa de Misericórdia de Porto Alegre, Hospital Dom Vicente Scherer, Centro Histórico, Av. Independência, Nº 155, Porto Alegre, Rio Grande Do Sul, CEP 90035- 074, Brazil
| | - Janaína Franciele Stein
- Laboratório de Microbiologia Molecular, Universidade Feevale, Rodovia ERS-239, N◦ 2755, Prédio Vermelho, Piso 1, Sala 103, Vila Nova, Novo Hamburgo, Rio Grande Do Sul, CEP 93525-075, Brazil
| | - Bruna Seixas da Rocha
- Laboratório de Microbiologia Molecular, Universidade Feevale, Rodovia ERS-239, N◦ 2755, Prédio Vermelho, Piso 1, Sala 103, Vila Nova, Novo Hamburgo, Rio Grande Do Sul, CEP 93525-075, Brazil
| | - Vinícius Monteagudo de Barros
- Laboratório de Microbiologia Molecular, Universidade Feevale, Rodovia ERS-239, N◦ 2755, Prédio Vermelho, Piso 1, Sala 103, Vila Nova, Novo Hamburgo, Rio Grande Do Sul, CEP 93525-075, Brazil
| | - Eduardo Viegas da Silva
- Centro Estadual de Vigilância em Saúde do Rio Grande Do Sul, Av. Ipiranga, 5400, Jardim Botânico, Porto Alegre, Rio Grande Do Sul, CEP 90450-190, Brazil
| | - Juliane Deise Fleck
- Laboratório de Microbiologia Molecular, Universidade Feevale, Rodovia ERS-239, N◦ 2755, Prédio Vermelho, Piso 1, Sala 103, Vila Nova, Novo Hamburgo, Rio Grande Do Sul, CEP 93525-075, Brazil
| | - Caroline Rigotto
- Laboratório de Microbiologia Molecular, Universidade Feevale, Rodovia ERS-239, N◦ 2755, Prédio Vermelho, Piso 1, Sala 103, Vila Nova, Novo Hamburgo, Rio Grande Do Sul, CEP 93525-075, Brazil
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Treggiari D, Pomari C, Zavarise G, Piubelli C, Formenti F, Perandin F. Characteristics of Respiratory Syncytial Virus Infections in Children in the Post-COVID Seasons: A Northern Italy Hospital Experience. Viruses 2024; 16:126. [PMID: 38257826 PMCID: PMC10820224 DOI: 10.3390/v16010126] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2023] [Revised: 01/11/2024] [Accepted: 01/14/2024] [Indexed: 01/24/2024] Open
Abstract
BACKGROUND Public health measures for COVID-19 mitigation influenced the circulation of Respiratory Syncytial Virus (RSV) during the 2020-2021 winter season. In the following autumn, an unprecedented resurgence of RSV occurred. Our study monitored RSV pediatric infections one and two years after the relaxation of containment measures for the COVID-19 pandemic. METHODS We analyzed diagnostic molecular data for SARS-CoV-2, flu, and RSV infections and clinical data from children with respiratory symptoms referring to our hospital during the 2021-2022 and 2022-2023 seasons. RESULTS In the 2021-2022 season, the number of RSV-affected children was very high, especially for babies <1 year. The outbreak appeared in a shorter interval of time, with a high clinical severity. In the 2022-23 season, a reduced number of infected pediatric patients were detected, with a similar hospitalization rate (46% vs. 40%), and RSV accounted for 12% of the infections. Coinfections were observed in age <2 years. In RSV patients, symptoms were similar across the two seasons. CONCLUSIONS The clinical presentation of RSV in the two post-COVID seasons suggests that the pathophysiology of the virus did not change across these two years. Further studies are needed to continuously monitor RSV to support an effective prevention strategy.
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Affiliation(s)
- Davide Treggiari
- Department of Tropical, Infectious Diseases and Microbiology, IRCCS Sacro Cuore-Don Calabria Hospital, 37024 Negrar di Valpolicella, Verona, Italy; (F.F.); (F.P.)
| | - Chiara Pomari
- Andrus Center, University of Southern California, Los Angeles, CA 90089, USA;
| | - Giorgio Zavarise
- Department of Pediatrics, IRCCS Sacro Cuore-Don Calabria Hospital, 37024 Negrar di Valpolicella, Verona, Italy;
| | - Chiara Piubelli
- Department of Tropical, Infectious Diseases and Microbiology, IRCCS Sacro Cuore-Don Calabria Hospital, 37024 Negrar di Valpolicella, Verona, Italy; (F.F.); (F.P.)
| | - Fabio Formenti
- Department of Tropical, Infectious Diseases and Microbiology, IRCCS Sacro Cuore-Don Calabria Hospital, 37024 Negrar di Valpolicella, Verona, Italy; (F.F.); (F.P.)
| | - Francesca Perandin
- Department of Tropical, Infectious Diseases and Microbiology, IRCCS Sacro Cuore-Don Calabria Hospital, 37024 Negrar di Valpolicella, Verona, Italy; (F.F.); (F.P.)
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Sun Y, Zhou J, Nie W, Tian D, Ye Q. Study on the epidemiological characteristics of enterovirus among pediatric patients in Hangzhou, China: A comparison between the pre-COVID-19, COVID-19 pandemic, and post-COVID-19 periods. J Med Virol 2024; 96:e29412. [PMID: 38258311 DOI: 10.1002/jmv.29412] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2023] [Revised: 12/19/2023] [Accepted: 01/09/2024] [Indexed: 01/24/2024]
Abstract
Nonpharmaceutical interventions (NPIs) for coronavirus disease 2019 (COVID-19) not only reduce the prevalence of this disease among children but also influence the transmission of other viruses. This retrospective study investigated the impact of NPIs on human enterovirus (HEV) infection in children diagnosed with hand, foot, and mouth disease (HFMD) or herpangina (HA) in Hangzhou, China. We collected and analyzed the laboratory results and clinical data of children diagnosed with HFMD or HA during the following periods: pre-COVID-19 (January 2019 to December 2019), the COVID-19 pandemic (January 2020 to December 2022), and post-COVID-19 (January to December 2023). A total of 41 742 specimens that met the inclusion criteria were obtained, of which 1998 (4.79%) tested positive for enterovirus. In comparison to those in the pre-COVID-19 period, which had 695 (5.63%) HEV-positive specimens, the numbers dramatically decreased to 69 (1.19%), 398 (5.12%), and 112 (1.58%) in 2020, 2021, and 2022, respectively, but significantly increased to 724 (8.27%) in 2023. Seasonal peaks of infections occurred in May, June, July, and August each year, with the total detection rate ranging from 2019 to 2023 being 9.41% in May, 22.47% in June, 28.23% in July, and 12.16% in August, respectively. The difference in the detection rates of HEV infection between males and females was statistically significant (p < 0.005), with 5.11% (1221/23 898) of males and 4.35% (777/17 844) of females testing positive, resulting in a male-to-female positive ratio of 1.57:1. Among the age groups, 11.25% (378/3360) of the children aged 3-5 years had the highest detection rate, which steadily decreased with increasing or decreasing age. The detection of HEV indicated that >95% of the viruses were other types than the previously commonly reported enterovirus 71 (EV-A71) and coxsackievirus A16 (CV-A16). In conclusion, NPIs for COVID-19 may be effective at reducing the transmission of HEV. However, with the relaxation of NPIs, the detection rate of HEVs increased slowly to a certain extent. Active awareness and surveillance of the epidemiological characteristics of HEV are essential for preventing, controlling, and managing the development of HFMD and HA, as well as contributing to the development of a multivalent HFMD vaccine.
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Affiliation(s)
- Yanhong Sun
- Department of Clinical Laboratory, National Clinical Research Center for Child Health, National Children's Regional Medical Center, The Children's Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Jianming Zhou
- Department of Clinical Laboratory, National Clinical Research Center for Child Health, National Children's Regional Medical Center, The Children's Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Wenjian Nie
- Department of Clinical Laboratory, National Clinical Research Center for Child Health, National Children's Regional Medical Center, The Children's Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Dandan Tian
- Department of Clinical Laboratory, National Clinical Research Center for Child Health, National Children's Regional Medical Center, The Children's Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Qing Ye
- Department of Clinical Laboratory, National Clinical Research Center for Child Health, National Children's Regional Medical Center, The Children's Hospital, Zhejiang University School of Medicine, Hangzhou, China
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Walker GJ, Foster CSP, Sevendal A, Domazetovska A, Kamalakkannan A, Williams PCM, Kim KW, Condylios A, Stelzer-Braid S, Bartlett AW, Rawlinson W. Clinical, Genomic, and Immunological Characterization of RSV Surge in Sydney, Australia, 2022. Pediatrics 2024; 153:e2023063667. [PMID: 38225912 DOI: 10.1542/peds.2023-063667] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 11/14/2023] [Indexed: 01/17/2024] Open
Abstract
OBJECTIVES The 2022 seasonal respiratory syncytial virus (RSV) epidemic in Sydney, Australia saw an unprecedented number of RSV detections. We aimed to characterize genomic and immunologic factors associated with the surge in RSV cases. METHODS Whole genome sequences of RSV were generated from 264 RSV-infected infants and linked to case-matched clinical data from the 2022 southern hemisphere RSV season. We then performed an immunologic analysis of baseline RSV-specific humoral immunity in women of childbearing age before and throughout the coronavirus disease 2019 pandemic. RESULTS Clinical analysis revealed a high burden of disease across patients of all health backgrounds. More than one-half of RSV-related health care visits by infants resulted in hospitalization, and one-quarter required high-flow respiratory support or a higher level of care. Viral phylogenetic analyses revealed that 2022 Sydney RSV sequences were closely related to viruses that had been circulating globally since 2017, including those detected in recent US outbreaks. Nonsynonymous mutations within the palivizumab and nirsevimab binding sites were detected at low frequencies. There was no difference in baseline RSV-neutralizing antibody titers between 2020 and 2022. CONCLUSIONS Collectively, these findings suggest that neither the emergence of a novel RSV genotype nor hypothesized immune debt was associated with the surge of RSV cases and hospitalizations in 2022. Continued genomic and immunologic surveillance is required to further understand the factors driving outbreaks of RSV globally, and to inform guidelines for the rollout and ongoing use of recently developed immunotherapeutics and vaccines.
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Affiliation(s)
- Gregory J Walker
- Virology Research Laboratory, Serology and Virology Division (SAViD), NSW Health Pathology, Prince of Wales Hospital, Sydney, New South Wales, Australia
- School of Biomedical Sciences, Faculty of Medicine and Health
| | - Charles S P Foster
- Virology Research Laboratory, Serology and Virology Division (SAViD), NSW Health Pathology, Prince of Wales Hospital, Sydney, New South Wales, Australia
- School of Biomedical Sciences, Faculty of Medicine and Health
| | - Andrea Sevendal
- Virology Research Laboratory, Serology and Virology Division (SAViD), NSW Health Pathology, Prince of Wales Hospital, Sydney, New South Wales, Australia
| | - Ana Domazetovska
- Virology Research Laboratory, Serology and Virology Division (SAViD), NSW Health Pathology, Prince of Wales Hospital, Sydney, New South Wales, Australia
| | - Abbish Kamalakkannan
- School of Public Health, Faculty of Medicine, University of Sydney, Sydney, New South Wales, Australia
| | - Phoebe C M Williams
- National Centre for Immunisation Research and Surveillance, Westmead, New South Wales, Australia
- Discipline of Paediatrics and Child Health, School of Clinical Medicine, Faculty of Medicine and Health
- Kirby Institute, University of New South Wales, Sydney, New South Wales, Australia
| | - Ki Wook Kim
- Virology Research Laboratory, Serology and Virology Division (SAViD), NSW Health Pathology, Prince of Wales Hospital, Sydney, New South Wales, Australia
- Australian Institute of Health Innovation, Macquarie University, Sydney, New South Wales, Australia
| | - Anna Condylios
- Virology Research Laboratory, Serology and Virology Division (SAViD), NSW Health Pathology, Prince of Wales Hospital, Sydney, New South Wales, Australia
| | - Sacha Stelzer-Braid
- Virology Research Laboratory, Serology and Virology Division (SAViD), NSW Health Pathology, Prince of Wales Hospital, Sydney, New South Wales, Australia
| | - Adam W Bartlett
- Australian Institute of Health Innovation, Macquarie University, Sydney, New South Wales, Australia
- Department of Immunology and Infectious Diseases, Sydney Children's Hospital Network, Sydney, New South Wales, Australia
- National Centre for Immunisation Research and Surveillance, Westmead, New South Wales, Australia
| | - William Rawlinson
- Virology Research Laboratory, Serology and Virology Division (SAViD), NSW Health Pathology, Prince of Wales Hospital, Sydney, New South Wales, Australia
- School of Biomedical Sciences, Faculty of Medicine and Health
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Wan L, Li L, Zhang H, Liu C, Li R, Wu X, Chen J. The changing pattern of common respiratory viruses among children from 2018 to 2021 in Wuhan, China. Arch Virol 2023; 168:291. [PMID: 37962775 PMCID: PMC10645662 DOI: 10.1007/s00705-023-05891-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2023] [Accepted: 08/18/2023] [Indexed: 11/15/2023]
Abstract
BACKGROUND Acute respiratory infections in children are a global public health challenge. Owing to the coronavirus disease (COVID-19) pandemic, non-pharmaceutical interventions, including patient isolation, social distancing, hand washing, and mask wearing, have been widely implemented, impacting the transmission of common respiratory viruses. The aim of this study was to clarify the epidemiological features of respiratory viruses in children less than 14 years of age in Wuhan before and after COVID-19. METHODS Respiratory specimens were collected from patients aged < 14 years at two hospitals in Wuhan, China, from January 2018 to December 2021. Seven respiratory viruses were identified using an immunofluorescence assay. Pathogen profiles and seasonality were analysed. RESULTS The number of visits and virus detection rate decreased dramatically after February 2020. The respiratory virus detection rate peaked in January and December and decreased dramatically in February and August. The detection rate was lower in 2021 than in 2018 and 2019. Respiratory syncytial virus (RSV) was identified as the leading pathogen in children aged < 1 year and 1-4 years before and after the COVID-19 pandemic. In children aged 5-14 years, influenza virus was detected at the highest rate before, and RSV after, the COVID-19 pandemic. RSV was the most common virus in coinfections. CONCLUSIONS This study revealed the epidemiological patterns of common respiratory viruses from 2018 to 2021. The spectrum of pathogens involved in paediatric respiratory infections had partly changed. Non-pharmaceutical interventions resulted in fewer opportunities for the spread of common viruses but also in an "immunity debt" that could have negative consequences when the pandemic is under control in Wuhan.
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Affiliation(s)
- Lu Wan
- Department of Pulmonary and Critical Care Medicine, Renmin Hospital of Wuhan University, Wuhan, Hubei, China
| | - Liangyu Li
- Department of Pulmonary and Critical Care Medicine, Renmin Hospital of Wuhan University, Wuhan, Hubei, China
| | - Haiyue Zhang
- Department of Pulmonary and Critical Care Medicine, Renmin Hospital of Wuhan University, Wuhan, Hubei, China
| | - Chan Liu
- Department of Pulmonary and Critical Care Medicine, Renmin Hospital of Wuhan University, Wuhan, Hubei, China
| | - Ruiyun Li
- Department of Pulmonary and Critical Care Medicine, Renmin Hospital of Wuhan University, Wuhan, Hubei, China
| | - Xiaojun Wu
- Department of Pulmonary and Critical Care Medicine, Renmin Hospital of Wuhan University, Wuhan, Hubei, China.
| | - Jianjun Chen
- CAS Key Laboratory of Special Pathogens, Center for Biosafety Mega Science, Wuhan Institute of Virology, Chinese Academy of Sciences, Wuhan, Hubei, China.
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Gil E, Roy S, Best T, Hatcher J, Breuer J. Increasing rhinovirus prevalence in paediatric intensive care patients since the SARS-CoV2 pandemic. J Clin Virol 2023; 166:105555. [PMID: 37536014 DOI: 10.1016/j.jcv.2023.105555] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2023] [Revised: 07/27/2023] [Accepted: 07/28/2023] [Indexed: 08/05/2023]
Abstract
BACKGROUND Rhinovirus (HRV) is a significant seasonal pathogen in children. The emergence of SARS-CoV2, and the social restrictions introduced in, disrupted viral epidemiology. Here we describe the experience of Great Ormond Street Hospital (GOSH), where HRV almost entirely disappeared from the paediatric intensive care units (PICU) during the first national lockdown and then rapidly re-emerged with a fast-increasing incidence, leading to concerns about possible nosocomial transmission in a vulnerable population. OBJECTIVES To describe alterations in HRV infection amongst PICU patients at GOSH since the emergence of SARS-COV2 STUDY DESIGN: 10,950 nasopharyngeal aspirate viral PCR samples from GOSH PICU patients from 2019 to 2023 were included. 3083 returned a positive result for a respiratory virus, with 1530 samples positive for HRV. 66 HRV isolates from August 2020 - Jan 2021, the period of rapidly increasing HRV incidence, were sequenced. Electronic health record data was retrospectively collected for the same period. RESULTS Following a reduction in the incidence of HRV infection during the first national lockdown, multiple genotypes of HRV emerged amongst GOSH PICU patients, with the incidence of HRV infection rapidly surging to levels higher than that seen prior to the emergence of SARS-CoV2 and continuing to circulate at increased incidence year-round. CONCLUSIONS The incidence of HRV infection amongst GOSH PICU patients is markedly higher than prior to the emergence of SARS-CoV2, a pattern not seen in other respiratory viruses. The increased burden of HRV-infection in vulnerable PICU patients has both clinical and infection prevention and control Implications.
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Affiliation(s)
- Eliza Gil
- Department of Clinical Research, London School of Hygiene and Tropical Medicine; Department of Microbiology, Virology & Infection Control, Great Ormond Street Hospital for Children, UK; Infection, Immunity and Inflammation Department, GOS Institute of Child Health, University College London, London, UK.
| | - Sunando Roy
- Infection, Immunity and Inflammation Department, GOS Institute of Child Health, University College London, London, UK
| | - Tim Best
- Department of Microbiology, Virology & Infection Control, Great Ormond Street Hospital for Children, UK
| | - James Hatcher
- Department of Microbiology, Virology & Infection Control, Great Ormond Street Hospital for Children, UK
| | - Judith Breuer
- Department of Microbiology, Virology & Infection Control, Great Ormond Street Hospital for Children, UK; Infection, Immunity and Inflammation Department, GOS Institute of Child Health, University College London, London, UK
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Rankin DA, Spieker AJ, Perez A, Stahl AL, Rahman HK, Stewart LS, Schuster JE, Lively JY, Haddadin Z, Probst V, Michaels MG, Williams JV, Boom JA, Sahni LC, Staat MA, Schlaudecker EP, McNeal MM, Harrison CJ, Weinberg GA, Szilagyi PG, Englund JA, Klein EJ, Gerber SI, McMorrow M, Rha B, Chappell JD, Selvarangan R, Midgley CM, Halasa NB. Circulation of Rhinoviruses and/or Enteroviruses in Pediatric Patients With Acute Respiratory Illness Before and During the COVID-19 Pandemic in the US. JAMA Netw Open 2023; 6:e2254909. [PMID: 36749589 PMCID: PMC10408278 DOI: 10.1001/jamanetworkopen.2022.54909] [Citation(s) in RCA: 19] [Impact Index Per Article: 19.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/30/2022] [Accepted: 12/19/2022] [Indexed: 02/08/2023] Open
Abstract
IMPORTANCE Rhinoviruses and/or enteroviruses, which continued to circulate during the COVID-19 pandemic, are commonly detected in pediatric patients with acute respiratory illness (ARI). Yet detailed characterization of rhinovirus and/or enterovirus detection over time is limited, especially by age group and health care setting. OBJECTIVE To quantify and characterize rhinovirus and/or enterovirus detection before and during the COVID-19 pandemic among children and adolescents seeking medical care for ARI at emergency departments (EDs) or hospitals. DESIGN, SETTING, AND PARTICIPANTS This cross-sectional study used data from the New Vaccine Surveillance Network (NVSN), a multicenter, active, prospective surveillance platform, for pediatric patients who sought medical care for fever and/or respiratory symptoms at 7 EDs or hospitals within NVSN across the US between December 2016 and February 2021. Persons younger than 18 years were enrolled in NVSN, and respiratory specimens were collected and tested for multiple viruses. MAIN OUTCOMES AND MEASURES Proportion of patients in whom rhinovirus and/or enterovirus, or another virus, was detected by calendar month and by prepandemic (December 1, 2016, to March 11, 2020) or pandemic (March 12, 2020, to February 28, 2021) periods. Month-specific adjusted odds ratios (aORs) for rhinovirus and/or enterovirus-positive test results (among all tested) by setting (ED or inpatient) and age group (<2, 2-4, or 5-17 years) were calculated, comparing each month during the pandemic to equivalent months of previous years. RESULTS Of the 38 198 children and adolescents who were enrolled and tested, 11 303 (29.6%; mean [SD] age, 2.8 [3.7] years; 6733 boys [59.6%]) had rhinovirus and/or enterovirus-positive test results. In prepandemic and pandemic periods, rhinoviruses and/or enteroviruses were detected in 29.4% (9795 of 33 317) and 30.9% (1508 of 4881) of all patients who were enrolled and tested and in 42.2% (9795 of 23 236) and 73.0% (1508 of 2066) of those with test positivity for any virus, respectively. Rhinoviruses and/or enteroviruses were the most frequently detected viruses in both periods and all age groups in the ED and inpatient setting. From April to September 2020 (pandemic period), rhinoviruses and/or enteroviruses were detectable at similar or lower odds than in prepandemic years, with aORs ranging from 0.08 (95% CI, 0.04-0.19) to 0.76 (95% CI, 0.55-1.05) in the ED and 0.04 (95% CI, 0.01-0.11) to 0.71 (95% CI, 0.47-1.07) in the inpatient setting. However, unlike some other viruses, rhinoviruses and/or enteroviruses soon returned to prepandemic levels and from October 2020 to February 2021 were detected at similar or higher odds than in prepandemic months in both settings, with aORs ranging from 1.47 (95% CI, 1.12-1.93) to 3.01 (95% CI, 2.30-3.94) in the ED and 1.36 (95% CI, 1.03-1.79) to 2.44 (95% CI, 1.78-3.34) in the inpatient setting, and in all age groups. Compared with prepandemic years, during the pandemic, rhinoviruses and/or enteroviruses were detected in patients who were slightly older, although most (74.5% [1124 of 1508]) were younger than 5 years. CONCLUSIONS AND RELEVANCE Results of this study show that rhinoviruses and/or enteroviruses persisted and were the most common respiratory virus group detected across all pediatric age groups and in both ED and inpatient settings. Rhinoviruses and/or enteroviruses remain a leading factor in ARI health care burden, and active ARI surveillance in children and adolescents remains critical for defining the health care burden of respiratory viruses.
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Affiliation(s)
- Danielle A. Rankin
- Department of Pediatrics, Vanderbilt University Medical Center, Nashville, Tennessee
- Vanderbilt Epidemiology PhD Program, Vanderbilt University School of Medicine, Nashville, Tennessee
| | - Andrew J. Spieker
- Department of Biostatistics, Vanderbilt University Medical Center, Nashville, Tennessee
| | - Ariana Perez
- Division of Viral Diseases, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia
- General Dynamics Information Technology Inc, Falls Church, Virginia
| | - Anna L. Stahl
- Department of Pediatrics, Vanderbilt University Medical Center, Nashville, Tennessee
| | - Herdi K. Rahman
- Department of Pediatrics, Vanderbilt University Medical Center, Nashville, Tennessee
| | - Laura S. Stewart
- Department of Pediatrics, Vanderbilt University Medical Center, Nashville, Tennessee
| | - Jennifer E. Schuster
- Division of Pediatric Infectious Diseases, Children’s Mercy Kansas City, Kansas City, Missouri
| | - Joana Y. Lively
- Division of Viral Diseases, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Zaid Haddadin
- Department of Pediatrics, Vanderbilt University Medical Center, Nashville, Tennessee
| | - Varvara Probst
- Department of Pediatrics, Vanderbilt University Medical Center, Nashville, Tennessee
| | - Marian G. Michaels
- Department of Pediatrics, University of Pittsburgh School of Medicine, University of Pittsburgh Medical Center Children’s Hospital of Pittsburgh, Pittsburgh, Pennsylvania
| | - John V. Williams
- Department of Pediatrics, University of Pittsburgh School of Medicine, University of Pittsburgh Medical Center Children’s Hospital of Pittsburgh, Pittsburgh, Pennsylvania
| | - Julie A. Boom
- Department of Pediatrics, Baylor College of Medicine, Houston, Texas
- Texas Children’s Hospital, Houston
| | - Leila C. Sahni
- Department of Pediatrics, Baylor College of Medicine, Houston, Texas
- Texas Children’s Hospital, Houston
| | - Mary A. Staat
- Division of Infectious Diseases, Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati Children’s Hospital Medical Center, Cincinnati, Ohio
| | - Elizabeth P. Schlaudecker
- Division of Infectious Diseases, Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati Children’s Hospital Medical Center, Cincinnati, Ohio
| | - Monica M. McNeal
- Division of Infectious Diseases, Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati Children’s Hospital Medical Center, Cincinnati, Ohio
| | - Christopher J. Harrison
- Division of Pediatric Infectious Diseases, Children’s Mercy Kansas City, Kansas City, Missouri
| | - Geoffrey A. Weinberg
- Department of Pediatrics, University of Rochester School of Medicine and Dentistry, Rochester, New York
| | - Peter G. Szilagyi
- Department of Pediatrics, University of Rochester School of Medicine and Dentistry, Rochester, New York
- Department of Pediatrics, UCLA (University of California, Los Angeles) Mattel Children’s Hospital, UCLA, Los Angeles
| | - Janet A. Englund
- Seattle Children’s Hospital, Department of Pediatrics, University of Washington School of Medicine, Seattle
| | - Eileen J. Klein
- Seattle Children’s Hospital, Department of Pediatrics, University of Washington School of Medicine, Seattle
| | - Susan I. Gerber
- Division of Viral Diseases, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Meredith McMorrow
- Division of Viral Diseases, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Brian Rha
- Division of Viral Diseases, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - James D. Chappell
- Department of Pediatrics, Vanderbilt University Medical Center, Nashville, Tennessee
| | - Rangaraj Selvarangan
- Division of Pediatric Infectious Diseases, Children’s Mercy Kansas City, Kansas City, Missouri
- Department of Pathology and Laboratory Medicine, Children’s Mercy Kansas City, Kansas City, Missouri
| | - Claire M. Midgley
- Division of Viral Diseases, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Natasha B. Halasa
- Department of Pediatrics, Vanderbilt University Medical Center, Nashville, Tennessee
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9
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Shatizadeh Malekshahi S, Farahmand M, Choobin H. SARS-CoV-2 Related Viral Respiratory Co-Infections: A Narrative Review. Tanaffos 2023; 22:19-26. [PMID: 37920316 PMCID: PMC10618585] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Subscribe] [Scholar Register] [Received: 01/01/2022] [Accepted: 09/05/2022] [Indexed: 11/04/2023]
Abstract
Background Severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) is the new coronavirus originating from Wuhan, China, responsible for the illness known as coronavirus disease 2019 (COVID-19). Early experience and the recent literature have shown that co-infection of SARS-CoV-2 with another respiratory virus might occur. Similar symptoms of acute respiratory infections (ARIs) and COVID-19 represent a challenge for diagnostic and therapeutic efficacy and may modify COVID-19 outcomes. Materials and Methods We reviewed the literature on the epidemic pattern and major learning points on important aspects of SARS-CoV-2-related viral respiratory co-infections during the COVID-19 pandemic. Databases such as PubMed, Scopus, Science Direct, and Google Scholar were used to conduct a comprehensive search. Results The circulation of respiratory viruses changed as the COVID-19 epidemic continues. Phenomena like viral interference, resource competition, and differences in virus-host range might explain why simultaneous viral respiratory infections have seemed to vanish with the spread of SARS-CoV-2. Conclusion Key research to be conducted during this pandemic should include the simultaneous screening of other respiratory pathogens with many available commercial platforms for transmission containment and appropriate clinical management.
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Affiliation(s)
| | - Mohammad Farahmand
- Research Center for Emergency and Disaster Resilience, Red Crescent Society of the Islamic Republic of Iran, Tehran, Iran
| | - Hamzeh Choobin
- Department of Virology, Faculty of Medical Sciences, Tarbiat Modares University, Tehran, Iran
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10
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Sattari A, Kazory CI, Kazory KJ, Sattari M. Knowledge of Teenagers and Young Adults about COVID-19 and Compliance with Social Distancing Guidelines. South Med J 2022; 115:760-764. [PMID: 36191912 PMCID: PMC9512141 DOI: 10.14423/smj.0000000000001449] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/03/2022]
Abstract
OBJECTIVES Understanding the coronavirus disease 2019 (COVID-19) knowledge and personal preventive behaviors of younger individuals is important as it can affect not only their own health but also the health of other potentially more vulnerable individuals. The aims of this study were to explore the knowledge of teenagers and young adults about COVID-19 and assess their personal preventive behavior. METHODS We developed a 14-item questionnaire to conduct a cross-sectional online survey. Survey responses with missing variables were excluded. SPSS was used to perform the analyses, including descriptive statistics. RESULTS Thirty-five participants, 15 to 27 years of age, completed the survey between May 2020 and March 2021. Thirty-one (88.57%) reported feeling sufficiently informed to avoid the risk of COVID-19 transmission. The most frequent sources of COVID-19 information were social media (68.6%) and parents (68.6%), whereas the least were teachers (11.4%). Thirty-three (94.29%) participants reported practicing social distancing, citing the main reasons to keep oneself, family members, and others safe. Thirty-three (94.29%) identified taking classes online instead of going to school as an example of social distancing, 26 (74.29%) calling friends on the telephone, and 24 (68.57%) going on a walk alone. Twelve (34.29%) chose eating infected foods and 8 (22.86%) touching animals, including pets, as transmission means for COVID-19. When asked about COVID-19 prevention, 34 (97.14%) reported that COVID-19 can be prevented by avoiding close contact with people who are sick, 31 (88.57%) by covering coughs and sneezes with a tissue, and 8 (22.86%) by avoiding contact with animals, including pets. CONCLUSIONS We found high awareness of COVID-19, but also identified important knowledge gaps about COVID-19 and preventive measures. Digital platforms and social media campaigns can be important sources for providing evidence-based and age-appropriate information about COVID-19 and recommendations for safe activities to reduce social isolation during the pandemic and its negative mental health effects. This study also suggests that teachers may be an underused source of accurate information about COVID-19. These findings can be used to develop effective educational interventions to help combat the COVID-19 pandemic and its impact on young individuals.
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Affiliation(s)
- Anahita Sattari
- From the Mercer University School of Medicine, Macon, Georgia, Buchholz High School, Gainesville, Florida, and Division of General Internal Medicine, University of Florida College of Medicine, Gainesville
| | - Camelia I. Kazory
- From the Mercer University School of Medicine, Macon, Georgia, Buchholz High School, Gainesville, Florida, and Division of General Internal Medicine, University of Florida College of Medicine, Gainesville
| | - Kimia J. Kazory
- From the Mercer University School of Medicine, Macon, Georgia, Buchholz High School, Gainesville, Florida, and Division of General Internal Medicine, University of Florida College of Medicine, Gainesville
| | - Maryam Sattari
- From the Mercer University School of Medicine, Macon, Georgia, Buchholz High School, Gainesville, Florida, and Division of General Internal Medicine, University of Florida College of Medicine, Gainesville
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11
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Haddadin Z, Spieker AJ, Rahman H, Rankin DA, Talj R, Yanis A, Amarin JZ, Schmitz J, Chappell J, Halasa NB. Respiratory pathogens during the COVID-19 pandemic: Alterations in detection and seasonality in Nashville, Tennessee. PLoS One 2022; 17:e0270469. [PMID: 35921608 PMCID: PMC9348857 DOI: 10.1371/journal.pone.0270469] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2021] [Accepted: 06/12/2022] [Indexed: 11/30/2022] Open
Abstract
Shortly after the implementation of community mitigation measures in response to severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2), sharp declines in respiratory syncytial virus and influenza circulation were noted; post-mitigation circulation of other respiratory pathogens has gone unexplored. We retrospectively analyzed all records of a provider-ordered multiplex test between April 1, 2018, and July 31, 2021, in Nashville, Tennessee, and we noted disrupted historical seasonal patterns for common respiratory pathogens during the SARS-CoV-2 pandemic.
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Affiliation(s)
- Zaid Haddadin
- Department of Pediatrics, Vanderbilt University Medical Center, Nashville, TN, United States of America
| | - Andrew J. Spieker
- Department of Biostatistics, Vanderbilt University Medical Center, Nashville, TN, United States of America
| | - Herdi Rahman
- Department of Pediatrics, Vanderbilt University Medical Center, Nashville, TN, United States of America
| | - Danielle A. Rankin
- Department of Pediatrics, Vanderbilt University Medical Center, Nashville, TN, United States of America
- Vanderbilt Epidemiology PhD Program, Vanderbilt University School of Medicine, Nashville, TN, United States of America
| | - Rana Talj
- Department of Pediatrics, Vanderbilt University Medical Center, Nashville, TN, United States of America
| | - Ahmad Yanis
- Department of Pediatrics, Vanderbilt University Medical Center, Nashville, TN, United States of America
| | - Justin Z. Amarin
- Department of Pediatrics, Vanderbilt University Medical Center, Nashville, TN, United States of America
| | - Jonathan Schmitz
- Departments of Pathology, Microbiology and Immunology, Vanderbilt University Medical Center, Nashville, TN, United States of America
| | - James Chappell
- Department of Pediatrics, Vanderbilt University Medical Center, Nashville, TN, United States of America
| | - Natasha B. Halasa
- Department of Pediatrics, Vanderbilt University Medical Center, Nashville, TN, United States of America
- * E-mail:
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12
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Farfour E, Yung T, Baudoin R, Vasse M. Evaluation of Four Fully Integrated Molecular Assays for the Detection of Respiratory Viruses during the Co-Circulation of SARS-CoV-2, Influenza and RSV. J Clin Med 2022; 11:jcm11143942. [PMID: 35887705 PMCID: PMC9317686 DOI: 10.3390/jcm11143942] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2022] [Revised: 06/27/2022] [Accepted: 07/05/2022] [Indexed: 11/30/2022] Open
Abstract
Background: The clinical presentation of viral respiratory infections is unspecific. We assessed the performances of two new RT-PCR, the Idylla™ SARS-CoV-2 and the Idylla™ SARS-CoV2/Flu/RSV, and two isothermal amplification assays, the ID NOW COVID and the ID NOW influenza A & B 2. Methods: The study was conducted in two parts: (i) the Idylla™ assays were assessed using a collection of nasopharyngeal swabs which were positive for various respiratory viruses. (ii) The performances of the four assays were assessed prospectively: all of the symptomatic patients admitted to the emergency department from 10 to 21 December were enrolled. Results: (i) All of the SARS-CoV-2 false negatives with the Idylla™ assays had a Ct value greater than 30 with the reference RT-PCR. No cross-reactivity was identified. (ii) Overall, 218 patients were enrolled. The respective prevalences of SARS-CoV-2, influenza A, and RSV were 19.8%, 4.8%, and 3.2%. All of the assays were 100% specific. The sensitivity of SARS-CoV-2 detection was 97.7%, 82.5%, and 86.3% for the Idylla™ SARS-CoV2, the Idylla™ SARS-CoV2/Flu/RSV, and the ID NOW COVID-19, respectively. For influenza A, it was 90.0% for the Idylla™ SARS-CoV2/Flu/RSV and 80.0% for the ID NOW Influenza. Discussion. All of the assays are suitable for testing patients with respiratory symptoms. False negatives should be considered, and the test should be repeated regarding the context.
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Affiliation(s)
- Eric Farfour
- Service de Biologie Clinique, Hôpital Foch, 92150 Suresnes, France; (T.Y.); (M.V.)
- Correspondence: or ; Tel.: +33-1-46-25-75-51
| | - Thomas Yung
- Service de Biologie Clinique, Hôpital Foch, 92150 Suresnes, France; (T.Y.); (M.V.)
| | - Robin Baudoin
- Service d’Otho-Rhino-Laryngologie, Hôpital Foch, 92150 Suresnes, France;
| | - Marc Vasse
- Service de Biologie Clinique, Hôpital Foch, 92150 Suresnes, France; (T.Y.); (M.V.)
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13
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Scotta MC, Kern LB, Polese-Bonatto M, Azevedo TR, Varela FH, Zavaglia GO, Fernandes IR, de David CN, Fazolo T, da Costa MSC, de Carvalho FC, Sartor ITS, Zavascki AP, Stein RT. Impact of rhinovirus on hospitalization during the COVID-19 pandemic: a prospective cohort study. J Clin Virol 2022; 156:105197. [PMID: 35691819 PMCID: PMC9170614 DOI: 10.1016/j.jcv.2022.105197] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2022] [Revised: 05/31/2022] [Accepted: 06/02/2022] [Indexed: 12/01/2022]
Abstract
Background Although the clinical course of the COVID-19 in adults has been extensively described, the impact of the co-detection of SARS-CoV-2 and rhinovirus on severity outcomes is not understood. Objectives This study aimed to compare the risk of hospitalization of outpatients with COVID-19 with and without the co-detection of rhinovirus in southern Brazil. Secondarily, such risk was also compared between all individuals with COVID-19 and those with single rhinovirus infection. Study design Outpatients (>18 years) with acute signs of cough, fever, or sore throat were prospectively enrolled at two emergency departments from May to September 2020. Sample collection was performed to detect SARS-CoV-2 and other 20 respiratory pathogens. Participants were followed for 28 days through telephone interviews. Results 1,047 participants were screened and 1,044 were included. Of these, 4.9% were lost during follow-up, and 993/1,044 (95.1%) were included in severity-related analysis. Rhinovirus was the most prevalent pathogen (25.0%, 248/993), followed by SARS-CoV-2 (22.6%, 224/993), with coinfection of these two viruses occurring in 91/993 (9.2%) participants. The risk of COVID-19-related hospitalizations were not different between individuals with and without co-detection of rhinovirus (9.9% vs. 7.6%, respectively, P = 0.655). Conversely, subjects with COVID-19 had a higher hospitalization risk than single rhinovirus infection (8.3 vs 0.4%, respectively, P < 0.001). Conclusions The co-detection of SARS-CoV-2 and rhinovirus did not change the risk of hospitalizations in adults. Furthermore, COVID-19 was more severe than single rhinovirus infection.
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Affiliation(s)
- Marcelo Comerlato Scotta
- Social Responsibility, Hospital Moinhos de Vento, Porto Alegre, Brazil; School of Medicine, Pontifícia Universidade Católica do Rio Grande do Sul, Porto Alegre, Brazil.
| | | | | | | | - Fernanda Hammes Varela
- Social Responsibility, Hospital Moinhos de Vento, Porto Alegre, Brazil; School of Medicine, Pontifícia Universidade Católica do Rio Grande do Sul, Porto Alegre, Brazil
| | | | | | | | - Tiago Fazolo
- Universidade Federal de Ciências da Saúde de Porto Alegre - UFCSPA, Porto Alegre, Rio Grande do Sul, Brazil
| | | | - Felipe Cotrim de Carvalho
- General Coordination, Health Surveillance Secretariat, Brazilian Ministry of Health, Brasilia, Brazil
| | | | - Alexandre Prehn Zavascki
- Infectious Diseases Service, Hospital Moinhos de Vento, Porto Alegre, Brazil; Department of Internal Medicine, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
| | - Renato T Stein
- Social Responsibility, Hospital Moinhos de Vento, Porto Alegre, Brazil; School of Medicine, Pontifícia Universidade Católica do Rio Grande do Sul, Porto Alegre, Brazil
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14
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Reyes Domínguez AI, Pavlovic Nesic S, Urquía Martí L, Pérez González MDC, Reyes Suárez D, García-Muñoz Rodrigo F. Effects of public health measures during the SARS-CoV-2 pandemic on the winter respiratory syncytial virus epidemic: An interrupted time series analysis. Paediatr Perinat Epidemiol 2022; 36:329-336. [PMID: 34981845 DOI: 10.1111/ppe.12829] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/18/2021] [Revised: 09/09/2021] [Accepted: 10/04/2021] [Indexed: 12/13/2022]
Abstract
BACKGROUND Public health measures (PHM) designed to contain the spread of COVID-19 pandemic have influenced the epidemiological characteristics of other viral infections. Its impact on acute RSV bronchiolitis in infants of ≤24 months old has not been systematically studied in our setting. OBJECTIVES To describe the monthly pattern of visits to the Paediatric Emergency Department (PED) of patients 0 to 14 years of age, the rate of patients diagnosed with RSV acute bronchiolitis per thousand inhabitants of 0 to 24 months, and the rate of them requiring hospital admission during the winter 2020-2021, in the context of local and national COVID-19 restrictions and compare them to the four previous seasons. METHODS Interrupted time series analysis of patients assisted in the PED and diagnosed with or admitted for RSV acute bronchiolitis in a tertiary University Hospital from January 2016 to February 2020 (pre-intervention period) and from March 2020 to June 2021 (post-intervention period). INTERVENTION Preventive PHM implemented by the Spanish government weighted by the Containment and Health Index of the Oxford COVID-19 Government Response Tracker. RESULTS The intervention was followed by an immediate reduction of the rate of visits to the PED of -19.5 (95% confidence interval [CI] -24.0, -14.9) per thousand, and the rate of diagnoses and admissions for RSV acute bronchiolitis of -44.3 (95% CI -73.8, -14.8) and -1.4 (95% CI -2.7, -0.1) per thousand, respectively, with a delayed rebound. CONCLUSIONS After the implementation of PHM to prevent the spread of SARS-CoV-2 infection, an immediate and important decline in the visits to the PED was observed, with an upward change thereafter. There was also an initial reduction in the diagnoses of and admissions by RSV acute bronchiolitis. An upward trend was observed six to nine months after the usual time of the winter RSV epidemic, coinciding with the relaxation of the preventive PHM.
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Affiliation(s)
- Ana Isabel Reyes Domínguez
- Department of Paediatrics, Hospital Universitario Materno-Infantil de Las Palmas, Las Palmas de Gran Canaria, Spain
| | - Svetlana Pavlovic Nesic
- Department of Paediatrics, Hospital Universitario Materno-Infantil de Las Palmas, Las Palmas de Gran Canaria, Spain
| | - Lourdes Urquía Martí
- Division of Neonatology, Hospital Universitario Materno-Infantil de Las Palmas, Las Palmas de Gran Canaria, Spain
| | | | - Desiderio Reyes Suárez
- Division of Neonatology, Hospital Universitario Materno-Infantil de Las Palmas, Las Palmas de Gran Canaria, Spain
| | - Fermín García-Muñoz Rodrigo
- Division of Neonatology, Hospital Universitario Materno-Infantil de Las Palmas, Las Palmas de Gran Canaria, Spain
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15
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Mulcahy B, Rolnik DL, Matheson A, Liu Y, Palmer KR, Mol BW, Malhotra A. Preterm Infant Outcomes Following COVID-19 Lockdowns in Melbourne, Australia. Children (Basel) 2021; 8:children8121169. [PMID: 34943366 PMCID: PMC8700561 DOI: 10.3390/children8121169] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/13/2021] [Revised: 12/03/2021] [Accepted: 12/08/2021] [Indexed: 06/14/2023]
Abstract
Background Community lockdowns during the coronavirus disease 2019 (COVID-19) pandemic may influence preterm birth rates, but mechanisms are unclear. Methods We compared neonatal outcomes of preterm infants born to mothers exposed to community lockdowns in 2020 (exposed group) to those born in 2019 (control group). Main outcome studied was composite of significant neonatal morbidity or death. Results Median gestational age was 35 + 4 weeks (295 infants, exposed group) vs. 35 + 0 weeks (347 infants, control group) (p = 0.108). The main outcome occurred in 36/295 (12.2%) infants in exposed group vs. 46/347 (13.3%) in control group (p = 0.69). Continuous positive airway pressure (CPAP) use, jaundice requiring phototherapy, hypoglycaemia requiring treatment, early neonatal white cell and neutrophil counts were significantly reduced in the exposed group. Conclusions COVID-19 community lockdowns did not alter composite neonatal outcomes in preterm infants, but reduced rates of some common outcomes as well as early neonatal inflammatory markers.
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Affiliation(s)
- Brendan Mulcahy
- Monash Newborn, Monash Children’s Hospital, Melbourne, VIC 3168, Australia;
| | - Daniel L. Rolnik
- Department of Obstetrics and Gynaecology, Monash University, Melbourne, VIC 3168, Australia; (D.L.R.); (Y.L.); (K.R.P.)
- Department of Obstetrics and Gynaecology, Monash Health, Melbourne, VIC 3168, Australia; (A.M.); (B.W.M.)
| | - Alexia Matheson
- Department of Obstetrics and Gynaecology, Monash Health, Melbourne, VIC 3168, Australia; (A.M.); (B.W.M.)
| | - Yizhen Liu
- Department of Obstetrics and Gynaecology, Monash University, Melbourne, VIC 3168, Australia; (D.L.R.); (Y.L.); (K.R.P.)
- Department of Obstetrics and Gynaecology, Monash Health, Melbourne, VIC 3168, Australia; (A.M.); (B.W.M.)
| | - Kirsten R. Palmer
- Department of Obstetrics and Gynaecology, Monash University, Melbourne, VIC 3168, Australia; (D.L.R.); (Y.L.); (K.R.P.)
- Department of Obstetrics and Gynaecology, Monash Health, Melbourne, VIC 3168, Australia; (A.M.); (B.W.M.)
| | - Ben W. Mol
- Department of Obstetrics and Gynaecology, Monash Health, Melbourne, VIC 3168, Australia; (A.M.); (B.W.M.)
- Aberdeen Centre for Women’s Health Research, School of Medicine, University of Aberdeen, Aberdeen AB24 3FX, UK
| | - Atul Malhotra
- Monash Newborn, Monash Children’s Hospital, Melbourne, VIC 3168, Australia;
- Department of Paediatrics, Monash University, Melbourne, VIC 3168, Australia
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16
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Doroshenko A, Lee N, MacDonald C, Zelyas N, Asadi L, Kanji JN. Decline of Influenza and Respiratory Viruses With COVID-19 Public Health Measures: Alberta, Canada. Mayo Clin Proc 2021; 96:3042-3052. [PMID: 34863395 PMCID: PMC8450272 DOI: 10.1016/j.mayocp.2021.09.004] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/19/2021] [Accepted: 09/13/2021] [Indexed: 12/05/2022]
Abstract
OBJECTIVE To determine the incidence of influenza and noninfluenza respiratory viruses (NIRVs) pre-/post-implementation of public health measures aimed to decrease coronavirus disease 2019 (COVID-19) transmission using population-based surveillance data. We hypothesized that such measures could reduce the burden of respiratory viruses (RVs) transmitting via the same routes. PATIENTS AND METHODS An interrupted time-series analysis of RV surveillance data in Alberta, Canada, from May 2017 to July 2020 was conducted. The burden of influenza and NIRVs before and after intervention initiation at week 11 was compared. The analysis was adjusted for seasonality, overdispersion, and autocorrelation. RESULTS During the study period, an average of 708 and 4056 weekly respiratory multiplex molecular panels were conducted pre-/post-intervention, respectively. We found significant reductions in test positivity rates in the postintervention period for influenza (-94.3%; 95% CI, -93.8 to 97.4%; P<.001) and all NIRVs (-76.5%; 95% CI, -77.3 to -75.8%; P<.001) in the crude model, and -86.2% (95% CI, -91.5 to -77.4%: P<.001) and -75% (95% CI, -79.7 to -69.3%; P<.001), respectively, in the adjusted models. Subanalyses for individual viruses showed significant decreases in respiratory syncytial virus, human metapneumovirus, enterovirus/rhinovirus, and parainfluenza. For non-severe acute respiratory coronavirus 2 human coronaviruses, the decline was not statistically significant after adjustment (-22.3%; 95% CI, -49.3 to +19%, P=.246). CONCLUSION The implementation of COVID-19 public health measures likely resulted in reduced transmission of common RVs. Although drastic lockdowns are unlikely to be required given widespread COVID-19 vaccination, targeted implementation of such measures can lower RV disease burden. Studies to evaluate relative contributions of individual interventions are warranted.
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Key Words
- hcov, human coronavirus
- herv, human entero/rhinovirus
- hmpv, human metapneumovirus
- irr, incident rate ratio
- its, interrupted time series
- nirv, noninfluenza respiratory virus
- pcr, polymerase chain reaction
- piv, parainfluenza virus
- rsv, respiratory syncytial virus
- tpr, test positivity rate
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Affiliation(s)
- Alexander Doroshenko
- Division of Preventive Medicine, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Alberta, Canada; School of Public Health, University of Alberta, Edmonton, Alberta, Canada
| | - Nelson Lee
- Division of Infectious Diseases, Department of Medicine, University of Alberta, Edmonton, Alberta, Canada
| | - Clayton MacDonald
- Department of Medical Microbiology and Infection Control, Vancouver Coastal Health, Vancouver, British Columbia, Canada
| | - Nathan Zelyas
- Department of Laboratory Medicine and Pathology, University of Alberta, Edmonton, Alberta, Canada; Public Health Laboratory, Alberta Precision Laboratories, Edmonton, Alberta, Canada
| | - Leyla Asadi
- Department of Medicine, University of Alberta, Edmonton, Alberta, Canada
| | - Jamil N Kanji
- Division of Infectious Diseases, Department of Medicine, University of Alberta, Edmonton, Alberta, Canada; Department of Laboratory Medicine and Pathology, University of Alberta, Edmonton, Alberta, Canada; Public Health Laboratory, Alberta Precision Laboratories, Edmonton, Alberta, Canada.
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Navarro A, Gómez L, Sanseverino I, Niegowska M, Roka E, Pedraccini R, Vargha M, Lettieri T. SARS-CoV-2 detection in wastewater using multiplex quantitative PCR. Sci Total Environ 2021; 797:148890. [PMID: 34298359 PMCID: PMC8278834 DOI: 10.1016/j.scitotenv.2021.148890] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 03/12/2021] [Revised: 07/02/2021] [Accepted: 07/03/2021] [Indexed: 05/03/2023]
Abstract
A multiplex reverse transcription quantitative PCR (RT-qPCR)-based method was designed for the simultaneous detection of different SARS-CoV-2 genes. In this study, we used three target genes encoding for the nucleocapsid 1 and 3 (N1, N3), and the spike (S) proteins, all commonly used in the detection of SARS-CoV-2 in human and environmental samples. The performance of the multiplex assay, compared to the single assay was assessed for the standard calibration curve, required for absolute quantification, and then, for the real environmental samples to detect SARS-CoV-2. For this latter, four environmental samples were collected at a local wastewater treatment plant (WWTP). The results showed that the cycle threshold (Ct) values of the multiplex were comparable to the values obtained by the singleplex PCR. The amplification of the three target genes indicated the presence of SARS-CoV-2 in the four water samples with an increasing trend in February and these results were confirmed in the multiplex approach, showing the robustness of this method and its applicability for the relative abundance analysis among the samples. Overall, both the laboratory and field work results demonstrated that the multiplex PCR assay developed in this study could provide a method for SARS-CoV-2 detection as robust as the single qPCR, but faster and cost-effective, reducing by three times the number of reactions, and consequently the handling time and reagents.
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Affiliation(s)
- Anna Navarro
- European Commission Joint Research Centre, Via E. Fermi 2749, 21027 Ispra, VA, Italy
| | - Livia Gómez
- European Commission Joint Research Centre, Via E. Fermi 2749, 21027 Ispra, VA, Italy
| | - Isabella Sanseverino
- European Commission Joint Research Centre, Via E. Fermi 2749, 21027 Ispra, VA, Italy
| | - Magdalena Niegowska
- European Commission Joint Research Centre, Via E. Fermi 2749, 21027 Ispra, VA, Italy
| | - Eszter Roka
- Department of Public Health Laboratory, National Public Health Centre, Albert Flórián út 2-6, 1097 Budapest, Hungary
| | | | - Marta Vargha
- Department of Public Health Laboratory, National Public Health Centre, Albert Flórián út 2-6, 1097 Budapest, Hungary
| | - Teresa Lettieri
- European Commission Joint Research Centre, Via E. Fermi 2749, 21027 Ispra, VA, Italy.
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18
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Lumley SF, Richens N, Lees E, Cregan J, Kalimeris E, Oakley S, Morgan M, Segal S, Dawson M, Walker AS, Eyre DW, Crook DW, Beer S, Novak A, Stoesser NE, Matthews PC. Changes in paediatric respiratory infections at a UK teaching hospital 2016-2021; impact of the SARS-CoV-2 pandemic. J Infect 2021; 84:40-47. [PMID: 34757137 PMCID: PMC8591975 DOI: 10.1016/j.jinf.2021.10.022] [Citation(s) in RCA: 36] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2021] [Revised: 10/25/2021] [Accepted: 10/26/2021] [Indexed: 01/21/2023]
Abstract
Objective To describe the impact of the SARS-CoV-2 pandemic on the incidence of paediatric viral respiratory tract infection in Oxfordshire, UK. Methods Data on paediatric Emergency Department (ED) attendances (0-15 years inclusive), respiratory virus testing, vital signs and mortality at Oxford University Hospitals were summarised using descriptive statistics. Results Between 1-March-2016 and 30-July-2021, 155,056 ED attendances occurred and 7,195 respiratory virus PCRs were performed. Detection of all pathogens was suppressed during the first national lockdown. Rhinovirus and adenovirus rates increased when schools reopened September-December 2020, then fell, before rising in March-May 2021. The usual winter RSV peak did not occur in 2020/21, with an inter-seasonal rise (32/1,000 attendances in 0-3 yr olds) in July 2021. Influenza remained suppressed throughout. A higher paediatric early warning score (PEWS) was seen for attendees with adenovirus during the pandemic compared to pre-pandemic (p = 0.04, Mann-Witney U test), no other differences in PEWS were seen. Conclusions SARS-CoV-2 caused major changes in the incidence of paediatric respiratory viral infection in Oxfordshire, with implications for clinical service demand, testing strategies, timing of palivizumab RSV prophylaxis, and highlighting the need to understand which public health interventions are most effective for preventing respiratory virus infections.
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Affiliation(s)
- Sheila F Lumley
- NHS Foundation Trust, Oxford University Hospitals, Oxford, UK; Nuffield Department of Medicine, University of Oxford, Medawar Building, South Parks Road, Oxford OX1 3SY, UK.
| | | | - Emily Lees
- Department of Paediatrics, University of Oxford, Oxford UK
| | - Jack Cregan
- Nuffield Department of Medicine, University of Oxford, Medawar Building, South Parks Road, Oxford OX1 3SY, UK
| | | | - Sarah Oakley
- NHS Foundation Trust, Oxford University Hospitals, Oxford, UK
| | - Marcus Morgan
- NHS Foundation Trust, Oxford University Hospitals, Oxford, UK
| | - Shelley Segal
- NHS Foundation Trust, Oxford University Hospitals, Oxford, UK
| | - Moya Dawson
- NHS Foundation Trust, Oxford University Hospitals, Oxford, UK
| | - A Sarah Walker
- Nuffield Department of Medicine, University of Oxford, Medawar Building, South Parks Road, Oxford OX1 3SY, UK; NIHR Oxford Biomedical Research Centre, University of Oxford, Oxford, UK; NIHR Health Protection Research Unit in Healthcare Associated Infections and Antimicrobial Resistance, University of Oxford, Oxford, UK
| | - David W Eyre
- NHS Foundation Trust, Oxford University Hospitals, Oxford, UK; NIHR Oxford Biomedical Research Centre, University of Oxford, Oxford, UK; NIHR Health Protection Research Unit in Healthcare Associated Infections and Antimicrobial Resistance, University of Oxford, Oxford, UK; Nuffield Department of Population Health, University of Oxford, Oxford, UK; Big Data Institute, University of Oxford, Oxford, UK
| | - Derrick W Crook
- NHS Foundation Trust, Oxford University Hospitals, Oxford, UK; Nuffield Department of Medicine, University of Oxford, Medawar Building, South Parks Road, Oxford OX1 3SY, UK; NIHR Oxford Biomedical Research Centre, University of Oxford, Oxford, UK; NIHR Health Protection Research Unit in Healthcare Associated Infections and Antimicrobial Resistance, University of Oxford, Oxford, UK
| | - Sally Beer
- NHS Foundation Trust, Oxford University Hospitals, Oxford, UK
| | - Alex Novak
- NHS Foundation Trust, Oxford University Hospitals, Oxford, UK
| | - Nicole E Stoesser
- NHS Foundation Trust, Oxford University Hospitals, Oxford, UK; Nuffield Department of Medicine, University of Oxford, Medawar Building, South Parks Road, Oxford OX1 3SY, UK; NIHR Oxford Biomedical Research Centre, University of Oxford, Oxford, UK; NIHR Health Protection Research Unit in Healthcare Associated Infections and Antimicrobial Resistance, University of Oxford, Oxford, UK
| | - Philippa C Matthews
- NHS Foundation Trust, Oxford University Hospitals, Oxford, UK; Nuffield Department of Medicine, University of Oxford, Medawar Building, South Parks Road, Oxford OX1 3SY, UK; NIHR Oxford Biomedical Research Centre, University of Oxford, Oxford, UK; NIHR Health Protection Research Unit in Healthcare Associated Infections and Antimicrobial Resistance, University of Oxford, Oxford, UK.
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19
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Metersky ML. Fewer Bronchiectasis Exacerbations During the "Lockdown" for COVID-19: Can We Convert Knowledge into Action? Am J Respir Crit Care Med 2021; 204:759-760. [PMID: 34384044 PMCID: PMC8528535 DOI: 10.1164/rccm.202107-1731ed] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Affiliation(s)
- Mark L Metersky
- University of Connecticut Medical Center, Division of Pulmonary and Critical Care Medicine, Farmington, Connecticut, United States;
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20
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Kuitunen I, Artama M, Haapanen M, Renko M. Rhinovirus spread in children during the COVID-19 pandemic despite social restrictions-A nationwide register study in Finland. J Med Virol 2021; 93:6063-6067. [PMID: 34228369 PMCID: PMC8426983 DOI: 10.1002/jmv.27180] [Citation(s) in RCA: 34] [Impact Index Per Article: 11.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2021] [Accepted: 07/01/2021] [Indexed: 01/20/2023]
Abstract
Social restrictions during the coronavirus disease 2019 pandemic strongly affected the epidemiology of influenza and respiratory syncytial virus (RSV). As rhinovirus seemed to spread despite the restrictions, we aimed to analyze rhinovirus epidemiology in children during the pandemic. This register‐based study used data from the Finnish Infectious Disease Register. Nationwide rhinovirus findings from July 2015 to March 2021 were included and stratified by age (0–4, 5–9, and 10–14). Cumulative 14‐day incidence per 100000 children was calculated. Four thousand five hundred and seventy six positive rhinovirus findings were included, of which 3788 (82.8%) were among children aged 0–4. The highest recorded incidence was 36.2 among children aged 0–4 in October 2017. The highest recorded incidence during the pandemic period was 13.6 in November 2020. The impact of the restrictions was mostly seen among children aged 0–4 years of age in weeks 14–22 in 2020. The incidence has since remained near reference levels in all age groups. Strict restrictions temporarily interrupted the circulation of rhinovirus in spring 2020. Rhinovirus incidence returned to normal levels soon after the harsh restrictions were lifted. These looser social restrictions prevented RSV and influenza seasons but failed to prevent the spread of rhinovirus.
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Affiliation(s)
- Ilari Kuitunen
- Department of Pediatrics, University of Eastern Finland, Institute of Clinical Medicine, Kuopio, Finland.,Department of Pediatrics, Mikkeli Central Hospital, Mikkeli, Finland
| | - Miia Artama
- Faculty of Social Sciences, Department of Epidemiology, Tampere University, Tampere, Finland.,Department of Infectious Diseases and Vaccinations, Finnish Institute of Health and Welfare, Tampere, Finland
| | - Marjut Haapanen
- Department of Pediatrics, University of Eastern Finland, Institute of Clinical Medicine, Kuopio, Finland
| | - Marjo Renko
- Department of Pediatrics, University of Eastern Finland, Institute of Clinical Medicine, Kuopio, Finland.,Department of Pediatrics, Kuopio University Hospital, Kuopio, Finland.,PEDEGO Research Unit, University of Oulu, Oulu, Finland
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21
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Oh DY, Buda S, Biere B, Reiche J, Schlosser F, Duwe S, Wedde M, von Kleist M, Mielke M, Wolff T, Dürrwald R. Trends in respiratory virus circulation following COVID-19-targeted nonpharmaceutical interventions in Germany, January - September 2020: Analysis of national surveillance data. Lancet Reg Health Eur 2021; 6:100112. [PMID: 34124707 PMCID: PMC8183189 DOI: 10.1016/j.lanepe.2021.100112] [Citation(s) in RCA: 74] [Impact Index Per Article: 24.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
BACKGROUND During the initial COVID-19 response, Germany's Federal Government implemented several nonpharmaceutical interventions (NPIs) that were instrumental in suppressing early exponential spread of SARS-CoV-2. NPI effect on the transmission of other respiratory viruses has not been examined at the national level thus far. METHODS Upper respiratory tract specimens from 3580 patients with acute respiratory infection (ARI), collected within the nationwide German ARI Sentinel, underwent RT-PCR diagnostics for multiple respiratory viruses. The observation period (weeks 1-38 of 2020) included the time before, during and after a far-reaching contact ban. Detection rates for different viruses were compared to 2017-2019 sentinel data (15350 samples; week 1-38, 11823 samples). FINDINGS The March 2020 contact ban, which was followed by a mask mandate, was associated with an unprecedented and sustained decline of multiple respiratory viruses. Among these, rhinovirus was the single agent that resurged to levels equalling those of previous years. Rhinovirus rebound was first observed in children, after schools and daycares had reopened. By contrast, other nonenveloped viruses (i.e. gastroenteritis viruses reported at the national level) suppressed after the shutdown did not rebound. INTERPRETATION Contact restrictions with a subsequent mask mandate in spring may substantially reduce respiratory virus circulation. This reduction appears sustained for most viruses, indicating that the activity of influenza and other respiratory viruses during the subsequent winter season might be low,whereas rhinovirus resurgence, potentially driven by transmission in educational institutions in a setting of waning population immunity, might signal predominance of rhinovirus-related ARIs. FUNDING Robert Koch-Institute and German Ministry of Health.
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Affiliation(s)
- Djin-Ye Oh
- Unit 17: Influenza and Other Respiratory Viruses | German National Influenza Center, Department of Infectious Diseases, Robert Koch-Institute, D-13353 Berlin, Germany
- The Rockefeller University, New York, NY, United States
| | - Silke Buda
- Department of Infectious Diseases Epidemiology, Robert-Koch Institute, Germany
| | - Barbara Biere
- Unit 17: Influenza and Other Respiratory Viruses | German National Influenza Center, Department of Infectious Diseases, Robert Koch-Institute, D-13353 Berlin, Germany
| | - Janine Reiche
- Unit 17: Influenza and Other Respiratory Viruses | German National Influenza Center, Department of Infectious Diseases, Robert Koch-Institute, D-13353 Berlin, Germany
| | - Frank Schlosser
- Computational Epidemiology (P4), Robert Koch-Institute, Germany
- Institute for Theoretical Biology, Humboldt University of Berlin, D-10115 Berlin, Germany
| | - Susanne Duwe
- Unit 17: Influenza and Other Respiratory Viruses | German National Influenza Center, Department of Infectious Diseases, Robert Koch-Institute, D-13353 Berlin, Germany
| | - Marianne Wedde
- Unit 17: Influenza and Other Respiratory Viruses | German National Influenza Center, Department of Infectious Diseases, Robert Koch-Institute, D-13353 Berlin, Germany
| | - Max von Kleist
- Systems Medicine of Infectious Disease (P5), Robert Koch-Institute, Germany
| | - Martin Mielke
- Department of Infectious Diseases, Robert Koch-Institute, Germany
| | - Thorsten Wolff
- Unit 17: Influenza and Other Respiratory Viruses | German National Influenza Center, Department of Infectious Diseases, Robert Koch-Institute, D-13353 Berlin, Germany
| | - Ralf Dürrwald
- Unit 17: Influenza and Other Respiratory Viruses | German National Influenza Center, Department of Infectious Diseases, Robert Koch-Institute, D-13353 Berlin, Germany
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22
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Kitanovski S, Horemheb-Rubio G, Adams O, Gärtner B, Lengauer T, Hoffmann D, Kaiser R. Rhinovirus prevalence as indicator for efficacy of measures against SARS-CoV-2. BMC Public Health 2021; 21:1178. [PMID: 34154549 PMCID: PMC8215636 DOI: 10.1186/s12889-021-11178-w] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2021] [Accepted: 05/27/2021] [Indexed: 12/17/2022] Open
Abstract
BACKGROUND Non-pharmaceutical measures to control the spread of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) should be carefully tuned as they can impose a heavy social and economic burden. To quantify and possibly tune the efficacy of these anti-SARS-CoV-2 measures, we have devised indicators based on the abundant historic and current prevalence data from other respiratory viruses. METHODS We obtained incidence data of 17 respiratory viruses from hospitalized patients and outpatients collected by 37 clinics and laboratories between 2010-2020 in Germany. With a probabilistic model for Bayes inference we quantified prevalence changes of the different viruses between months in the pre-pandemic period 2010-2019 and the corresponding months in 2020, the year of the pandemic with noninvasive measures of various degrees of stringency. RESULTS We discovered remarkable reductions δ in rhinovirus (RV) prevalence by about 25% (95% highest density interval (HDI) [-0.35,-0.15]) in the months after the measures against SARS-CoV-2 were introduced in Germany. In the months after the measures began to ease, RV prevalence increased to low pre-pandemic levels, e.g. in August 2020 δ=-0.14 (95% HDI [-0.28,0.12]). CONCLUSIONS RV prevalence is negatively correlated with the stringency of anti-SARS-CoV-2 measures with only a short time delay. This result suggests that RV prevalence could possibly be an indicator for the efficiency for these measures. As RV is ubiquitous at higher prevalence than SARS-CoV-2 or other emerging respiratory viruses, it could reflect the efficacy of noninvasive measures better than such emerging viruses themselves with their unevenly spreading clusters.
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Affiliation(s)
- Simo Kitanovski
- Bioinformatics and Computational Biophysics, Faculty of Biology and Centre for Medical Biotechnology (ZMB), University of Duisburg-Essen, Essen, 45141, Germany
| | - Gibran Horemheb-Rubio
- Institute of Virology, University of Cologne, Faculty of Medicine and University Hospital of Cologne, Cologne, 50935, Germany
- Department of Infectious Diseases, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City, 14080, Mexico
| | - Ortwin Adams
- Institute of Virology, University Hospital Düsseldorf, Heinrich Heine University Düsseldorf, Düsseldorf, 40225, Germany
| | - Barbara Gärtner
- Institute of Medical Microbiology and Hygiene, Saarland University Medical Center, Homburg, 66421, Germany
| | - Thomas Lengauer
- Computational Biology, Max Planck Institute for Informatics, Saarland Informatics Campus, Saarbrücken, 66123, Germany
| | - Daniel Hoffmann
- Bioinformatics and Computational Biophysics, Faculty of Biology and Centre for Medical Biotechnology (ZMB), University of Duisburg-Essen, Essen, 45141, Germany.
| | - Rolf Kaiser
- Institute of Virology, University of Cologne, Faculty of Medicine and University Hospital of Cologne, Cologne, 50935, Germany
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23
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Sinha P, Reifler K, Rossi M, Sagar M. Coronavirus Disease 2019 Mitigation Strategies Were Associated With Decreases in Other Respiratory Virus Infections. Open Forum Infect Dis 2021; 8:ofab105. [PMID: 34514014 PMCID: PMC8083776 DOI: 10.1093/ofid/ofab105] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2021] [Accepted: 03/02/2021] [Indexed: 12/31/2022] Open
Abstract
Detection of diverse respiratory viruses in Boston was approximately 80% lower after practices were instituted to limit coronavirus disease 2019 (COVID-19) spread compared with the same time period during the previous 5 years. Continuing the strategies that lower COVID-19 dissemination may be useful in decreasing the incidence of other viral respiratory infections.
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Affiliation(s)
- Pranay Sinha
- Department of Medicine, Boston Medical Center, Boston
University School of Medicine, Boston,
Massachusetts, USA
| | - Katherine Reifler
- Department of Medicine, Boston Medical Center, Boston
University School of Medicine, Boston,
Massachusetts, USA
| | - Michael Rossi
- Department of Medicine, Boston Medical Center, Boston
University School of Medicine, Boston,
Massachusetts, USA
| | - Manish Sagar
- Department of Medicine, Boston Medical Center, Boston
University School of Medicine, Boston,
Massachusetts, USA
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24
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Park S, Michelow IC, Choe YJ. Shifting patterns of respiratory virus activity following social distancing measures for COVID-19 in South Korea. J Infect Dis 2021; 224:1900-1906. [PMID: 34009376 PMCID: PMC8135809 DOI: 10.1093/infdis/jiab231] [Citation(s) in RCA: 49] [Impact Index Per Article: 16.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2021] [Accepted: 04/26/2021] [Indexed: 12/16/2022] Open
Abstract
BACKGROUND We hypothesized that nationwide social distancing and other preventive measures for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) were associated with reduced detection of other respiratory viruses in South Korea. METHODS We analyzed national surveillance data to compare incidence of respiratory viruses during 2016-2019 vs. 2020. Results of multiplex reverse transcriptase-polymerase chain reaction assays for eight respiratory viruses were included: adenovirus (ADV), parainfluenza virus (PIV), respiratory syncytial virus (RSV), influenza virus (IFV), human coronavirus (HCoV; non-SARS-CoV-2), human rhinovirus (HRV), human bocavirus (HBoV), and human metapneumovirus (HMPV). RESULTS During 2016-2019, rates of detection of respiratory viruses were relatively stable: ADV, 3.7%-9.2%; PIV, 1.4%-17.0%; RSV, 0.3%-15.3%; IFV, 0.4%-35.6%; HCoV, 1.5%-8.4%; HRV, 7.0%-25.1%; HBoV, 0.6%-6.3%; and HMPV, 0.7%-14.5%. Following implementation of social distancing in February 2020, rates of detection of enveloped viruses (HCoV, HMPV, IFV, PIV and RSV) were significantly reduced by up to 100%. However, non-enveloped viruses (ADV, HRV and HBoV) persisted throughout 2020, and HRV rates in hospitalized patients significantly increased. CONCLUSIONS After implementation of social distancing for SARS-CoV-2 in South Korea, rates of detection of enveloped respiratory viruses decreased significantly, whereas non-enveloped viruses persisted, suggesting that enhanced infection prevention strategies are required to mitigate spread of these viruses.
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Affiliation(s)
- Sangshin Park
- Graduate School of Urban Public Health, University of Seoul, Seoul, Republic of Korea
| | - Ian C Michelow
- Department of Pediatrics, Division of Infectious Diseases, Warren Alpert Medical School of Brown University, Providence, Rhode Island, USA.,Center for International Health Research, Rhode Island Hospital, Providence, Rhode Island, USA
| | - Young June Choe
- Department of Pediatrics, Korea University Anam Hospital, Seoul, Republic of Korea
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25
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Lai CC, Chen SY, Yen MY, Lee PI, Ko WC, Hsueh PR. The impact of the coronavirus disease 2019 epidemic on notifiable infectious diseases in Taiwan: A database analysis. Travel Med Infect Dis 2021; 40:101997. [PMID: 33640476 PMCID: PMC7905388 DOI: 10.1016/j.tmaid.2021.101997] [Citation(s) in RCA: 27] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2020] [Revised: 02/17/2021] [Accepted: 02/18/2021] [Indexed: 12/13/2022]
Abstract
Introduction The impact of the COVID-19 pandemic on the incidence of notifiable infectious diseases (NIDs) in Taiwan remains unclear. Materials and methods The number of cases of NID (n = 42) between January and September 2019 and 2020 were obtained from the open database from Taiwan Centers for Disease Control. Results The number of NID cases was 21,895 between January and September 2020, which was lower than the number of cases during the same period in 2019 (n = 24,469), with a decline in incidence from 102.9 to 91.7 per 100,000 people in 2019 and 2020, respectively. Fourteen airborne/droplet, 11 fecal-oral, seven vector-borne, and four direct-contact transmitted NID had an overall reduction of 2700 (−28.1%), 156 (−23.0%), 557 (−54.8%), and 73 (−45.9%) cases, respectively, from 2019 to 2020. Similar trends were observed for the changes in incidence, which were 11.5 (−28.4%), 6.7 (−23.4%), 2.4 (−55.0%), and 0.3 (−46.2%) per 100,000 people for airborne/droplet, fecal-oral, vector-borne, and direct-contact transmitted NID, respectively. In addition, all the 38 imported NID showed a reduction of 632 (−73.5%) cases from 2019 to 2020. In contrast, 4 sexually transmitted diseases (STDs) showed an increase of 903 (+7.2%) cases from 2019 to 2020, which was attributed to the increase in gonorrhea (from 3220 to 5028). The overall incidence of STDs increased from 52.5 to 56.0 per 100,000 people, with a percentage change of +6.7%. Conclusion This study demonstrated a collateral benefit of COVID-19 prevention measures for various infectious diseases, except STDs, in Taiwan, during the COVID-19 epidemic.
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Affiliation(s)
- Chih-Cheng Lai
- Department of Internal Medicine, Kaohsiung Veterans General Hospital, Tainan Branch, Tainan, Taiwan
| | - Shey-Ying Chen
- Department of Emergency Medicine, National Taiwan University Hospital, National Taiwan University College of Medicine, Taipei, Taiwan; Center for Quality Management, National Taiwan University Hospital, College of Medicine, National Taiwan University, Taipei, Taiwan
| | - Muh-Yong Yen
- Division of Infectious Diseases, Taipei City Hospital, School of Medicine, National Yang-Ming University, Taipei, Taiwan
| | - Ping-Ing Lee
- Department of Pediatrics, National Taiwan University Children's Hospital and National Taiwan University College of Medicine, Taipei, Taiwan
| | - Wen-Chien Ko
- Department of Medicine, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Po-Ren Hsueh
- Department of Laboratory Medicine, National Taiwan University Hospital, National Taiwan University College of Medicine, Taipei, Taiwan; Department of Internal Medicine, National Taiwan University Hospital, National Taiwan University College of Medicine, Taipei, Taiwan.
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26
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Kim KW, Deveson IW, Pang CNI, Yeang M, Naing Z, Adikari T, Hammond JM, Stevanovski I, Beukers AG, Verich A, Yin S, McFarlane D, Wilkins MR, Stelzer-Braid S, Bull RA, Craig ME, van Hal SJ, Rawlinson WD. Respiratory viral co-infections among SARS-CoV-2 cases confirmed by virome capture sequencing. Sci Rep 2021; 11:3934. [PMID: 33594223 DOI: 10.1038/s41598-021-83642-x] [Citation(s) in RCA: 38] [Impact Index Per Article: 12.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2020] [Accepted: 02/03/2021] [Indexed: 02/07/2023] Open
Abstract
Accumulating evidence supports the high prevalence of co-infections among Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) patients, and their potential to worsen the clinical outcome of COVID-19. However, there are few data on Southern Hemisphere populations, and most studies to date have investigated a narrow spectrum of viruses using targeted qRT-PCR. Here we assessed respiratory viral co-infections among SARS-CoV-2 patients in Australia, through respiratory virome characterization. Nasopharyngeal swabs of 92 SARS-CoV-2-positive cases were sequenced using pan-viral hybrid-capture and the Twist Respiratory Virus Panel. In total, 8% of cases were co-infected, with rhinovirus (6%) or influenzavirus (2%). Twist capture also achieved near-complete sequencing (> 90% coverage, > tenfold depth) of the SARS-CoV-2 genome in 95% of specimens with Ct < 30. Our results highlight the importance of assessing all pathogens in symptomatic patients, and the dual-functionality of Twist hybrid-capture, for SARS-CoV-2 whole-genome sequencing without amplicon generation and the simultaneous identification of viral co-infections with ease.
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27
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Schlachetzki F, Wilfling S, Hubert ND, Wagner A, Haberl RL, Linker RA, Hubert GJ. Decline and Recurrence of Stroke Consultations during the COVID-19 Pandemic Lockdown Parallels Population Activity Levels. Cerebrovasc Dis 2021; 50:317-325. [PMID: 33540410 PMCID: PMC7900457 DOI: 10.1159/000514154] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2020] [Accepted: 11/22/2020] [Indexed: 11/28/2022] Open
Abstract
Background The COVID-19 pandemic lockdown (CPL) lead to a significant decrease in emergency admissions worldwide. We performed a timely analysis of ischemic stroke (IS) and related consultations using the telestroke TEMPiS “working diagnosis” database prior (PL), within (WL), and after easing (EL) of CPL. Methods Twelve hospitals were selected and data analyzed regarding IS (including intravenous thrombolysis [intravenous recombinant tissue plasminogen; IV rtPA] and endovascular thrombectomy [EVT]) and related events from February 1 to June 15 during 2017–2020. In addition, we aimed to correlate events to various mobile phone mobility data. Results Following the significant reduction of IS, IV rtPA, and EVT cases during WL compared to PL in 2020 longitudinally (p values <0.048), we observed increasing numbers of consultations, IS, recommendations for EVT, and IV rtPA with the network in EL over WL not reaching PL levels yet. Absolute numbers of all consultations paralleled best to mobility data of public transportation over walking and driving mobility. Conclusions While the decrease in emergency admissions including stroke during CPL can only be in part attributed by patients not seeking medical attention, stroke awareness in the pandemic, and direct COVID-19 triggered stroke remains of high importance. The number of consultations in TEMPiS during the lockdown parallels best with mobility of public transportation. As a consequence, exposure to common viruses, well-known triggers for acute cerebrovascular events and other diseases, are reduced and may add to the decline in stroke consultations. Further studies comparing national responses toward the course of the COVID-19 pandemic and stroke incidences are needed.
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Affiliation(s)
- Felix Schlachetzki
- Department of Neurology, TEMPiS Telemedical Stroke Center, Bezirksklinikum Regensburg, University of Regensburg, Regensburg, Germany,
| | - Sibylle Wilfling
- Department of Neurology, TEMPiS Telemedical Stroke Center, Bezirksklinikum Regensburg, University of Regensburg, Regensburg, Germany
| | - Nikolai Dominik Hubert
- Department of Neurology, TEMPiS Telemedical Stroke Center, Academic Teaching Hospital of the University of Munich, München Klinik Harlaching, Munich, Germany
| | - Andrea Wagner
- Department of Neurology, TEMPiS Telemedical Stroke Center, Bezirksklinikum Regensburg, University of Regensburg, Regensburg, Germany
| | - Roman L Haberl
- Department of Neurology, TEMPiS Telemedical Stroke Center, Academic Teaching Hospital of the University of Munich, München Klinik Harlaching, Munich, Germany
| | - Ralf Andreas Linker
- Department of Neurology, TEMPiS Telemedical Stroke Center, Bezirksklinikum Regensburg, University of Regensburg, Regensburg, Germany
| | - Gordian Jan Hubert
- Department of Neurology, TEMPiS Telemedical Stroke Center, Academic Teaching Hospital of the University of Munich, München Klinik Harlaching, Munich, Germany
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De la Puerta R, Montoro J, Aznar C, Lorenzo I, González-Barberá EM, Balaguer-Roselló A, Guerreiro M, Domínguez L, Salavert M, Aguilar C, de la Rubia J, Sanz J, Gómez MD, Piñana JL. Common seasonal respiratory virus infections in allogeneic stem cell transplant recipients during the SARS-COV-2 pandemic. Bone Marrow Transplant 2021; 56:2212-20. [PMID: 33947980 DOI: 10.1038/s41409-021-01319-5] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2021] [Revised: 04/06/2021] [Accepted: 04/15/2021] [Indexed: 02/05/2023]
Abstract
The SARS-COV-2 pandemic has led to strict and generalized transmission prevention measures that may have changed the epidemiological landscape of common seasonal respiratory virus (CSRV). Through a prospective CSRV survey program conducted from 2016 onwards in allogeneic stem cell transplant (allo-HSCT) recipients with respiratory symptoms, we aimed to analyze and compare the epidemiology and characteristics of CSRV over three consecutive periods [from February 1 to September 30 of 2018 (P1), 2019 (P2), and 2020 (P3)]. CSRV screening was performed through multiplex PCR assays during the study period. We identified 188 consecutive allo-HSCT recipients with 406 episodes screened for CSRV during the study period, of which 147 developed 300 CSRV. In P1 and P2 we diagnosed 115 (38.3%) and 145 (48.3%) CSRV episodes, respectively, whereas in P3 only 40 (13.3%) episodes were detected (p < 0.001). During P3, we observed a reduction of 80.2% in Ev/Rh, 93.3% in RSV, 80% in hIV, 96.3% HPIV, 68.4% in hMPV, 77.7% in ADV, 100% in HBoV, and 53.6% in HCoV as compared to P1 and P2. Consequently, we also observed a decline in absolute numbers of lower respiratory tract disease (68.1%), co-infections (91.7%), and hospitalizations (72.6%) during P3. We diagnosed SARS-COV-2 in nine allo-HSCT recipients, representing 23% of all CSRV detections in that period. In conclusion, we provide evidence of a significant drop in CSRV circulation during the SARS-COV-2 pandemic in our allo-HSCT recipients, indicating that prevention measures in the general population are highly effective in reducing CSRV prevalence and its complications in immunocompromised patients.
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